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Abstract

Purpose: Falls continue to be a major health issue when considering health risks for older individuals. The multi-factorial nature of falls in older adults leads to an overwhelming number of causal factors. Cervical joint position sense and joint position error could be additional factors that could influence the fall risk of older individuals. This research examined the effects of a proprioceptive rehabilitation protocol for the cervical spine using a laser head set in older community dwelling individuals. Methods: Sixty (60) subjects were purposively assigned into an experimental and a control group. Control group subjects were given a general lower extremity strengthening home exercise program (HEP) to adhere to for eight weeks. Experimental group subjects were given the same 8-week lower extremity HEP along with a defined cervical proprioceptive protocol utilizing a laser head light. All subjects were pre-tested and post-tested on several impairment and functional level measures. Results: Data analysis indicated moderate to excellent reliability of the laser head-set tool utilized to measure cervical joint position error. The ICC values for six of the eight positions ranged from 0.700 (p = .016) to 0.953 (p < 0.001). Cervical joint position error decreased more significantly in the experimental group indicating increased cervical joint position sense. Post change cervical joint position error score differences between groups indicated a significant difference in improvement in six of the eight test positions. F values drawn from these positions ranged from 8.825 (p = .004) to 29.991 (p < .001). Significant between group post change improvement was also observed on gait speed measures, F = 19.053 (p < .001) and timed up and go measures, F = 5.809 (p = .019). Additional analysis revealed significant post change score differences between groups for improved Berg balance scale scores U = 208.500 (p = .002) and improved falls efficacy scale scoring U = 264.500 (p = .024). Conclusions: The findings have the potential to enable an additional training modality to effect fall risk in older community dwelling adults who are displaying imbalance issues.

Author Bio(s)

Vern M. Swanson Jr DPT, PT, PhD, NCS is a Physical Therapy Director at Integrative Rehab in Estero, FL. He is also an adjunct professor of physical therapy in the Doctor of Physical Therapy program at South College in Knoxville, TN,

M. Samuel Cheng, PT, MS, ScD is a professor of physical therapy in the Doctor of Physical Therapy program in the College of Health Care Sciences at Nova Southeastern University in Ft. Lauderdale, FL

Leah Nof, PT, MS, PhD is a professor of physical therapy in the Doctor of Physical Therapy program in the College of Health Care Sciences at Nova Southeastern University in Ft. Lauderdale, FL

Eric Shamus, PT, DPT, PhD is a professor of physical therapy in the Doctor of Physical Therapy program in the Marieb College of Health and Human Services at Florida Gulf Coast University in Fort Myers, FL.

Acknowledgements

Words cannot express my gratitude to my chair of my committee, Dr. M. Samuel Cheng, PT, MS, ScD, for his invaluable patience, experience, and feedback. I also would not have been successful in this journey without my defense committee which consisted of Dr. Leah Nof, PT, MS, PhD and Dr. Eric Shamus, PT, DPT, PhD who generously provided knowledge and expertise. Additionally, this endeavor would not have been possible without the support from the southwest Florida regional HOPE healthcare system. In particular, the efforts Carol Wydra, MS and Michael Halmos, SPT must be acknowledged who both went above and beyond in their roles as secondary researchers. I am also grateful for the support from Dr. Gregory Robrahn, PT, DPT, GCS whose expertise was a tremendous help during this process.

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