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An evaluation of a nurse-led rehabilitation programme (the ProBalance Programme) to improve balance and reduce fall risk of community-dwelling older people: a randomised controlled trial [with consumer summary]
Gouveia BR, Jardim HG, Martins MM, Gouveia ER, de Freitas DL, Maia JA, Rose DJ
International Journal of Nursing Studies 2016 Apr;56:1-8
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: This study aims to assess the effect of a nurse-led rehabilitation programme (the ProBalance Programme) on balance and fall risk of community-dwelling older people from Madeira Island, Portugal. DESIGN: Single-blind, randomised controlled trial. SETTING: University laboratory. PARTICIPANTS: Community-dwelling older people, aged 65 to 85, with balance impairments. Participants were randomly allocated to an intervention group (IG; n = 27) or a wait-list control group (CG; n = 25). INTERVENTION: A rehabilitation nursing programme included gait, balance, functional training, strengthening, flexibility, and 3D training. One trained rehabilitation nurse administered the group-based intervention over a period of 12 weeks (90min sessions, 2 days per week). A wait-list control group was instructed to maintain their usual activities during the same time period. OUTCOME: Balance was assessed using the Fullerton Advanced Balance (FAB) scale. The time points for assessment were at zero (pre-test), 12 (post-test), and 24 weeks (follow up). RESULTS: Changes in the mean (SD) FAB scale scores immediately following the 12-week intervention were 5.15 (2.81) for the IG and -1.45 (2.80) for the CG. At follow-up, the mean (SD) change scores were -1.88 (1.84) and 0.75 (2.99) for the IG and CG, respectively. The results of a mixed between-within subjects analysis of variance, controlling for physical activity levels at baseline, revealed a significant interaction between group and time (F[2,42] = 27.89, p < 0.001, Partial Eta Squared = 0.57) and a main effect for time (F[2,43] = 3.76, p = 0.03, Partial Eta Squared = 0.15), with both groups showing changes in the mean FAB scale scores across the three time periods. A significant main effect comparing the two groups (F[1,43] = 21.90, p < 0.001, Partial Eta Squared = 0.34) confirmed a clear positive effect of the intervention when compared to the control. CONCLUSION: This study demonstrated that the rehabilitation nursing programme was effective in improving balance and reducing fall risk in a group of older people with balance impairment, immediately after the intervention. A decline in balance was observed for the IG after a period of no intervention. CLINICAL TRIAL REGISTRATION NUMBER: ACTRN12612000301864.
With permission from Excerpta Medica Inc.

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