Intervention Study on Program Development of the Exercise Adherence for the Elderly of Musculoskeletal Ambulation Disability Symptom Complex

OBJECTIVE

This study evaluate the effectiveness of this intervention program that home exercise adherence for fall prevention. The first is comparison of activities of daily living (ADL) and physical measured value between pre and post intervention in both groups. The second evaluate of feedback effect of change in gait by motion analyzer.

DESIGN

54 subjects recruited from female 65 years of age or older patients with Musculoskeletal Ambulation Disability Symptom Complex (MADS) under treatment at the orthopedic clinic. We provided the home exercise to improve the ability to trunk balance, range of motion in the ankle joint, toe grip force, back muscle strength for them, and instructed them specific guidance on exercise to continue every day for 6 months. We have analyzed 27 subjects who had continued exercise more than 5 days a week. The number of subjects of intervention group is 17, and the control group is 10.In both groups, we conducted the physical measured value and gait analysis between pre and post intervention. Only intervention group, the subjects have interviewed about implementation status once a month by nurse.The questionnaire response of 13 ADL item, 3 physical measured value (5m fast walking, Timed up and go (TUG), balance on one-leg standing with vision),6 gait measurement item by motion analyzer were compared between pre and post intervention. The physical measurements was analyzed that within-group comparison with t-test, and comparison between group with paired t-test (p<0.05).

RESULTS:

1.Comparison of physical measured value

It showed significant differences improvement of the measurement value in 5m fast-walking and TUG in the intervention group between pre and post intervention in the intervention group. The measured value of range of motion in the ankle joint in the intervention group was significant improvement compared to the control group.The high improvement rate of the measured value of each was gait cycle(65%),toe-up(53%),heel-up(41%) in the intervention group, although there were no significant differences in the measured value of gait analysis in both groups.

2.Comparison of ADL

The high improvement rate of the measured value of each was up stairs(35%),down stairs(47%),uphill(41%) in the intervention group, and both were higher than the control group.In the intervention group, the account for 40% or more subjects who were aware of improvement in “down stairs” in the high improvement rate items(gait cycle, toe-up, heel-up).

CONCLUSIONS:

There were no significant differences in amount of gait data change between pre and post intervention. However, in the intervention group, it was high improvement rate in self-awareness of ADL , and measured value of intervention group was high compared with control group. It suggests a possible beneficial effect of feedback of change in gait by motion analyzer. As a consequence, it showed significant differences in 5m fast-walking and TUG in the intervention group between pre and post intervention. We will examine effective feedback by motion analyzer more closely in the future.