AquaReBal - Aquatic Reactive Balance Training for Older Adults
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 12
- 试验地点
- 1
- 主要终点
- Feasibility
研究概览
简要总结
Falls are the second leading cause of accidental injury deaths worldwide, mostly in older adults. Injuries resulting from a fall are a leading cause of hospitalizations among older adults in Canada with a higher total injury cost than any other cause of injury. People must often perform rapid and complex movements to keep from falling. Reactive balance training (RBT) is a type of training that focuses on improving an individual's ability to perform those types of movements and respond to unexpected or sudden changes. RBT and aquatic therapy were identified as a research priority for fall prevention. There is evidence that RBT reduces the rate of falls by a half in daily life and improvements in reactive balance are maintained up to a year after the end of the program. When RBT is conducted on land, some adverse events such as fear of falling and joint pain may occur. The water environment could minimize the limitations and barriers associated with land-based RBT. To date, there are no studies showing the effects of water-based RBT on reactive balance control in older adults.The study aims to explore if water-based RBT is a practical intervention to reduce the number of falls in older adults. Older adults will be recruited from the Greater Toronto Area. They will receive training 2 times per week for 6 weeks. The main practical factors around the intervention, such as how participants adhere to the treatment and how they accept the intervention will be measured. It will be assessed how the water-based and land-based RBT affects falls, balance, mobility and quality of life. With this study, the aim is to inform the way for a larger study targeting falls - one of the biggest problems among older adults.
详细描述
Background and Importance: Falls are the second leading cause of unintentional injury deaths worldwide, mostly in older adults. In 2018 falls in Canada had a higher total cost than any other cause of injury. Injuries resulting from a fall are a leading cause of hospitalizations among Canadian adults aged > 65 years. Recent clinical practice guidelines for older adults identified reactive balance training (RBT) and aquatic therapy as research priorities for fall prevention. There is evidence that RBT almost halves the rate of falls in daily life and improvements in reactive balance control are maintained even up to a year after the end of the program. When RBT is conducted on land, some adverse events (e.g. fear of falling and joint pain) occur. The water environment could minimize the limitations and barriers associated with land-based RBT. To date, there is a lack of studies reporting on the feasibility of conducting RBT in water for reactive balance control in older adults.
Goal(s) / Research Aims: Primary aim is to assess the feasibility AquaReBal intervention.
Methods / Approaches / Expertise: A single-arm pre-post study will be conducted among older adults. Participants will be recruited from the Greater Toronto Area. The intervention will be held twice per week for 6 weeks, 60 minutes per session. We will assess feasibility measures (indicators for process, resources, management, and safety parameters), reactive balance control and secondary outcome measures - history of falls, Physical Activity Scale for the Elderly (PASE), Activities-Specific Balance Confidence (ABC) Scale, European Quality of Life Instrument (EQ-5D), Mini Balance Evaluation Systems Test (mini-BESTest), Timed Up and Go (TUG) test. Participants' number of falls after intervention (6 weeks) until 6-month follow-up period will be monitored. Semi-structured interviews (qualitative component) will be conducted to understand the experiences of the participants with the interventions. Primary and secondary outcome measures will again be collected at 6 months post-intervention. The core research staff will consist of experts in the field of aquatic therapy and reactive balance. To facilitate knowledge translation after this study, we have adopted an integrated knowledge translation approach, including a patient partner and a knowledge user early in the preparation of this application and planning stages for the study.
Expected Outcomes: The proposed project will result in the development of a novel aquatic RBT. In addition, the participants' perspectives on the RBT training in water can provide further information on the feasibility of such interventions.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Prevention
- 盲法
- None (Investigator, Outcomes Assessor)
入排标准
- 年龄范围
- 65 Years 至 —（Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •65 years and older
- •able to stand ≥1 min
- •able to independently walk ≥10 m without assistance
- •a history of ≥2 falls in the past 12 months, history of an injurious fall in the past 12 months, and/or self-reported balance difficulties
排除标准
- •Current diagnosis of neurological or sensory disorders
- •uncorrected vision problems
- •recurrent dizziness
- •cognitive deficits
- •medical conditions that could increase injury risk during balance tests (e.g. presence of a prior fragility fracture)
- •conditions that would not allow the participant to get into the therapy pool (e.g. wounds, fear of water)
- •currently attending physiotherapy or supervised exercise.
研究组 & 干预措施
AquaReBal - water-based RBT
AquaReBal (water-based RBT) will be conducted at a warm therapy pool. Participants will not wear a safety harness in water as there is minimal risk of injury due to the water properties. The level of the water will be between umbilicus and xiphoid process to allow the participant to freely move in the standing position and ensure safety during perturbations. In addition, in the tasks that involve moving, the turbulence of the water will create additional perturbations.
干预措施: AquaReBal (Other)
结局指标
主要结局
Feasibility
时间窗: From enrollment to the end of treatment at 6 weeks and at 6 months post intervention
Feasibility of recruitment, adherence and intervention fidelity will be measured. Because feasibility is a multidimensional construct we will also collect qualitative data about recruitment capability, randomization acceptability, data collection procedures and outcome measures, intervention delivery, intervention adherence and safety, barriers and facilitators to implementing the study, and retention of participants. Qualitative methods will include one-on-one interviews, unstructured observations, field notes and session recordings. We will use a flexible approach with regard to timing when qualitative data is collected as problems and implementation barriers arise; this will allow us to document information in real time, thus allowing us to make necessary refinements to the intervention and study protocol.
次要结局
- Falls monitoring(From enrollment to the end of treatment at 6 weeks and 6 months post intervention)
- The Mini Balance Evaluation Systems Test (mini-BESTest)(From enrollment to the end of treatment at 6 weeks and 6 months post intervention)
- Timed Up and Go (TUG)(From enrollment to the end of treatment at 6 weeks and at 6 months post intervention)
- Physical activity(From enrollment to the end of treatment at 6 weeks and at 6 months post intervention)
- Psychological consequences(From enrollment to the end of treatment at 6 weeks and 6 months post intervention)
- Health-related quality of life(From enrollment to the end of treatment at 6 weeks and 6 months post intervention)
- Reactive balance control(From enrollment to the end of treatment at 6 weeks and 6 months post intervention)
研究者
Anna Ogonowska-Słodownik
Dr
Józef Piłsudski University of Physical Education