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Health in Motion- A Pragmatic Clinical Trial- Home

Not Applicable
Completed
Conditions
Aging
Interventions
Behavioral: digital fall prevention program
Registration Number
NCT05016141
Lead Sponsor
Blue Marble Rehab Inc
Brief Summary

Falls among older adults are a serious public health concern and injuries resulting from falls can cause significant loss of independence, premature death, and higher caregiver burden. Home-based fall prevention programs, such as the Otago Exercise Program, educate older adults about the importance of identifying fall risk and provide strategies for reducing fall risk; however, many are costly and are not scalable, accessible, or sustainable. This project will evaluate the use of a digital solution that translates evidence-based fall prevention programs (such as Otago Exercise Program and Matter of Balance) to a digital solution (Health in Motion Fall Prevention Platform), as an alternative to home-based fall prevention programs that is affordable, scales to the millions of older adults across the country at risk for falls and is sustainable for the older adult's life.

Detailed Description

This study will involve 2 groups. Both groups will be followed for 12 months. The investigators will use a comparative prospective longitudinal (12-months) observational cohort study to compare the Health in Motion Fall Prevention Program with a no-intervention group. Metrics of effectiveness include the rate of falls, fall risk, fear of falling, and falls efficacy. Economic benefit will be measured using the EQ-5D-5L, along with hospital and clinical visits. The primary outcome is the incidence of falls (rate in person-months).

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
101
Inclusion Criteria
  • age of 55 and older
  • if history of 2 or more falls in the past year with a physician or physical therapist approval
  • Score >31 on the TICS (Telephone Interview for Cognitive Screen)
  • Easy for Me screen for inclusion
Exclusion Criteria
  • any person who has been told by their physician that they should not exercise

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
digital fall prevention programdigital fall prevention programParticipants will complete the Health in Motion digital fall prevention program for 12 months. This program consists of education modules (modified from the Matter of Balance Program) and exercises based on a digital translation of the Otago Exercise Program.
Primary Outcome Measures
NameTimeMethod
Rate of Falls per monthChange from baseline fall rate at 12 months

Number of falls per month / number of participants x 1000

Secondary Outcome Measures
NameTimeMethod
One Leg Stand TestChange from baseline at 12 months

This test measures the ability to stand for on one leg for up to 30 seconds. If a participant is not able to stand for 5 seconds, they are considered at higher risk of falling.

VR-12Change from baseline at 12 months

This questionnaire measures quality of life over the past 4 weeks.

Education Modules Data (Intervention Group Only)through study completion, an average of 1 year.

Qualitative Analysis of text entries.

Total number of repetitions of all exercises completedthrough study completion, an average of 1 year

Total number of repetitions of all exercises completed

Adherence to Education Modulesthrough study completion, an average of 1 year

Total number of education modules completed

Activities Specific Balance Confidence Scale 5 LevelChange from baseline at 12 months

This questionnaire measures the participant's confidence in performing activities of daily living in which each item is rated from 0% (no confidence) to 100% (complete confidence). It correlates with other measures of self-efficacy and balance measures.

Depression ScreenChange from baseline at 12 months

The Depression Screen is a 2-item questionnaire that asks about how the person has been feeling over the past 2 weeks.

Timed Up and Go TestChange from baseline at 12 months

Time taken to stand up from a seated position, walk 10 feet, turn around, return to the chair, sit down

30 Second Sit to Stand TestChange from baseline at 12 months

This test measures the number of times a participant can stand up from a seated position in 30 seconds.

4 Stage Balance TestChange from baseline at 12 months

This test measures the ability to stand for 10 seconds in 4 progressively more challenging positions from standing with feet side by side to standing on one leg. The score is equal to the total time taken to achieve the highest level. The maximum score is 40. If a participant is not able to stand with their feet in tandem, they are considered at higher risk of falling.

European Quality of Life 5-Dimensional Questionnaire (EQ-5D-5L)Change from baseline at 12 months

This is a standardized measure of health status for clinical and economic appraisal. The test is a self report health state that domains including mobility, self-care, anxiety/depression, pain/discomfort) using a 5 point scale and a visual analog scale (VAS).

We will calculate quality-adjusted life years (QALY) using the EQ-5D-5L and the appropriate weights from each instrument to compare differences in the incremental cost-effectiveness ratios.

Trail Making Test - DigitalChange from baseline at 12 months

This is a standardized test of cognitive function. The test consists of two Trails, Trail A and Trail B. Trail A requires the participant to tap on 25 numbers on the screen in order from smallest to largest (1, 2, 3, etc). Trail B requires participants to tap on alternative numbers and letters in consecutive order from smallest/first to largest/last (1, A, 2, B, 3, C etc).

Modified Fear of Falling Avoidance Behavior QuestionnaireChange from baseline at 12 months

This is a standardized self-report assessment that measures behaviors that may be avoided due to a fear of falling

Fall Risk QuestionnaireChange from baseline at 12 months

This is a multi-factorial questionnaire that can be used to predict fall risk. Questions relate to history of falls, gait/balance, muscle weakness, incontinence, sensation/proprioception, depression, vision and medications. The highest (worst) score = 14. A score of 0-3 denotes low fall risk and scores from 4-14 denote higher fall risk.

System Usability ScaleChange from baseline at 12 months

The System Usability Scale is used to evaluate usability and learnability of software products. We will use information from this survey to improve the usability of Health in Motion. The test uses a 0-5 Likert scale. The statements are worded such that the best score alternates between 1 (Strongly Disagree) and 5 (Strongly Agree). For example, statement #1 is "I think that I would like to use this system frequently" whereas statement #2 is "I found this system unnecessarily complex". The participant's scores for each question are converted to a new number, added together, and then multiplied by 2.5 to convert the original scores of 0-40 to 0-100. Though the scores are 0-100, these are not percentages and should be considered only in terms of their percentile ranking.

SUS scores above 68 are considered above average and anything below 68 is below average.

Adherence to Exercise Program (Intervention Group Only)through study completion, an average of 1 year

Average number of days per week the exercise program was completed

Trial Locations

Locations (1)

Blue Marble Health

🇺🇸

Altadena, California, United States

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