Effects of three home-based exercise programmes regarding falls, quality of life and exercise-adherence in older adults at risk of falling: protocol for a randomized controlled trial.
Exercise-adherence
Falls
Home-based exercises programmes
Older adults
Quality of life
Journal
BMC geriatrics
ISSN: 1471-2318
Titre abrégé: BMC Geriatr
Pays: England
ID NLM: 100968548
Informations de publication
Date de publication:
14 01 2019
14 01 2019
Historique:
received:
19
02
2018
accepted:
20
12
2018
entrez:
16
1
2019
pubmed:
16
1
2019
medline:
19
11
2019
Statut:
epublish
Résumé
Fall prevention interventions with home-based exercise programmes are effective to reduce the number and the rate of falls, by reducing risk factors. They improve balance, strength, function, physical activity, but it is known that older adults' exercise adherence declines over time. However, it is unclear which delivery-modalities of the home-based exercise programmes show the best adherence and the largest effect. We created a new home-based exercise programme, the Test-and-Exercise (T&E) programme, based on the concepts of self-efficacy and empowerment. Patients learn to build their own exercise programme with a mobile application, a brochure and cards, as well as with eight coaching sessions by physiotherapists. The main objective of this study is to compare the T&E programme with the Otago Exercise Programme and the recommendation-booklet and exercise-cards of Helsana regarding incidence of falls. Other outcomes are severity of falls, functional capacities, quality of life and exercise-adherence. The design of this study is a Swiss multicentre assessor blind randomized controlled trial. A block-randomization, stratified in groups for age and risk of fall categories, will be used to allocate the participants to three groups. The targeted study sample consists of 405 older adults, ≥ 65 years of age, living in the community and evaluated as at "risk of falling". Experimental group will receive the T&E programme (N = 162). Second group will receive the Otago programme (N = 162) and the third group will receive the Helsana programme (N = 81). All interventions last six months. Blinded assessors will assess participants three times: at baseline before the start of the intervention, after six months of intervention and a final assessment after twelve months (six months of follow up). Although home-based exercises programmes show positive effects in fall prevention in elderly persons, existing programmes do often not include patients in the decision-making process about exercise selection. In our programme the physiotherapist and the older adult work together to select the exercises; this collaboration helps to increase health literacy, pleasure of exercising, and empowers patients to be more autonomy. ClinicalTrials.gov: NCT02926105 , First Posted: October 6, 2016, Last Update: November 11, 2016: Enrolment of the first participant.
Sections du résumé
BACKGROUND
Fall prevention interventions with home-based exercise programmes are effective to reduce the number and the rate of falls, by reducing risk factors. They improve balance, strength, function, physical activity, but it is known that older adults' exercise adherence declines over time. However, it is unclear which delivery-modalities of the home-based exercise programmes show the best adherence and the largest effect. We created a new home-based exercise programme, the Test-and-Exercise (T&E) programme, based on the concepts of self-efficacy and empowerment. Patients learn to build their own exercise programme with a mobile application, a brochure and cards, as well as with eight coaching sessions by physiotherapists. The main objective of this study is to compare the T&E programme with the Otago Exercise Programme and the recommendation-booklet and exercise-cards of Helsana regarding incidence of falls. Other outcomes are severity of falls, functional capacities, quality of life and exercise-adherence.
METHODS
The design of this study is a Swiss multicentre assessor blind randomized controlled trial. A block-randomization, stratified in groups for age and risk of fall categories, will be used to allocate the participants to three groups. The targeted study sample consists of 405 older adults, ≥ 65 years of age, living in the community and evaluated as at "risk of falling". Experimental group will receive the T&E programme (N = 162). Second group will receive the Otago programme (N = 162) and the third group will receive the Helsana programme (N = 81). All interventions last six months. Blinded assessors will assess participants three times: at baseline before the start of the intervention, after six months of intervention and a final assessment after twelve months (six months of follow up).
