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Fall Prevention by Otago Exercise Program based on Health Belief Model in Community-Dwelling Older Persons


Affiliations
1 Mahasarakham University, Maha Sarakham, Thailand
2 Sirindhorn College of Public Health Khon Kaen, Khon Kaen, Thailand
     

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Health belief model (HBM) has been widely used to communicate with older persons in order to change their behaviors. This group of people have a higher risk of fall due to poor postural balance and inappropriate fall-related behaviors. Home-exercise programs like Otago exercise program (OEP) can ameliorate postural balance, but most of the older persons do not well comply with the program. This mixed methods research study was aimed to investigate effects of a 12-week HBM-based OEP (HBM-OEP) on postural balance (Berg balance scale, BBS) and quadriceps torque in 72 healthy community-dwelling older persons (control group, n = 36 and HBM-OEP group, n = 36). Levels of fall-related HBM domains (knowledge, perception, and behaviors) were also recorded at baseline and 12-week post-intervention. Results showed that the BBS increased from 51.3±0.4 to 53.2±0.3 (p < 0.05). The quadriceps torque between baseline and post-intervention were not significantly different (181.7±12.2 vs 188.2±9.9 Nm). In contrast, the quadriceps torque in the HBM-OEP group significantly increased from 176.8±10.6 to 220.0±9.2 Nm (p < 0.05). Both quadriceps torque and BBS were positively correlated with the levels of knowledge, perception, and behavior scores. In conclusion, the 12-week HBM-based OEP was effective to improve postural balance and the levels fallrelated health beliefs.

Keywords

Health Belief Model, Otago Exercise Program, Older Persons, Postural Balance, Fall Prevention.
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  • National Institute on Aging. Global health and aging. Bethesda, Maryland: National Institute on Aging, National Institutes of Health, U.S. Department of Health and Human Services; 2011. 26 pages p.

  • Menz HB, Lord SR, Fitzpatrick RC. A structural equation model relating impaired sensorimotor function, fear of falling and gait patterns in older people. Gait Posture. 2007;25(2):243-9.

  • Cho KH, Bok SK, Kim YJ, Hwang SL. Effect of lower limb strength on falls and balance of the elderly. Ann Rehabil Med. 2012;36(3):386-93.

  • Gamage N, Rathnayake N, Alwis G. Knowledge and Perception of Falls among Community Dwelling Elderly: A Study from Southern Sri Lanka. Curr Gerontol Geriatr Res. 2018;2018:7653469.

  • Davis JC, Marra CA, Liu-Ambrose TY. Fallsrelated self-efficacy is independently associated with quality-adjusted life years in older women. Age Ageing. 2011;40(3):340-6.

  • Katoh M, Isozaki K. Reliability of Isometric Knee Extension Muscle Strength Measurements of Healthy Elderly Subjects Made with a Hand-held Dynamometer and a Belt. J Phys Ther Sci. 2014;26(12):1855-9.

  • Martins AC, Santos C, Silva C, Baltazar D, Moreira J, Tavares N. Does modified Otago Exercise Program improves balance in older people? A systematic review. Prev Med Rep. 2018;11:231-9.

  • Gardner MM, Buchner DM, Robertson MC, Campbell AJ. Practical implementation of an exercise-based falls prevention programme. Age Ageing. 2001;30(1):77-83.

  • Thomas S, Mackintosh S, Halbert J. Does the ‘Otago exercise programme’ reduce mortality and falls in older adults?: a systematic review and metaanalysis. Age Ageing. 2010;39(6):681-7.

  • Janz NK, Becker MH. The Health Belief Model: a decade later. Health Educ Q. 1984;11(1):1-47.

  • Hochbaum GM, Sorenson JR, Lorig K. Theory in health education practice. Health Educ Q. 1992;19(3):295-313.

  • Cummings KM, Jette AM, Rosenstock IM. Construct validation of the health belief model. Health Educ Monogr. 1978;6(4):394-405.

  • Ott LD. The impact of implementing a fall prevention educational session for community-dwelling physical therapy patients. Nurs Open. 2018;5(4):567-74.

  • Shojaei S, Farhadloo R, Aein A, Vahedian M. Effects of the Health Belief Model (HBM)-Based Educational Program on the Nutritional Knowledge and Behaviors of CABG Patients. J Tehran Heart Cent. 2016;11(4):181-6.

  • Shao C, Wang J, Liu J, Tian F, Li H. Effect of a Health Belief Model-based education program on patients’ belief, physical activity, and serum uric acid: a randomized controlled trial. Patient Prefer Adherence. 2018;12:1239-45.

  • Hazavehei SM, Taghdisi MH, Saidi M. Application of the Health Belief Model for osteoporosis prevention among middle school girl students, Garmsar, Iran. Educ Health (Abingdon). 2007;20(1):23.

  • Ellul J, Watkins C, Barer D. Estimating total Barthel scores from just three items: the European Stroke Database ‘minimum dataset’ for assessing functional status at discharge from hospital. Age Ageing. 1998;27(2):115-22.

