Quasi‑experimental pilot study to improve mobility and balance in recurrently falling nursing home residents by voluntary non‑targeted side‑stepping exercise intervention

Abstract

Background: Side-stepping is a potential exercise program to reduce fall risk in community-dwelling adults in their seventies, but it has never been tested in nursing home residents. This was a pilot quasi-experimental study to examine the feasibility and potential mobility and balance benefits of an intervention based on voluntary non-targeted side-stepping exercises in nursing home residents who fall recurrently. Methods: Twenty-two participants were recruited and non-randomly assigned to an intervention group ( n =11, side-stepping exercises, STEP) participating in an 8-week protocol and to a control group ( n =11, usual physiotherapy care, CTRL). They were clinically assessed at 4-time points: baseline, after 4 and 8 weeks, and after a 4-week followup period (usual physiotherapy care). Statistical differences between time points were assessed with a Friedman repeated measures ANOVA on ranks or a one-way repeated measures ANOVA. Results: Compared to baseline, significant benefits were observed in the STEP group at 8 weeks for the Timed Up and Go ( p =0.020) and 6-minute walking test ( p =0.001) as well as for the Berg Balance Scale ( p =0.041) and Mini motor test ( p =0.026). At follow-up, the Tinetti Performance Oriented Mobility Assessment and Berg Balance Scale significantly worsened in the STEP group ( p =0.009 and p <0.001, respectively). No significant differences were found between the groups at the same time points. Conclusions: Our intervention was feasible and improved mobility and balance after almost 8 weeks. Studies with larger samples and randomized control trials are needed to consolidate our preliminary observations and confirm the deterioration of some tests when side-stepping exercises are discontinued.