title: An evaluation of a nurse-led rehabilitation programme (the ProBalance Programme) to improve balance and reduce fall risk of community-dwelling older people: A randomised controlled trial.
abstract: OBJECTIVE
  This study aims to assess the effect of a nurse-led rehabilitation programme (the ProBalance Programme) on balance and fall risk of community-dwelling older people from Madeira Island, Portugal.
  
  
  METHODS
  Single-blind, randomised controlled trial.
  
  
  METHODS
  University laboratory.
  
  
  METHODS
  Community-dwelling older people, aged 65-85, with balance impairments. Participants were randomly allocated to an intervention group (IG; n=27) or a wait-list control group (CG; n=25).
  
  
  METHODS
  A rehabilitation nursing programme included gait, balance, functional training, strengthening, flexibility, and 3D training. One trained rehabilitation nurse administered the group-based intervention over a period of 12 weeks (90min sessions, 2 days per week). A wait-list control group was instructed to maintain their usual activities during the same time period.
  
  
  RESULTS
  Balance was assessed using the Fullerton Advanced Balance (FAB) scale. The time points for assessment were at zero (pre-test), 12 (post-test), and 24 weeks (follow up).
  
  
  RESULTS
  Changes in the mean (SD) FAB scale scores immediately following the 12-week intervention were 5.15 (2.81) for the IG and -1.45 (2.80) for the CG. At follow-up, the mean (SD) change scores were -1.88 (1.84) and 0.75 (2.99) for the IG and CG, respectively. The results of a mixed between-within subjects analysis of variance, controlling for physical activity levels at baseline, revealed a significant interaction between group and time (F (2, 42)=27.89, p<0.001, Partial Eta Squared=0.57) and a main effect for time (F (2, 43)=3.76, p=0.03, Partial Eta Squared=0.15), with both groups showing changes in the mean FAB scale scores across the three time periods. A significant main effect comparing the two groups (F (1, 43)=21.90, p<0.001, Partial Eta Squared=0.34) confirmed a clear positive effect of the intervention when compared to the control.
  
  
  CONCLUSIONS
  This study demonstrated that the rehabilitation nursing programme was effective in improving balance and reducing fall risk in a group of older people with balance impairment, immediately after the intervention. A decline in balance was observed for the IG after a period of no intervention.
  
  
  BACKGROUND
  ACTRN12612000301864.
authors.affiliation: Saint Joseph of Cluny Higher School of Nursing, Portugal; Institute of Biomedical Sciences Abel Salazar, University of Porto, Portugal. Electronic address: bgouveia@esesjcluny.pt.
authors.forename: Bruna Raquel
authors.initials: BR
authors.lastname: Gouveia
authors.affiliation: Higher School of Health, University of Madeira, Portugal.
authors.forename: Helena
authors.initials: H
authors.lastname: Gonçalves Jardim
authors.affiliation: Higher School of Nursing of Porto, Portugal.
authors.forename: Maria Manuela
authors.initials: MM
authors.lastname: Martins
authors.affiliation: Department of Physical Education and Sports, University of Madeira, Portugal.
authors.forename: Élvio Rúbio
authors.initials: ÉR
authors.lastname: Gouveia
authors.affiliation: Department of Physical Education and Sports, University of Madeira, Portugal.
authors.forename: Duarte Luís
authors.initials: DL
authors.lastname: de Freitas
authors.affiliation: CIFID, Faculty of Sport, University of Porto, Portugal.
authors.forename: José António
authors.initials: JA
authors.lastname: Maia
authors.affiliation: Division of Kinesiology and Health Science, California State University Fullerton, USA.
authors.forename: Debra J
authors.initials: DJ
authors.lastname: Rose
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005684:Gait; D006801:Humans; D008297:Male; D004856:Postural Balance; D015397:Program Evaluation; D012307:Risk Factors
keywords: Aged; Community-dwelling; Postural balance; Rehabilitation nursing