  • Mat S, Ng CT, Tan PJ, Ramli N, Fadzli F, Rozalli FI, et al. Effect of Modified Otago Exercises on Postural Balance, Fear of Falling, and Fall Risk in Older Fallers With Knee Osteoarthritis and Impaired Gait and Balance: A Secondary Analysis. PM R. 2018;10(3):254-62.

  • Lee J, Yoo HN, Lee BH. Effects of augmented reality-based Otago exercise on balance, gait, and physical factors in elderly women to prevent falls: a randomized controlled trial. Journal of physical therapy science. 2017;29(9):1586-9.

  • Munro S, Lewin S, Swart T, Volmink J. A review of health behaviour theories: how useful are these for developing interventions to promote long-term medication adherence for TB and HIV/AIDS? BMC Public Health. 2007;7:104.

  • Hahm HC, Speliotis AE, Bachman SS. Failure to receive health care among people with mental illness: theory and implications. J Soc Work Disabil Rehabil. 2008;7(2):94-114.

  • Ross DJ, Guggenheim FG. Compliance and the health belief model: a challenge for the liaison psychiatrist. Gen Hosp Psychiatry. 1983;5(1):31-5.

  • Kamran A, Sadeghieh Ahari S, Biria M, Malepour A, Heydari H. Determinants of Patient’s Adherence to Hypertension Medications: Application of Health Belief Model Among Rural Patients. Ann Med Health Sci Res. 2014;4(6):922-7.

  • Becker MH, Radius SM, Rosenstock IM, Drachman RH, Schuberth KC, Teets KC. Compliance with a medical regimen for asthma: a test of the health belief model. Public Health Rep. 1978;93(3):268-77.

  • Moxley Scarborough D, Krebs DE, Harris BA. Quadriceps muscle strength and dynamic stability in elderly persons. Gait Posture. 1999;10(1):10-20.

  • Ahmadiahangar A, Javadian Y, Babaei M, Heidari B, Hosseini S, Aminzadeh M. The role of quadriceps muscle strength in the development of falls in the elderly people, a cross-sectional study. Chiropr Man Therap. 2018;26:31.

  • Shrivastava SR, Shrivastava PS, Ramasamy J. Health-care of Elderly: Determinants, Needs and Services. Int J Prev Med. 2013;4(10):1224-5.

  • Lee SB, Oh JH, Park JH, Choi SP, Wee JH. Differences in youngest-old, middle-old, and oldest-old patients who visit the emergency department. Clin Exp Emerg Med. 2018;5(4):249-55.

  • Zizza CA, Ellison KJ, Wernette CM. Total water intakes of community-living middle-old and oldest-old adults. J Gerontol A Biol Sci Med Sci. 2009;64(4):481-6.

  • Roberts S, Colombier P, Sowman A, Mennan C, Rolfing JH, Guicheux J, et al. Ageing in the musculoskeletal system. Acta Orthop. 2016;87(sup363):15-25.

  • Siparsky PN, Kirkendall DT, Garrett WE, Jr. Muscle changes in aging: understanding sarcopenia. Sports Health. 2014;6(1):36-40.


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  • Fall Prevention by Otago Exercise Program based on Health Belief Model in Community-Dwelling Older Persons

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Authors

Songvut Punlomso
Mahasarakham University, Maha Sarakham, Thailand
Phitthaya Srimuang
Sirindhorn College of Public Health Khon Kaen, Khon Kaen, Thailand
Kukiat Tudpor
Mahasarakham University, Maha Sarakham, Thailand

Abstract


Health belief model (HBM) has been widely used to communicate with older persons in order to change their behaviors. This group of people have a higher risk of fall due to poor postural balance and inappropriate fall-related behaviors. Home-exercise programs like Otago exercise program (OEP) can ameliorate postural balance, but most of the older persons do not well comply with the program. This mixed methods research study was aimed to investigate effects of a 12-week HBM-based OEP (HBM-OEP) on postural balance (Berg balance scale, BBS) and quadriceps torque in 72 healthy community-dwelling older persons (control group, n = 36 and HBM-OEP group, n = 36). Levels of fall-related HBM domains (knowledge, perception, and behaviors) were also recorded at baseline and 12-week post-intervention. Results showed that the BBS increased from 51.3±0.4 to 53.2±0.3 (p < 0.05). The quadriceps torque between baseline and post-intervention were not significantly different (181.7±12.2 vs 188.2±9.9 Nm). In contrast, the quadriceps torque in the HBM-OEP group significantly increased from 176.8±10.6 to 220.0±9.2 Nm (p < 0.05). Both quadriceps torque and BBS were positively correlated with the levels of knowledge, perception, and behavior scores. In conclusion, the 12-week HBM-based OEP was effective to improve postural balance and the levels fallrelated health beliefs.

Keywords


Health Belief Model, Otago Exercise Program, Older Persons, Postural Balance, Fall Prevention.

References