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Falls Prevention in Older Home Care Recipients

Not Applicable
Completed
Conditions
Accidental Falls
Interventions
Other: Exercise and education
Registration Number
NCT02374307
Lead Sponsor
Oslo Metropolitan University
Brief Summary

The aim of this study is to investigate the effect of a falls-prevention exercise programme on health-related quality of life, fear of falling, falls and physical function in older people receiving home care. Participants in the intervention group perform the Otago exercise programme. Participants in the control group continue their usual activities.

Detailed Description

Falls and falls-related injuries are considered a serious public health issue in the older population. Strength and balance exercise in combination with information about falls prevention seems to be effective in reducing falls, but less is known about the effect of this kind of intervention on quality of life. This randomized controlled trial investigates the effect of a falls prevention program on health-related quality of life, fear of falling, falls and physical function in community-dwelling older people who receive home care.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
155
Inclusion Criteria
  • has fallen at least one time in the last 12 months
  • receives home-help services
  • able to walk independently indoors with or without walking aid
Exclusion Criteria
  • medical contraindication to exercise
  • life expectancy <1 year
  • scores under 23 points on Mini Mental Scale Examination
  • participating in another falls prevention programme during the 12 weeks of the programme, for example a falls prevention group

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Exercise and educationExercise and educationThis group performs a 12-week individual tailored home exercise programme in accordance with the manual of Otago exercise programme. Physiotherapists visit the participants 5 times during the 12 weeks (at week 1,2,4,8 and 10) to prescribe and progress exercises. Motivational conversations on telephone are performed the weeks when no visits are scheduled. Additionally, the participants receive information on the first visit which will focus on motivation, importance of adherence and effectiveness of falls prevention. The participants are expected to do exercises on their own, and in that way perform exercises 3 times weekly. If safe, the participant are provided with a walking plan and be encouraged to walk twice weekly.
Primary Outcome Measures
NameTimeMethod
Short Form 36 Health Survey Summary ScoresBaseline, 3 months, 6 months

Changes in the Short Form 36 Health Survey (SF-36) summary scores from baseline to 3-months follow-up. SF-36 measures health-related quality of life. Its summary score is comprised of a physical component summary (PCS) and a mental component summary (MCS). The scores range from 0-100 (worst-best) in each scale. A positive change in the summary score indicates a better health-related quality of life.

Secondary Outcome Measures
NameTimeMethod
4-meter Walk TestBaseline, 3 months, 6 months

Changes in the 4-meter walk test. Participants are asked to walk a distance of 4 meters at their usual pace, measured in m/s

EQ-5DBaseline, 3 months, 6 months

Changes in the EuroQOL EQ-5D instrument indicating changes in health-related quality of life. Preference weights for United Kingdom were employed to generate utility scores ranging from -0.59 to 1. A score of 1 is associated with a health state without problems. A positive change in EQ-5D indicates a better health-related quality of life.

Berg Balance ScaleBaseline, 3 months, 6 months

Changes in the Berg Balance Scale (BBS), a 14-item scale applied to assess static and dynamic balance in older adults. The summary score ranges from 0 (low, wheelchair bound) to 56 (high, independent)

Sit-to-stand TestBaseline, 3 months, 6 months

Changes in the no. of raises in 30 seconds. From the sitting position, the subject stands completely up, then sits completely back down, repeated for 30 seconds.

Mini Nutritional AssessmentBaseline, 3 months, 6 months

The summary score of the Mini Nutritional Assessment (MNA) maps to three nutritional statuses "Normal nutritional status", "Risk of malnutrition" and being "Malnourished".

No. of Participants Exercising Post-intervention3 months and 6 months

Self-reported exercise behavior post-intervention between 3-months follow-up to 6-months follow-up.

No. of Falls3 months and 6 months

No. of falls in the post-intervention period between 3-months follow-up and 6-months follow-up. Falls are defined as an event, i.e. fall, trip, slip, which results in the person coming to rest on the ground or floor or other lower level.

Falls Efficacy Scale - InternationalBaseline, 3 months, 6 months

Changes in falls-efficacy measured with the Falls Efficacy Scale - International (FES-I) derives from a self-report questionnaire, assessing concerns about falling in 16 different daily activities. The total score ranges from 16 (no concern) to 64 (high concern). A decrease in scores indicates less concerns.

Instrumental Activities of Daily LivingBaseline, 3-months, 6-months

No. of participants with scores on the Instrumental Activities of Daily Living (IADL) scale, Lawton and Brody. IADL is a measure of a person's self-reported ability to perform complex activities of daily living. The summary score ranges from 0 (low function, dependent) to 8 (high function, independent).

Exercise According to the Protocol. AdherenceBaseline and 3 months

No. of participants in the intervention group performing exercises according to the protocol in the intervention period until 3-months follow-up. Participant are encouraged to complete an activity diary where they note if the exercise programme has been executed as planned. If they have not completed sufficient exercises, they are supposed to make a note in the diary.

Walking HabitsBaseline, 3 months, 6 months

Questions regarding walking habits in the last 7 days. Summarized in total minutes walking.

Trial Locations

Locations (6)

Municipality of Frogn

🇳🇴

Drøbak, Akershus, Norway

Municipality of Bærum

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Sandvika, Akershus, Norway

Municipality of Rælingen

🇳🇴

Fjerdingby, Akershus, Norway

Municipality of Lørenskog

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Lørenskog, Akershus, Norway

Municipality of Skedsmo

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Lillestrøm, Akershus, Norway

Municipality of Sørum

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Sørumsand, Akershus, Norway

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