Prevention of falls for adults with intellectual disability (PROFAID): a feasibility study

Abstract

Purpose: A novel physiotherapy intervention for people with intellectual disability (ID) to improve balance was developed and evaluated in a feasibility study which quantitatively assessed potential benefits on measures of balance, gait and activity participation, and qualitatively explored its acceptability, utility and feasibility. Methods: Participants were 27 adults with mild to profound ID (mean age 53 years SD 10.9). We used a mixed methods approach: an uncontrolled before–after study (data analysed with the related samples sign test) and a qualitative interview evaluation (data analysed with the general inductive approach). Balance, gait and participation were assessed at baseline and 6 months after introduction of the physiotherapy intervention with four standardised measures and two questionnaires. Results: Appropriate exercises and a physical activity could be found for all participants, irrespective of the level of ID, although for many this required a high level of assistance from support staff. Only the Balance Scale for ID changed significantly by a median score of 2 (95% CI = 0.00–2.50, p = 0.04). No other outcomes changed significantly. Four themes emerged: “Understanding the intervention”; “Routine and reality”; “Remembering what I have to do” and “What happens beyond the study itself”? Conclusions: The findings provide some evidence for the benefit, acceptability, utility and feasibility of the intervention justifying further evaluation.

Implications for Rehabilitation

• Falling is a frequent and serious problem for many adults with intellectual disability.

• Two to three exercises targeted at increasing lower limb strength and challenging balance, performed each day as part of daily routine may help improve balance in adults with intellectual disability.

• The importance of exercising needs to be stressed to those who support adults with intellectual disability to encourage ongoing adherence.

• Balance
• exercise
• fall prevention
• intellectual disability
• participation
• physical activity
• physiotherapy

Declaration of interest

The authors declare no conflict of interest.

The study was funded by the Health Research Council of New Zealand (grant number: 11/54).

Ethical approval

This study was approved by the New Zealand Upper South A Regional Ethics Committee (URA/I1108104).