OCCUPATIONAL THERAPY INTERVENTIONS TO IMPROVE OCCUPATIONAL PARTICIPATION AND REDUCE THE RISK OF FALLS IN ELDERLY PEOPLE WITH OSTEOARTHRITIS
Authors: Shevchuk Y.V. 
Published: December 2023

Global trends show an increase in life expectancy. A similar trend in life expectancy growth is typical for Ukraine. However, even a positive trend towards an increase in average life expectancy cannot stop the inevitable process of aging, which leads to a decrease in the functional and physiological capabilities of all body systems.

Osteoarthritis is the most common disease of elderly. Osteoarthritis of the joints of the lower extremities is a risk factor for falls syndrome. Falls lead to a decrease in physical functioning, independence and occupational participation, increase the fear of the next fall, and bring serious injuries, even depth. The role of an occupational therapist in falls prevention is undeniable. It helps maximize the ability to participate in the occupational activity that is meaningful to the client, and modifies the client's lifestyle and living environment for safe occupational performance.

The aim of the research. To scientifically justify and develop a comprehensive program of occupational therapy interventions to reduce the risk of falls for elderly women with osteoarthritis of the lower extremities by means of occupational therapy.

Materials and methods.  In order to fully solve the tasks and study the activity of elderly women with osteoarthritis of the joints of the lower extremities, the following research methods were chosen: analysis of special and scientific and methodical literature; content analysis of medical records, interviews, observations; WOMAC Osteoarthritis Index and assessment of fear of falling according to Falls Efficacy Scale International.

48 women aged 62 to 89 took part in the ascertainment experiment. Women were divided into 2 groups - main (MG) and control (CG), 24 people in each. The main group included women with osteoarthritis of the lower extremities. In the control group people were without damage to the joints. The program lasted for 6 (six) months. The people of CG received recommendations about general physical activity with reference to WHO guideline. The people of MG received therapeutic exercises on strength, balance, coordination, endurance, improvement of walking skills and occupational therapy interventions with: training to perform occupations safely; creation of a new stereotype of behavior to avoid falling; modification of the environment; review of medications which can provoke a fall; learning to use assistive equipment; techniques to get up safely and effectively after a fall.

Research results.  Based on the obtained data, it is evident that both groups experienced an increase of independence level in functioning, less of pain, stiffness and fear of falling.

 Conclusions. Both falling and the fear of falling significantly reduce the ability to lead a full and independent life, bring undesirable consequences, including serious injuries, and interfere with the ability to do what is most important for a person. In the foreign literature, there is a lot of evidence about the contribution of occupational therapy to the prevention of falls. The results of the conducted research give grounds for asserting that the application developed by us a multi-component program of occupational therapy interventions developed for elderly people with osteoarthritis of the joints of the lower extremities is an effective means of reducing the risk of falls in this category of people. The advantages of the developed program are confirmed by the results of own research.