Backward Chaining Method for Teaching Long-Term Care Residents to Stand Up from the Floor: A Pilot Randomized Controlled Trial

TL;DR

A new method called Backward Chaining helps older adults learn to stand up from the floor, reducing their fear of falling and improving mobility.

Contribution

The Backward Chaining Method is introduced as a novel training approach for long-term care residents to safely regain floor-standing skills.

Findings

Participants using the BCM showed significantly lower fear of falling compared to controls.

BCM participants had higher life-space and independent life-space mobility scores after training.

No significant differences were found in functional mobility or muscle strength between groups.

Abstract

Objectives: Older adults who worry about not being able to stand up from the floor after a fall, reduce their physical activity, which leads to a higher risk of falling. The Backward Chaining Method (BCM) was developed specifically for this population to safely teach and practice the movement sequence required to stand up from the floor. Our aim is to evaluate the effectiveness of using the BCM to teach older adults how to stand up from the floor, and to determine whether this training has an impact on functional mobility, muscle strength, fear of falling, and life-space mobility. Methods: A total of 26 residents of a long-term care facility were randomly allocated to two groups. Residents in the intervention group (IG, n = 13) participated in a seven-week training program to learn how to stand up from the floor with BCM, in addition to the usual care generally offered in long-term care facilities. The participants in the control group (CG, n = 13) received the usual care alone. The primary outcome measure was functional mobility, assessed by the Timed Up and Go test. Secondary outcome measures included functional lower limb strength, grip strength, fear of falling, and life-space mobility. The outcomes were measured at baseline and after the seven-week intervention period. Results: We found no significant between-group differences in functional mobility, lower limb strength and grip strength; however, IG subjects demonstrated significantly lower fear of falling scores, and significantly higher life-space mobility and independent life-space mobility scores compared to CG subjects after the training program. Conclusions: This study demonstrates that the Backward Chaining Method is a feasible, well-tolerated intervention in a long-term care setting and it may have meaningful benefits, particularly in lessening fear of falling and improving life-space mobility and independent life-space mobility when incorporated into the usual physiotherapy interventions.

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