Usefulness of an individualized balance and gait intervention programme based on the problem-oriented assessment of mobility in nursing home residents

Purpose: To examine the usefulness of an individualized balance and gait training proramme according to the specific problems identified from the problem-oriented assessment of mobility (POAM) in residents of a nursing home. Method: The clinical records of 74 NH residents (49 female, 25 male) who were consecutively referred to physical therapy for problems related to poor balance or gait or a recent fall in a 2 year period were reviewed retrospectively for the study. According to the medical charts, patients had received a four week (20 sessions) problem-oriented exercise programme that specifically targeted balance and gait deficits identified from the POAM and the retest had been done after four weeks of training. Results: The mean initial and final balance scores were 8.47 + / - 3.80, and 10.77 + / - 3.37, respectively, and the mean gait scores were 6.73 + / - 2.30 initially and 7.71 + / - 1.95 finally. A Wilcoxon signed-rank comparison of the initial and final POAM indicated that significant improvement occurred in the balance scores (Z = 5.345, p < 0.0001) and the gait scale (Z = 3.589, p < 0.0001) in this group. Item analysis demonstrated the number of patients who improved or did not change on individual items. Conclusions: Both balance and gait were significantly improved after a four-week intervention programme based on the deficits identified by POAM. The POAM is a useful tool to guide the clinician to target specific balance and gait deficits for individual nursing home elders.