Authors (including presenting author) :
Chan DYC(1), Lau MW(2), Lam SYS(1), Li RSM(2), Tam BHT(1), Cheng HKY(1), Chan FM(2), Leung KKL(1)
Affiliation :
(1)Physiotherapy Department, Kowloon Hospital, (2)Department of Psychiatry, Kowloon Hospital
Keyword 1: :
Body-Mind physiotherapy
Keyword 3: :
Psychogeriatric
Introduction :
Elderly with prolonged hospitalisation are at higher fall risk due to underlying medical comorbidities and possible physical deconditioning. On top of that, specific factors such as changes in mental state and impaired cognitive functions were identified as specific risk factors of fall for psychiatric patients in previous studies. A more tailored-made fall prevention program should be implemented for this group of patients in tackling their specific properties.
Objectives :
To investigate the effect of body-mind physiotherapy fall prevention program on physical and psychological outcomes among the higher-mobile psychogeriatric in-patient.
Methodology :
A quasi-experimental single-group pretest-posttest study was conducted in a female psychogeriatric and long-stay ward for independent or supervised walkers in 07-12/2025. The program was implemented by physiotherapists and nurses collaboratively, including daily video exercise training(with aerobic, strengthening and coordination components), twice-a-week face-to-face Taichi class and patient empowerment talk. Assessment on physical outcomes included Berg Balance Scale(BBS), Dynamic Gait Index(DGI), 30-second-sit-to-stand test(30STS) and Functional Reach test(FRT). Psychological outcomes included Hong Kong Brief Cognitive Test(HKBC), and sleep quality and wakening pattern by Sleep Chart(SC).
Result & Outcome :
28 patients were recruited(mean age 65.89±4.84). No fall incident reported during training until discharged. Significant improvements were found in all physical and psychological domains post training((BBS from 48.39±6.92 to 52.25±3.29(p=0.001);DGI from 19.82±3.06 to 21.71±3.06(p=0.003);30STS from 12.32±3.28 to 13.83±4.29(p=0.030);FRT from 21.82±7.84cm to 25.48±8.21cm(p=0.001);HKBC from 19.89±5.14 to 22.00±4.72(p< 0.001);deep sleep duration in 5-day period from 37.80±3.27hours to 39.68±0.82hours(p= 0.001)). Significant relationship was found among BBS and HKBC(r= 0.307, p= 0.027), indicating balance correlates with cognitive functions. With different body-mind awareness tasks training during the program, cognitive functions were better challenged and as a result, engaging more effective executive functions to integrate sensory and motor systems for balance. Another significant correlation was found with change in DGI and change in deep sleep duration(r= 0.458, p= 0.024). With more exercise done through the training, it stabilizes the circadian rhythm and promotes deep sleep. Promoting deep sleep creates a positive cycle in overall energy and alertness, therefore better concentration for complex balance tasks requiring high cognitive attention.
To conclude, the program demonstrated improvement in physical and psychological functions and showed positive relationship between the two domains. Incorporation of training with psychological aspect into physical training is inspired for further training for this group of patients.
