Effectiveness of Home-Based Physical Therapy in Enhancing Mobility Among Elderly Living Alone in Urban Communities

Abstract

Background: Functional mobility declines with aging, often resulting in reduced independence, falls, and hospitalization. Elderly individuals living alone in urban communities are particularly vulnerable due to lack of caregiver support and limited accessibility to outpatient physiotherapy. Home-based rehabilitation may provide an effective strategy to counter functional decline and promote independence. Objective: To evaluate the effectiveness of structured home-based physiotherapy in improving mobility, balance, and functional independence among elderly individuals residing alone in urban settings. Methods: A randomized controlled trial was conducted over eight months in South Punjab with 120 participants aged ≥65 years. Participants were randomly assigned to an intervention group receiving structured home-based physiotherapy or a control group maintaining usual activities. Primary outcomes included functional mobility assessed by the Timed Up and Go (TUG) test, gait speed by the 10-Meter Walk Test, and lower-limb strength by the Five Times Sit-to-Stand test. Secondary outcomes included balance (Berg Balance Scale) and functional independence (Barthel Index). Data were analyzed using paired and independent t-tests, and repeated measures ANOVA, with p<0.05 considered significant. Results: The intervention group demonstrated significant improvement in all primary outcomes, with TUG reduced from 15.2 ± 2.1 to 11.4 ± 1.9 seconds, gait speed increased from 0.79 ± 0.12 to 1.02 ± 0.14 m/s, and sit-to-stand performance improved from 18.4 ± 3.2 to 13.2 ± 2.8 seconds. Balance scores increased from 42.6 ± 4.8 to 50.1 ± 5.2, and functional independence rose from 78.3 ± 6.7 to 87.9 ± 6.1. Control group changes were minimal and not statistically significant. Conclusion: Structured home-based physiotherapy effectively improved mobility, balance, and independence in elderly individuals living alone in urban communities. The findings support its integration into community-based elderly care strategies to promote aging in place