None listed
Conditions
Brief summary
Interest in falls has never been stronger in both Australia and the International community. This interest is strongly fuelled by the knowledge that falls pose a serious threat to the health and wellbeing of older people and contribute to a substantial health-care burden. The primary research questions of this pilot randomised controlled study are: 1. Does physiotherapist delivered Pilates reduce falls in community-dwelling older people? 2. Does physiotherapist delivered Pilates improve standing balance in community-dwelling older people? 3. Does physiotherapist delivered Pilates improve bone mineral density in community-dwelling older people? Our hypothesis is that physiotherapist delivered Pilates will reduce falls by 30% and improve standing balance by 30% and bone mineral density by at least 1.5% in older people identified as being at high risk of falling when compared to standard care.
Interventions
Arm 1:
The intervention group will receive the Physiotherapist delivered Pilates exercise program. This includes a 60 minute program twice weekly for 12 weeks as well as a 20 minute tailored daily home exercise program.
Arm 2:
The intervention group will receive the Physiotherapist delivered Pilates exercise program. This includes a 60 minute program twice weekly for 24 weeks as well as a 20 minute tailored daily home exercise program.
The physiotherapist delivered Pilates exercise for both i
Arm 1: The intervention group will receive the Physiotherapist delivered Pilates exercise program. This includes a 60 minute program twice weekly for 12 weeks as well as a 20 minute tailored daily home exercise program. Arm 2: The intervention group will receive the Physiotherapist delivered Pilates exercise program. This includes a 60 minute program twice weekly for 24 weeks as well as a 20 minute tailored daily home exercise program. The physiotherapist delivered Pilates exercise for both intervention arms will include progressive balance and lower limb strength exercises that utilise Pilates equipment such as a Reformer, Trapeze Table, Wunda Chair and Swiss ball. All exercises will include 5 minutes of warm-up exercises at the start of the session and a 5 minute cool-down at the end of the session. Balance exercises will include standing with a decreased base of support (for example in single leg stance); reaching and extending the limbs forwards and sideways whilst keeping the trunks stable; controlled movements of the body; minimal use of hands for support; sensory challenges with eyes closed, head turns, unstable surfaces; and dual tasking (ball throwing). Lower limb strength exercises will be performed predominantly in standing positions and will involve moving the leg against resistance of the springs in the Pilates equipment. For example, standing and stepping down on the peddle of the Wunda Chair. Participants in both intervention arms will receive standardised falls prevention and bone health advice in the form of a booklet from Osteoporosis Australia "Exercise and Fracture Prevention: A Guide for Consumers". Participants in both intervention arms will be provided information surrounding their balance, falls risk and lower limb strength following the completion of the baseline, 12-week and 24-week physical assessments. Their performance will be compared to age normal values and the areas requiring focus to reduce falls risk will be identified. All participants will be encouraged to discuss these results with the Medical practitioner and any other health professionals involved with their care. The Medical practitioners of participants in both intervention arm's will receive a copy of the 'Falls facts for doctors' that details best practice recommendations and a summary of their patients physical assessment results at baseline, 12 weeks and 24 weeks. Medical practitioners of participants in Arm 2 will receive a copy of the 24 week DXA results.
Sponsors
Faculty of Medicine, Nursing and Health Sciences Strategic Grant Scheme Monash University
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used)
Eligibility
Sex/Gender
All
Age
60 Years to 100 Years
Healthy volunteers
Yes
Inclusion criteria
Arms 1, 2, 3 and 4: Community-dwelling men and women (i) identified as being at high risk of suffering a fall related injury on screening assessment; (ii) aged 60 years or over; and (iii) able to negotiate a set of 10 stairs independently without a gait aid. Medical clearance will be required from each participant's Medical practitioner to certify him/her as able to participate in moderate intensity physiotherapist supervised exercise before being accepted into the trial. And: Arm 2 and 4: Community-dwelling men and women that have low bone mineral density (t-score > 1SD below age related normal score) as diagnosed from a DXA scan within the last 6 months at a selected imaging centre.
Exclusion criteria
Arm 1, 2, 3 and 4: Participants will be excluded if they: (i) have a telephone Mini-Mental State Examination score of <17; (ii) are already attending Pilates or other formal exercise class (60 minutes or more per week) for 4 or more weeks in the previous 12 weeks; (iii) currently or recently have or have had an acute medical condition; (iv) have had cancer within the past 5 years and/or currently undergoing active treatment for cancer or (v) suffering from uncontrolled chronic conditions that would interfere with the safety and conduct of the assessments or Pilates exercise intervention. Arm 2 and 4: As stated above with the additional exclusion criteria of: (i) have received hormone therapy in the last 2 years; or (ii) have commenced taking medication(s) known to affect bone metabolism in the previous 90 days
Outcome results
None listed