RESUMO
Falls are a cause of health problem and lead to disability or death in the elderly. Prevention of falls, especially in the high risk group, is thus important with the determination of overall risk factors. The Thai Fall Risk Assessment Tool (Thai FRAT) is a test for evaluating the risk of falls by considering both intrinsic and extrinsic risk factors. Meanwhile the Berg Balance Scale (BBS) emphasizes only the intrinsic factors. This study aimed to examine the agreement of the Thai FRAT and the BBS on identifying the risk of falls in 47 community-dwelling elderly (18 men and 29 women, mean age 76.3 ± 4.2 years) of Samliam Community, Khon Kaen Province. The agreement of the Thai FRAT and the BBS was analyzed by Kappa statistic. The result showed that the agreement of the Thai FRAT and the BBS on identifying the elderly at risk for falling was fair (K = 0.33, P = 0.009). This finding may indicate that physical therapists should apply the Thai FRAT and the BBS for assessing risk of falls of the elderly in community to obtain both intrinsic and extrinsic risk factors.
RESUMO
Falls are an important cause of death for adults aged 65 years and above. Most preventive strategy studies of falls have involved exercises to promote strength and balance. However, these exercise programs were designed by therapists without the elderly’s participation in designing the programs. The objective of this research was to study effects of physical therapy program with client-centered approach on functional balance (Berg Balance Scale and Timed Up and Go Test) in the elderly. A 12-week study was conducted in 9 elders with fall risks (2 men and 7 women, mean age 77.4 ± 5.8 years) of Samliam 1 community, Khon Kaen Province. During the first 4 weeks, specific problems relating to functional balance of each subject were assessed and discussed between the subject and the investigator, after which a physical therapy program with client-centered approach to improve functional balance was cooperatively designed and individually tailored to each elder. The subject was then instructed to perform the program for 8 weeks. The subject’s functional balance was assessed at baseline and every 4 weeks until the end of the study, and was analyzed using paired t-test. It was found that the physical therapy program with client-centered approach significantly improved the Berg Balance Scale (P \< 0.05). However, it was observed that changes in the functional balance scores were frequently influenced by pain at any body part of the subjects but the present study program did not pay much attention on the issue of pain. Therefore, it is suggested that to improve older people’ balance, therapists should widen their approaches to cover other factors relating to balance as much as possible.