Aquatic Exercise and Efficacy Enhancement to Decrease Fall Risk in Older Adults With Hip Osteoarthritis

• Change in Balance [ Time Frame: baseline and 11 weeks ] [ Designated as safety issue: No ]
  Berg Balance Scale range 0 - 36 (36 is excellent balance, 0 is poor or no ability for standing balance)
• Change in Chair Stands [ Time Frame: baseline and 11 weeks ] [ Designated as safety issue: No ]
  change in number of repetitions (the number of times moving from full sitting to full standing in 30 seconds)
• Change in Walking [ Time Frame: baseline and 11 weeks ] [ Designated as safety issue: No ]
  change in 6 minute walk (distance in meters covered in 6 minutes)over 11 weeks
• Change in Falls-Efficacy [ Time Frame: baseline and 11 weeks ] [ Designated as safety issue: No ]
  change in Activities Balance Confidence Scale (0 - 100, 100 represents high confidence, 0 represents low confidence)
• Change in Dual Task Function [ Time Frame: baseline and 11 weeks ] [ Designated as safety issue: No ]
  change in Timed Up and Go Cognitive Test (time in sec., lower number means better performance)

• strength
• mobility
• balance
• efficacy
• function
• physical activity
• intent to exercise

The objective of this project is to determine the effect of aquatic exercise and aquatic exercise combined with an education program on decreasing fall risk in older adults with hip osteoarthritis. The hypothesis is that aquatic exercise will improve function, strength and balance and the addition of the education session will enhance confidence in movement.

Older adults with hip osteoarthritis (OA) often experience pain and loss of mobility that significantly impairs their ability to walk, climb stairs, shop or participate in exercise programs. This can result in social isolation, depression and loss of confidence in their ability to manage independently in the community. A decline in physical and psycho-social function leads to increased risk of falling. It is crucial to identify high-risk fallers as well as the best interventions to decrease that risk; hip fractures from falls are devastating, resulting in death or admission to long-term care for the majority who sustain them.

Exercise programs designed to improve balance, strength and mobility can help to improve function and decrease risk of falling. However, individuals with hip OA may have difficulty participating in these programs due to pain. Aquatic exercise offers an activity alternative to improve mobility, strength and decrease fall risk. As well, the addition of a group program designed to enhance confidence in movement may further reduce the risk of falls by improving independence to be more active at home and in the community.

This project will evaluate the effect of aquatic exercise and aquatic exercise combined with a group educational program on decreasing fall risk in older adults with hip OA. Determining optimal fall prevention programs may avert death and loss of quality of life for older adults, clearly an important contribution to preventative health care.

• Behavioral: exercise
  A community aquatic exercise program designed for older adults to improve balance, strength and mobility to decrease the risk of falls.
• Behavioral: 2
  Same as 1 with the addition of a 1/week educational group program to improve confidence in movement, learn about fall risk and fall prevention and the rationale for the exercises to decrease fall risk.
• Behavioral: Control
  no exercise

• Experimental: Aquatic Education
  Exercise combined with education
  Intervention: Behavioral: 2
• Experimental: Aquatic
  Intervention: Behavioral: exercise
• Placebo Comparator: Control
  Intervention: Behavioral: Control

Inclusion Criteria:

• over age 65
• clinical diagnosis of hip osteoarthritis

Exclusion Criteria:

• medical condition tha significantly decreases functional ability such that not safe to exercise in a community program
• already exercising in a moderate exercise program 2/week or more