Evaluation of a shortened PSI intervention and establishing the suitability of PNF for inclusion in exercise-based falls prevention intervention

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Type

Student thesis: Doctoral ThesisDoctor of Philosophy

Original languageEnglish
Awarding Institution
Supervisors/Advisors
  • Joanne Hudson
  • Samantha Lee Winter
Award date19 May 2014
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Abstract

Risk of falling increases with age. Increasing falls incidence and associated injuries sustained by the growing older adult population contributes towards an increasing strain placed on local health services. Long-term exercise interventions have elicited significant reductions in falls incidence in community-dwelling older adults, and may be used in a preventative manner to reduce fall incidence in older adult populations. However, the effectiveness of shorter interventions is less well-known. Study One of this thesis identified that an 18-week postural stability instruction (PSI) programme is effective in reducing fall prevalence in frail older adults by 33%, and may improve health-related quality of life, confidence, and clinic-based strength and balance measures. However, gait performance and whole body lean mass remain unchanged. Study Two established that proprioceptive neuromuscular facilitation (PNF) stretching does not cause acute deficits in strength or muscle activation in the plantarflexors and is safe for use by healthy older adults as a flexibility training component of PSI interventions. Study Three found chronic strength and flexibility gains following completion of a 4-week PNF stretching intervention at the ankle in old and young adults, without any acute strength deficits. Chronic strength gains during higher velocity contractions were demonstrated in dorsiflexion in the older group, while flexibility gains demonstrated during knee flexion suggests a training effect on the soleus muscle. These findings indicate that and 18-week PSI programme reduces falls risk and prevalence, and that PNF training at the ankle may be used safely and effectively by healthy older adults to improve strength and flexibility. Refinement of individual PSI components to ensure implementation of the most effective and age-appropriate strength, balance and flexibility training methods is warranted. Specifically there is a need for research to examine changes in falls incidence and risk factors following completion of an 18-week PSI intervention that incorporates PNF stretching.