DISCUSSION
Although home-based exercises programmes show positive effects in fall prevention in elderly persons, existing programmes do often not include patients in the decision-making process about exercise selection. In our programme the physiotherapist and the older adult work together to select the exercises; this collaboration helps to increase health literacy, pleasure of exercising, and empowers patients to be more autonomy.
TRIAL REGISTRATION
ClinicalTrials.gov: NCT02926105 , First Posted: October 6, 2016, Last Update: November 11, 2016: Enrolment of the first participant.
Identifiants
pubmed: 30642252
doi: 10.1186/s12877-018-1021-y
pii: 10.1186/s12877-018-1021-y
pmc: PMC6332592
doi:
Banques de données
ClinicalTrials.gov
['NCT02926105']
Types de publication
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
13Références
Syst Rev. 2015 Nov 17;4:163
pubmed: 26577545
BMC Geriatr. 2014 Feb 01;14:14
pubmed: 24484314
J Strength Cond Res. 2011 Feb;25(2):567-74
pubmed: 20838253
Can Fam Physician. 2008 Jan;54(1):66-73
pubmed: 18208958
Age Ageing. 2008 Jul;37(4):430-5
pubmed: 18487264
Age Ageing. 2006 Jan;35(1):5-10
pubmed: 16364930
J Psychiatr Res. 1975 Nov;12(3):189-98
pubmed: 1202204
PLoS One. 2015 Dec 30;10(12):e0146247
pubmed: 26716861
Phys Med Rehabil Clin N Am. 2010 May;21(2):357-73
pubmed: 20494282
J Am Geriatr Soc. 2004 Jun;52(6):972-6
pubmed: 15161464
Osteoporos Int. 2013 Mar;24(3):747-62
pubmed: 23296743
Gerontologist. 2006 Oct;46(5):650-60
pubmed: 17050756
J Am Geriatr Soc. 2007 Apr;55(4):603-15
pubmed: 17397441
BMC Med Res Methodol. 2013 Jul 31;13:99
pubmed: 23898993
Aging Clin Exp Res. 2011 Oct-Dec;23(5-6):406-12
pubmed: 22526072
Gait Posture. 2010 Mar;31(3):317-21
pubmed: 20047833
Health Qual Life Outcomes. 2015 Jul 15;13:101
pubmed: 26168922
J Physiother. 2014 Sep;60(3):151-6
pubmed: 25092418
J Am Geriatr Soc. 1991 Feb;39(2):142-8
pubmed: 1991946
Gerontology. 2005 Mar-Apr;51(2):116-21
pubmed: 15711078
J Trauma. 2011 Sep;71(3):748-53
pubmed: 21045738
J Med Internet Res. 2013 Aug 12;15(8):e159
pubmed: 23939401
J Clin Nurs. 2009 Aug;18(16):2261-72
pubmed: 19583659
Osteoporos Int. 2009 Jun;20(6):869-78
pubmed: 18846400
J Gerontol A Biol Sci Med Sci. 2005 Apr;60(4):530-4
pubmed: 15933397
BMC Public Health. 2005 Aug 26;5:90
pubmed: 16124871
Coll Antropol. 2014 Mar;38(1):247-54
pubmed: 24851625
Arch Gerontol Geriatr. 2007 Nov-Dec;45(3):259-71
pubmed: 17303264
J Gerontol Nurs. 2000 Mar;26(3):34-42
pubmed: 11111629
Gerontology. 2011;57(5):462-72
pubmed: 20975251
J Rehabil Res Dev. 2000 Jan-Feb;37(1):109-13
pubmed: 10847578
Med Sci Sports Exerc. 2009 Jul;41(7):1510-30
pubmed: 19516148
Age Ageing. 1997 Jan;26(1):15-9
pubmed: 9143432
Clin Rehabil. 2001 Dec;15(6):624-36
pubmed: 11777093
Cochrane Database Syst Rev. 2012 Sep 12;(9):CD007146
pubmed: 22972103
Qual Saf Health Care. 2007 Jun;16(3):230-4
pubmed: 17545352
Stat Med. 2016 Feb 20;35(4):505-21
pubmed: 26388314
J Gerontol. 1994 Mar;49(2):M85-94
pubmed: 8126356
Age Ageing. 2001 Jan;30(1):77-83
pubmed: 11322678
Arch Gerontol Geriatr. 2014 Jan-Feb;58(1):95-100
pubmed: 23993268
BMC Geriatr. 2014 Aug 20;14:91
pubmed: 25141850
BMJ Open. 2015 Oct 22;5(10):e009173
pubmed: 26493461
Prev Med. 2012 Oct;55(4):262-275
pubmed: 22813920
Phys Ther. 2006 Mar;86(3):401-10
pubmed: 16506876
Inj Prev. 2006 Oct;12(5):290-5
pubmed: 17018668
Age Ageing. 2005 Nov;34(6):614-9
pubmed: 16267188
Disabil Rehabil. 2014;36(6):457-63
pubmed: 23713969
Cochrane Database Syst Rev. 2009 Apr 15;(2):CD007146
pubmed: 19370674
J Aging Phys Act. 2015 Apr;23(2):200-4
pubmed: 24700385
Age Ageing. 2010 Nov;39(6):681-7
pubmed: 20817938
Osteoporos Int. 2010 Aug;21(8):1295-306
pubmed: 20195846
Gerontology. 2008;54(5):272-80
pubmed: 18787321
Stat Med. 2008 Nov 10;27(25):5093-110
pubmed: 18570271
Implement Sci. 2012 Sep 14;7:91
pubmed: 22978693
BMJ. 2011 Feb 07;342:d40
pubmed: 21300711
Age Ageing. 2010 Mar;39(2):210-6
pubmed: 20061508
J Aging Phys Act. 2007 Jul;15(3):272-86
pubmed: 17724394
J Gerontol. 1992 May;47(3):M93-8
pubmed: 1573190
Ann Intern Med. 2013 Feb 5;158(3):200-7
pubmed: 23295957
J Am Geriatr Soc. 1992 Mar;40(3):203-7
pubmed: 1538035
J Nutr Health Aging. 2011 Dec;15(10):933-8
pubmed: 22159785
J Gerontol B Psychol Sci Soc Sci. 2013 May;68(3):400-4
pubmed: 22929394
Phys Ther. 2013 Oct;93(10):1321-30
pubmed: 23641024
BMC Med Res Methodol. 2012 Apr 17;12:50
pubmed: 22510239
Assessment. 2005 Jun;12(2):137-44
pubmed: 15914716
Arch Phys Med Rehabil. 2014 Apr;95(4):753-769.e3
pubmed: 24291597
J Biopharm Stat. 2010 Sep;20(5):911-26
pubmed: 20721781
J Epidemiol Community Health. 2011 Mar;65(3):273-80
pubmed: 20719807
Aging Clin Exp Res. 2012 Aug;24(4):339-44
pubmed: 23238309
Age Ageing. 2007 Nov;36(6):656-62
pubmed: 18056731
Maturitas. 2015 Sep;82(1):72-84
pubmed: 25989701
J Gerontol. 1990 Nov;45(6):M192-7
pubmed: 2229941
JMIR Res Protoc. 2015 Mar 10;4(1):e33
pubmed: 25757808
Phys Ther. 2000 Sep;80(9):896-903
pubmed: 10960937
Patient Educ Couns. 2006 Oct;63(1-2):12-23
pubmed: 16406464
Maturitas. 2015 Sep;82(1):85-93
pubmed: 26255681
Int J Older People Nurs. 2011 Dec;6(4):289-98
pubmed: 22078019
BMJ. 2013 Oct 29;347:f6234
pubmed: 24169944
BMC Musculoskelet Disord. 2012 Jul 23;13:128
pubmed: 22824202
Gerontology. 2011;57(3):203-10
pubmed: 20484884
Rev Med Suisse. 2012 Jul 11;8(348):1453-7
pubmed: 22934473
BMJ. 2012 Aug 07;345:e4547
pubmed: 22872695
Age Ageing. 2006 Jul;35(4):409-15
pubmed: 16690636