None listed
Conditions
Brief summary
The aim of the study is to determine to effectiveness of a lower limb home-based exercise program compared with an upper limb home-based exercise program to prevent falls and upper limb dysfunction in older people. A definitive pragmatic randomised controlled trial (n=576) will be undertaken. People will be eligible to participate if they are: 65 years and older; not participating in an exercise program similar to either the lower limb or upper limb exercise program twice per week; do not have a cognitive impairment that would stop them providing informed consent and being able to follow instructions and understand program materials; able to speak and read English; and obtain medical clearance to participate. Recruitment will be via paid advertisements in local papers. Participants will be randomised into the lower limb exercise group or upper limb exercise group after providing informed consent and after completion of the baseline assessment (eg strength, balance and physical activity measures; self-administered questionnaire). Outcome assessors will be blinded to group allocation. The exercise programs will be delivered in three workshops (weeks 1, 4 and 12) by experienced physiotherapists. The lower limb group will be given exercises to improve balance and lower limb strength. The upper limb group participants will receive exercises designed to prevent upper limb dysfunction. All participants will be provided with a calendar to record their exercises and falls on a monthly basis; a program manual and weights. Participants in the lower limb exercise group will also receive a book/booklet about preventing falls. Participants will receive a 5-10 minute booster phone call at nine months after participation commencement. Participants will be asked to complete their exercises at home three times per week for 12 months. The weight to be used at the beginning of the program and progression of exercise intensity will be individualised and determined by the physiotherapists. Participants will be asked to return their calendars to the research team at the end of each month in the supplied reply paid envelopes.
Interventions
The lower limb group will receive a home-based exercise program for the lower limb. This program is based on the Otago Exercise Program, which has been found to reduce rates of falls and injurious falls. The lower limb exercise program includes balance and strength exercises for example sit to stand, semi squats from a standing position, calf raises, toe raises, sideways walking, backwards walking and one leg stand.
The exercise instruction will be delivered by an experienced physiotherapist i
The lower limb group will receive a home-based exercise program for the lower limb. This program is based on the Otago Exercise Program, which has been found to reduce rates of falls and injurious falls. The lower limb exercise program includes balance and strength exercises for example sit to stand, semi squats from a standing position, calf raises, toe raises, sideways walking, backwards walking and one leg stand. The exercise instruction will be delivered by an experienced physiotherapist in three group workshops (approximately one hour each). Exercise instruction workshops will occur at weeks 1, 4 and 12. Participants will be encouraged to perform the set of exercises three times per week at home for a period of 12 months. The set of exercises should take 20-30 minutes to complete. The weight to be used at the beginning of the program and progression of exercise intensity will be individualised and determined by the physiotherapists. The exercises are to be completed with good technique and control. Once exercises can be performed comfortably, they are progressed by increasing weight and/or decreasing the support. Participants will be provided with an ankle weight and a home exercise manual which contains clear pictures and descriptions of the exercises, and booklet about preventing falls. Participants will also be provided with a calendar to record their exercises and falls on a monthly basis. Participants will be asked to return their calendars to the research team at the end of each month in the supplied reply paid envelopes. Participants will receive a 5-10 minute booster phone call, by a member of the research team, at nine months after participation commencement.
Sponsors
Professor Cathie Sherrington
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Prevention
Masking
Blinded (masking used) (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
65 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
People aged 65 years and over, and living at home or independently in the community (eg self care unit in residential aged care facility) in the Illawarra Shoalhaven Local Health District.
Exclusion criteria
Residing in nursing home; cognitive impairment (Memory Impairment Screen score less than 5); inability to walk 10 metres despite assistance from walking aid; insufficient English language skills; a progressive neurological disease eg Parkinson’s disease; recent fracture/joint replacement; a medical condition precluding exercise eg unstable cardiac disease, uncontrolled hypertension, uncontrolled metabolic diseases; unable to obtain a medical clearance; currently participating in an exercise program similar to either study program two or more times per week.
Outcome results
None listed