Multidisciplinary Combined Exercise and Education Intervention for Falls in Older Adults
- Conditions
- Falls Prevention
- Interventions
- Other: Combined exercise-education intervention
- Registration Number
- NCT05615077
- Lead Sponsor
- Seoul National University Hospital
- Brief Summary
This study aims to demonstrate the effect of combined exercise-education intervention in old adults with fall risk. This study will be conducted with prospectively randomized controlled trial comparing outcome of combined exercise-education intervention with conventional medical care. Falls efficacy scale-international, fall history, Balance function, handgrip strength, gait speed, knee extensor muscle power, physical performance, muscle mass using DEXA and BIA, quality of life, depression, cognitive function, activities of daily living, nutritional assessment will be evaluated on baseline, 1-month, 3-months, 6-months, and 12-months after intervention.
- Detailed Description
A fall is defined as an event which results in a person coming to rest inadvertently on the ground or floor or other lower level. And also, falls are the second leading cause of unintentional injury deaths worldwide. In particular, adults older than 65 years of age suffer the greatest number of fatal falls. It has been reported exercise in fall risk patients not only improved physical performance but also reduced the fall risk. Also, it is recently demonstrated that combined exercise-education (e.g., exercise training, medication review, nutrition counseling, home hazards modification) intervention reduced fall risk in elderly patients. However, there is still not established standard protocol for the combined exercise-education intervention. Therefore, the aim of this trial is to compare the effects of combined exercise-education intervention in fall risk patients with multicenter, multidisciplinary, randomized controlled trial.
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 484
- patients older than 65 years and under 90 years
- if at least one <3 key question> is met or <stay independent score> ≥ 4 points
- patients who can walk more than 10m without an assistive device (ambulatory without an assistive device)
- patients who are willing to participate in exercise intervention for 12 months
- patients who can receive information about this study, submit written consent before participating in the study, and can comply with the requirements of the clinical trial
- medically unstable conditions (e.g., cirrhosis with complications, end-stage renal failure requiring regular dialysis, hemorrhagic disease, uncontrolled hypertension, those who have been treated for a malignant tumor within 5 years)
- in case of ongoing neurological deficit except for stroke survivors (e.g., dementia, Alzheimer's disease, Parkinson's disease, etc.)
- decreased cardiopulmonary function such as heart failure, chronic obstructive pulmonary disease
- musculoskeletal problems that affect physical function and athletic ability (e.g., those who have undergone hip joint surgery, artificial joint surgery, spine surgery within the last 1 year)
- patients who have experienced alcohol abuse within the last 1 year (if 3 or more are meet in Cut off, Annoyed, Guilty, Eye opener [CAGE] evaluation)
- in case the purpose of this clinical trial cannot be understood or the matters necessary for the study cannot be carried out
- when it is judged by other researchers that the subject's condition makes it difficult to participate in this study
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Combined exercise-education intervention group Combined exercise-education intervention Combined exercise-education intervention by fall risk state for 12 months during intervention period.
- Primary Outcome Measures
Name Time Method Korean Version of Falls Efficacy Scale-International (KFES-I) Baseline (visit 1), 1 month after intervention (visit 2), 3 months after intervention (visit 3), 6 months after intervention (visit 4), 12 months after intervention (visit 5) Change from baseline falls efficacy to 1, 3, 6, 12 months after assessment, measured by Korean Version of Falls Efficacy Scale-International (KFES-I) \[range from 16 to 64\]. A higher value represents a high concern for falling.
- Secondary Outcome Measures
Name Time Method Gait speed test Baseline (visit 1), 1 month after intervention (visit 2), 3 months after intervention (visit 3), 6 months after intervention (visit 4), 12 months after intervention (visit 5) measured by 10 meter gait speed
Falls history & injury Baseline (visit 1), 1 month after intervention (visit 2), 3 months after intervention (visit 3), 6 months after intervention (visit 4), 12 months after intervention (visit 5) Evaluation of number of falls and type of falls in previous 12 months
Handgrip strength Baseline (visit 1), 1 month after intervention (visit 2), 3 months after intervention (visit 3), 6 months after intervention (visit 4), 12 months after intervention (visit 5) measured in kilograms (kg) using hand-held dynamometer
Knee extensor muscle test Baseline (visit 1), 1 month after intervention (visit 2), 3 months after intervention (visit 3), 6 months after intervention (visit 4), 12 months after intervention (visit 5) measured using a belt-stabilized hand-held dynamometer
Balance function Baseline (visit 1), 1 month after intervention (visit 2), 3 months after intervention (visit 3), 6 months after intervention (visit 4), 12 months after intervention (visit 5) Evaluation of physical balance function using Mini-Balance Evaluation System Test (Mini-BESTest) \[range from 0 to 28\]. Low value means poor ability of balance function.
Nutritional Assessment Baseline (visit 1), 1 month after intervention (visit 2), 3 months after intervention (visit 3), 6 months after intervention (visit 4), 12 months after intervention (visit 5) Evaluation of nutritional state using Mini-Nutritional Assessment short form (MNA-SF) \[range from 0 to 14 score\]. Low value means poor nutrition status
Bone density Baseline (visit 1), 12 months after intervention (visit 5) measured using Dual-energy X-ray absorptiometry (DEXA)
Physical performance Baseline (visit 1), 1 month after intervention (visit 2), 3 months after intervention (visit 3), 6 months after intervention (visit 4), 12 months after intervention (visit 5) Short Physical Performance Battery \[range from 0 to 12 score\]
Health related quality of life Baseline (visit 1), 1 month after intervention (visit 2), 3 months after intervention (visit 3), 6 months after intervention (visit 4), 12 months after intervention (visit 5) Evaluation of quality of life using EuroQol-5 dimension (EQ-5D) \[range from 5 to 25 score\]. Higher value means worse quality of life
Depression status Baseline (visit 1), 1 month after intervention (visit 2), 3 months after intervention (visit 3), 6 months after intervention (visit 4), 12 months after intervention (visit 5) Evaluation of depression status using Patient Health Questionnaire-9 (PHQ-9) \[range from 0 to 27 score\]. Higher score indicates a higher severity of depressive symptoms
Physical activity volume Baseline (visit 1), 1 month after intervention (visit 2), 3 months after intervention (visit 3), 6 months after intervention (visit 4), 12 months after intervention (visit 5) Evaluation of physical activity volume using Korean version of Physical Activity Scale for the Elderly (K-PASE) \[range from 0 to 360 score\]. Low value means poor physical activity
Cognitive function Baseline (visit 1), 1 month after intervention (visit 2), 3 months after intervention (visit 3), 6 months after intervention (visit 4), 12 months after intervention (visit 5) Evaluation of cognitive function using Korean-Montreal Cognitive Assessment (K-MoCA) \[range from 0 to 30 score\]. Low value means poor cognitive function
Appendicular skeletal muscle mass Baseline (visit 1), 1 month after intervention (visit 2), 3 months after intervention (visit 3), 6 months after intervention (visit 4), 12 months after intervention (visit 5) measured using Bioelectrical Impedance Analysis (BIA)
Trial Locations
- Locations (1)
Seoul National University Hospital
🇰🇷Seoul, Korea, Republic of