Introduction
According to the Centers for Disease Control and Prevention, falls are the most common cause of fatal and non-fatal injuries among older adults over the age of 65. Falls can lead to a myriad of traumatic physical & emotional consequences and discourage older adults from engaging in meaningful activities. As fall is multi-factorial, new approach to address individualized need is important for better outcome. The Lifestyle integrated Functional Exercise Program (LiFE), has been proven to prevent falls and decrease the fear of falling in older adults worldwide. LiFE uses an occupation-based approach by incorporating balance and strengthening activities into individual’s lifestyle routine. Training is therefore accessible and elderly are better motivated. Compliance to training regime is improved. To meet worldwide fall prevention standard, Occupational Therapists (OT) have introduced and developed this worldwide fall prevention program for community dwelling elderly in Hong Kong (HK).
Objectives
To reduce fall rate and medical utilization for community dwelling elderly with fall risks through the LiFE program; and to develop a common practice guidelines in fall prevention for community dwelling elderly based on the LiFE program to enhance evidence-based practice for OT in Hong Kong.
Methodology
the development of local LiFE program consists of three parts: 1)Local program content development Collaborated with the Hong Kong Occupational Therapy Association and the University of Sydney for development and clinical application of the HK LiFE program in 2015 Established a task group on the HK LiFE program under the Elderly Specialty Group & Family Medicine Specialty Group, OTCOC, HA in 2015 Translated LiFE Participant’s and Trainer’s manuals (Chinese version) with internal peer reviewed. Manuals were published and trial used in HK in 2017 and 2018 respectively 2)Staff training and engagement Conducted commissioned training and workshops on HK LiFE program for HK OT in 2017 and 2018 respectively 3)Clinical application Implemented the HK LiFE program in HA OT Departments and conducted cross clusters pilot study in 2017
Results & Outcome
HK LiFE program was developed in 2017. A total 155 HK Occupational therapists in 7 clusters (13 acute and 7 rehabilitation/ convalescent hospitals) were trained of the program. HK LiFE Participant’s and Trainer’s manuals (Chinese version) were standardized and adopted in the OT departments in the 7 clusters. A total of 8 patients were recruited from 7 clusters and 8 OT units (include GDH, NAHC-Fall Prevention Clinic, SOPD, COT, ICDS) for the cross clusters pilot study from July to Oct 2017. Their mean age were 79.5 (SD 6.1) and mean program session were 7.7 (SD 2.0). Paired samples t-test revealed that there was significantly reduced in fall rate (1.2 to 0, p=0.00), hospital admission (0.5 to 0, p=0.03) and AED admission (0.87 to 0, p=0.00). Significantly increased balance outcome (Tandem walk time, p=0.00) & fall efficacy (ABC, p=0.01) and increased travelled distance (life space index, p=0.00). Patient feedback of the program was promising. Conclusion: Result of the pilot trial of the HK LiFE program to local community dwelling elderly was found effective. The HK LiFE program is a new approach to fall prevention in OT which addresses individualized needs through embedding fall prevention training with routine functional daily activities. Further review after more extensive application of the program and a cross-cluster research on its effectiveness are highly recommended.
Co-location with:
