|
Affiliation
|
1Des Moines University, Des Moines, Iowa. 2Mercy Physical Therapy Clinics, Des Moines, Iowa. |
|
Abstract
|
BACKGROUND AND PURPOSE: Older adults with balance deficits often fear falling and limit their mobility. Poor balance is multifactorial, influenced by medication interactions, musculoskeletal and sensory system changes, and poor neuromuscular response to changes in body positions. Aquatic physical therapy (APT) is an intervention used to improve balance and decrease falls. Ai Chi is a water-based exercise program. It incorporates slow movements of progressive difficulty utilizing the upper and lower extremities and trunk coordinated with deep breathing. It is used for relaxation, strengthening, and balance. The purpose of this study was to determine whether Ai Chi provides better results than conventional impairment-based aquatic therapy (IBAT) for older adults with balance deficits.
METHODS: Thirty-two community-dwelling adults, 65 to 85 years old, were referred to 2 different community pools for APT. Fifteen participants received Ai Chi-based aquatic interventions and 17 participants received an IBAT program. Physical therapists trained in both programs completed interventions and determined discharge. Physical balance measures, which included the Berg Balance Scale (BBS) and Timed Up and Go (TUG), were collected pre- and posttherapy. Self-reported outcome measures, the Activities-Specific Balance Confidence Scale (ABC) and Numerical Pain Rating Scale (NPRS), were collected pre- and posttherapy and 3- and 6-month postdischarge.
RESULTS: A 2-way (group by time) mixed-model analysis of covariance was used to analyze the data. The covariate was the initial outcome scores. Comparison of the 2 groups revealed no difference between groups in any of the outcome measures (BBS, P =.53; TUG, P =.39; ABC, P =.63; NPRS, P =.27). Repeated-measures analysis and dependent t test were done on the entire aquatic cohort to assess improvement over time. The BBS and TUG showed significant improvement (BBS, P =.00; TUG P =.03) after APT. The ABC and NPRS did not improve significantly (ABC, P =.27; NPRS, P =.77).
CONCLUSIONS: There were no significant differences found in balance measures, balance confidence, or pain levels for community-dwelling older adults between the Ai Chi and IBAT programs. Physical outcome measures improved with APT but patient-reported measures did not. Further study is indicated to determine the most effective treatment frequency and duration for this population.
Language: en |