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 t raining proramme according to the specific problems identified from the pro blem-oriented assessment of mobility (POAM) in residents of a nursing home. Method: The clinical records of 74 NH residents (49 female, 25 male) who we re consecutively referred to physical therapy for problems related to poor balance or gait or a recent fall in a 2 year period were reviewed retrospec tively for the study. According to the medical charts, patients had receive d a four week (20 sessions) problem-oriented exercise programme that specif ically 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 in itially and 7.71+/-1.95 finally. A Wilcoxon signed-rank comparison of the i nitial and final POAM indicated that significant improvement occurred in th e 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 fou r-week intervention programme based on the deficits identified by POAM. The POAM is a useful tool to guide the clinician to target specific balance an d gait deficits for individual nursing home elders.