Development of a Thai Folk Medicine–Based Fall Prevention Model for Older Adults in Loei Province: A Mixed-Methods Study
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Abstract
Falls are a leading cause of injury among Thai older adults. Balance-focused exercise has high-certainty evidence for fall prevention, yet culturally congruent, low-cost community models remain scarce. Objectives To analyse fall-risk situations, to codify Thai folk healers' knowledge of balance care, and to evaluate the effects of a coconut-shell exercise programme on functional mobility and balance. Methods An exploratory sequential mixed-methods design in three phases. Phase 3 employed a one-group, three-repeated-measures quasi-experimental design. Thirty-five community-dwelling adults aged ≥ 60 years in Na Din Dam Sub-district, Loei Province were purposively recruited; 34 completed the study (retention 97.1%). Participants performed a five-posture coconut-shell exercise programme 30 minutes/session, 3 sessions/week, for 8 weeks. Outcomes (TUGT, BBS) were measured at weeks 0, 4 and 8 and analysed using one-way repeated measures ANOVA with Greenhouse-Geisser correction and Bonferroni post hoc tests.
Mean TUGT decreased from (14.82 ± 2.91) to (11.46 ± 2.35) seconds, F(1.64, 54.12) = 70.34, p < .001, partial n² = .68. Mean BBS increased from (41.26 ± 5.14) to (48.09 ± 4.02), F(1.71, 56.43) = 34.75, p < .001, partial n² = .51. Adherence was (91.2)%, with no serious adverse events.
The programme was associated with clinically meaningful improvement in mobility and balance. Causal inference is limited by the absence of a control group; a randomised controlled trial is warranted.
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