Does the addition of two home visits to usual care improve outcomes for patients with balance impairments?

Mr Craig Whitbourne1, Mr Kenneth Koh1, Mrs Nora Sheilds2, Mr Mark Tacey3

1Northern Health, Watsonia, Australia

2Latrobe University, Bundoora, Australia

3University of Melbourne, Parkville, Australia

 

Title: Does the addition of two home visits to usual care improve outcomes for patients with balance impairments?

Aim: Investigate if the addition to usual care of two home visits to prescribe an individually tailored home exercise program (HEP) would improve outcomes for patients with balance impairments.

Method: Randomised controlled trial recruited 50 participants (32 female; mean age 74 years) with balance impairments. All participants attended a one-hour group exercise program once a week for eight weeks. The control group also received a HEP and the intervention group received two home visits by a physiotherapist to prescribe a HEP. The primary outcomes measured before and after intervention (week 9) and three-months after intervention (week 20) were the Balance Outcome Measure for Elder Rehabilitation (BOOMER) score and force platform balance measures using the NeuroCom Balance Master®.

Results: No difference between groups for BOOMER score at week 9 or week 22. Significant between group differences in favour of the intervention group for limits of stability reaction time at week 9 (MD -0.27, 95% CI -0.44 to -0.09) and week 22 (MD -0.28, 95% CI -0.45 to -0.10) and for the limits of stability maximal excursion scores at week 9 (MD 8.66, 95% CI 1.67 to 15.65) and week 22 (MD 14.58, 95% CI 7.59 to 21.57).  Significant between group differences in favour of the control group for the Clinical Test of Sensory Interaction of Balance at week 9 (MD 0.40, 95% CI 0.13 to 0.66) and week 22 (MD 0.45, 95% CI 0.18 to 0.72).

Significance of findings to allied health: Two home visits in addition to usual care, did not improve outcomes in older patients with balance impairments.