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MATTER OF BALANCE

Program Synopsis

  • General description of program

    • A Matter of Balance (MOB) acknowledges the risk of falling but emphasizes practical coping strategies to reduce this fear. These include:

      • Promoting a view of falls and fear of falling as controllable

      • Setting realistic goals for increasing activity

      • Changing the environment to reduce fall risk factors

      • Promoting exercise to increase strength and balance.

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The workshop is conducted over eight sessions, meeting weekly or twice weekly for two hours per session. Meetings are led by volunteer lay leaders called coaches. A Master Trainer is responsible for teaching the Matter of Balance curriculum to the coaches, providing them with guidance, a coach observation visit, and support as they lead the Matter of Balance classes. A Guest Healthcare Professional visit to the community class may be arranged by the Master Trainer.

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  • Program goal

    • The program’s goal is to reduce fear of falling, stop the fear of falling cycle, and increase activity levels among community-dwelling older adults.

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  • Reasoning behind the program design and elements

    • Studies indicate that up to half of community dwelling older adults experience fear of falling (Howland, Peterson, Levin, Fried, Pordon, & Bak, 1993), and that many respond to this concern by curtailing activity (Tinetti & Speechley, 1989).

    • A majority of falls occur during routine activities.

    • Falls usually are not caused by just one issue.

    • A large portion of falls are preventable.

    • Being inactive results in loss of muscle strength and balance. It can also compromise social interaction and increase the risk for isolation, depression, and anxiety. Fear of falling can actually contribute to falling.

    • MOB acknowledges the risk of falling but emphasizes practical coping strategies to reduce this concern. Participants learn to view falls and fear of falling as controllable and set realistic goals for increasing activity.

    • Participants also find ways to change the environment to reduce fall risk factors and learn simple exercises to increase strength and balance.

    • The group format provides an opportunity for people with a common problem to learn from each other and to help each other deal with the shared problem of fear of falling.

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  • Target population

    • 60 or older, ambulatory, able to problem-solve

    • Concerned about falls

    • Interested in improving flexibility, balance, and strength

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  • Essential program components and activities

    • Group discussion

    • Problem-solving

    • Skill building

    • Assertiveness training

    • Exercise training

    • Sharing practical solutions

    • Cognitive restructuring—learning to shift from negative to positive thinking patterns or thinking about something in a different way.

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  • Length/Timeframe of program

    • Eight two-hour sessions

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  • Recommended class size

    • 8 - 12 participants (minimum of 8, maximum of 14 )

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  • Desired outcomes

    • View falls and fear of falling as controllable

    • Set realistic goals for increasing activity

    • Change participants’ environment to reduce fall risk factors o Increase strength and balance through exercise

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  • Measures and evaluation activities

    • Initial survey (given during the first class) with questions regarding falls management, exercise levels, and background information.

    • Last class survey; repeat of questions regarding falls management and exercise levels.

    • Last class evaluation with questions concerning comfort in talking about fear of falling, changes made to environment, comfort in increasing activity levels, plans to increase activity levels, and background information.

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Health Outcomes and Evidence Supporting Health Outcomes

 

After completing A Matter of Balance:

  • 97% of participants are more comfortable talking about fear of falling

  • 97% feel comfortable increasing activity

  • 99% plan to continue exercising

  • 98% would recommend MOB

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Preliminary findings of the participant outcome evaluation indicate that there were significant improvements for participants regarding their level of falls management (the degree of confidence participants perceive concerning their ability to manage the risk of falls and of actual falls); falls control (the degree to which participants perceive their ability to prevent falls); level of exercise; and social limitations with regard to concern about falling. These measures indicate that the program has been successful to date in reducing the fear of falling by increasing participants’ confidence that they can manage falls risk better and actual falls if they occur and that they can take action to help reduce the risk of falling. In addition, participants indicated that their concerns about falling are interfering less with their social activity, and they report that they have increased their exercise levels (Healy, McMahon, & Haynes, 2006; Healy, Peng, Haynes, McMahon, Botler, & Gross, 2008).

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