Reducing Fall Risk in Older Adults with COPD: Pilot Study to Test the Efficacy of a Home-Based Exercise Program with Virtual Care Support.

Abstract

Purpose: Older adults with chronic obstructive pulmonary disease (COPD) have a higher risk of falls than their peers without COPD. Home-based exercise programs can improve balance and strength and reduce falls in older adults and could be an option for older adults with COPD who access virtual care. We pilot tested a 6-month home-based balance and strength exercise program with virtual care support aimed at improving strength and balance in people with COPD aged 50 years and over.

Patients and methods: Adults aged 50 years and over with COPD who access a virtual care service were invited to participate in an exercise program designed to improve balance and strength and reduce fall risk.

Results: Thirteen people enrolled in the pilot program (mean age 72 ± SD 7 years, 9 females). Six participants (46%) reported having one or more falls in the 12-months prior to the study. A mixed model for repeated measures and Bonferroni correction for post hoc pairwise comparisons showed significant improvement in the Short Physical Performance Battery (SPPB) score between baseline and 6-months, effect size of 2.01; 95% CI [0.45-3.58], and between 3-months and 6-months, effect size of 1.65; 95% CI [0.48 to 2.81]. The alternate step test improved by more than 3 seconds between baseline and 3-months, effect size of -3.30; 95% CI [-5.94 to -0.66] and improved by 4 seconds between baseline and 6-months, effect size of -4.01; 95% CI [-7.42 to -0.61]. There was no significant difference in fear of falling between between baseline, 3 months or 6 months. The program had a high level of acceptability, with all participants intending to continue to do the exercises and 10/12 (83%) participants stating that they would recommend the program to other people with COPD. The program was feasible to implement, with 12/13 participants remaining in the program and attending exercise sessions.

Conclusion: On average, participants completed the exercises twice per week rather than the recommended 3 times per week. Despite this, the home-based exercise program improved strength and balance, as measured by the SPPB. The program was acceptable to participants and feasible to implement and has the potential to reduce the risk of falls in older people with COPD.