EFFECTIVENESS OF THE LEBED METHOD THERAPY ON INTRINSIC PHYSIOLOGICAL RISK FACTORS OF FALLS AMONG ELDERLY INDIVIDUALS IN KAKAMEGA, KENYA

Abstract

The physical fitness of elderly individuals deteriorates as they grow older, and falls and fall-related injuries are common manifestations of this degradation. Existing interventions lack practical applicability, and high dropout rates in physical activity studies question their effectiveness. The Lebed Method, a dance program by Sherry Lebed Davis, which has successfully aided breast cancer survivors, offers promise in reducing risk factors for falls. Its potential to reduce fall risks among older people who struggle with physical activity merits exploration. This aligns with universal healthcare principles, emphasizing the importance of addressing and preventing falls and their consequent injuries in the elderly population. This study evaluated the Lebed Method's effects on intrinsic fall risk factors and cognitive function using a community-based randomized control trial with 30 participants aged 60 years. Participants, chosen based on low social support scores, were divided into intervention and control groups and had to meet specific inclusion criteria. Baseline measures were recorded for physical performance (Physical activity, handgrip strength, and leg press strength, 6-Minute Walk Test [6MWT]), functional stability (mobility and balance), assessed by gait speed, de Morton Mobility Index (DEMMI) score, Timed Up and Go (TUG) times, and Berg Balance Scale (BBS) scores) and fall apprehension, which entails Fall risk (Morse Fall Scale), fall efficacy (Falls Efficacy Scale International (FES-I) score), and cognitive function associated with fall (Mini-Mental State Examination [MMSE] score). An intention-to-treat analysis was applied, meaning participants were analysed based on their assigned group, regardless of the intervention received. Study design and implementation biases such as selection, performance, detection, attrition, and reporting biases were mitigated. The study used the Analysis of Covariance to assess changes between groups, controlling for baseline value variations, while within-group changes were examined using the dependent sample t-test. Statistical significance was set at p < 0.05. The results showed that the intervention group improved significantly in physical performance compared to the control group. Specifically, the intervention participants displayed elevated IPAQ scores (p < .001, ηp2 = 0.50, d=1.97), handgrip strength (p < .001, ηp2 = 0.64, d=2.95), leg press strength (p < .001, ηp2 = 0.51, d=1.76) and functional capacity as measured by the 6MWT performance (p < .001, ηp2 = 0.59, d=1.85). The findings also showed that the intervention group significantly improved physical stability compared to the control group. Specifically on gait speed (p < .001, ηp2 = 0.65, d=1.99), DEMMI score (p < .001, ηp2 = 0.38, d=1.94), TUG times (p < .001, ηp2 = 0.53, d=3.38), and BBS scores (p < .001, ηp2 = 0.64, d=1.97). Improvement in the intervention group was also noted in fall apprehension, as measured by the Morse fall scale (p < .001, ηp2 = 0.62, d=2.20) and fall efficacy (p < .001, ηp2 = 0.53, d=2.33). However, cognitive function, as assessed by the MMSE score, did not exhibit significant changes in either group (intervention m= 28.22, SD= 1.05, p = .092, vs. control m=26.07, SD= 2.12, p = .09). Linear regression analysis indicated that leg press strength, balance, and mobility significantly predict fear of falls, while other variables were not significant predictors. The intervention enhanced physical performance and stability and reduced fear of falls in older people, though it did not improve cognitive function. It is recommended that health promotion initiatives for the elderly by government or individuals include dance-based therapy programs. Future research should concentrate on improving cognitive function for more comprehensive interventions aimed at the well-being of the ageing population.