Fall
Conditions
Keywords
Exercise
Brief summary
Objective: To conduct a comparative efficacy and cost-effectiveness study of an evidence-based fall prevention program-Tai Ji Quan: Moving for Better Balance (TJQMBB).
Detailed description
To determine the effectiveness and cost-effectiveness of the two evidence-based exercise programs (Multimodal Exercise,TJQMBB) relative to stretching, a proxy for a minimum practice standard, in reducing falls among older adults at risk of falling.
Interventions
BEHAVIORALTai Ji Quan: Moving for Better Balance
The protocol involves a core 8-form routine training with built-in variations and a subroutine of integrated therapeutic movements.
BEHAVIORALMultimodal Exercise
The protocol involves a multi-modality program that involves aerobic, strength, balance, and flexibility exercises.
BEHAVIORALStretching
The protocol represents a minimum standard of practice for exercises for older adults with activities consisting primarily of seated exercises accompanied by breathing, stretching, and relaxation.
Sponsors
Oregon Research Institute
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
70 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* aged 70 years or older living independently in the community * at least one fall in the preceding 12 months and a referral from a healthcare provider indicating the participant is at risk of falls due to gait/balance impairment or medication use or impaired mobility as evidenced by Timed Up and Go result of \>13.5 seconds * no participation in daily and/or structured vigorous physical activity or walking for exercise that lasted 15 minutes or longer at a time or muscle-strengthening activities on 2 or more days a week in the previous 3 months * walking independently, with or without the use of an assistive device, * no severe cognitive impairment (Mini-Mental State Examination score ≥20) * able to exercise safely as determined by their healthcare provider, * a willingness to be randomly assigned to an intervention condition and complete the 6-month intervention and 6 month follow-up.
Exclusion criteria
* any medical or physical conditions deemed unacceptable by their physician or healthcare provider, * planned to leave the study area within the next 12 months.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in the number of falls | Baseline, 6 Months | Using a daily diary fall calendar, falls reported by participants across the 24-week surveillance period will be collected, starting from the date of first intervention class and continuing until participants withdrew, had died or were lost to follow-up. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Functional Reach | Baseline, 6 Months | assessing the maximal distance (in inch) participants one can reach forward, beyond arm's length, while maintaining a fixed based of support in the standing position. Differences between baseline and 6 months scores will be calculated to assess change. |
| Instrumented Timed Up and Go | Baseline, 6 Months | assessing the time to complete a series of functional tasks (sit-to-stand, 180 degree turn, turn-to-sit.) while walking through a 7-meter walkway (7 meters towards a line, turn, and 7 meters towards the chair). The measure is assessed in second. Differences between baseline and 6 months scores will be calculated to assess change. |
| Physical Performance | Baseline, 6 Months | The physical performance measure consists of 4-meter walk at usual pace, a timed repeated chair stand, and 3 increasingly difficult standing balance tests. Each measure is assigned a categorical score ranging from 0 (inability to complete the test) to 4 (best performance). A summary score ranging from 0 (worst performance) to 12 (best performances) will be calculated by summing the 3 components scores. |
| Cognitive function | Baseline, 6 Months | Montreal Cognitive Assessment (in points). Differences between baseline and 6 months scores will be calculated to assess change. |
| Cost per fall prevented | Baseline, 6 Months | determined by calculating total intervention cost estimates divided by number of falls observed during the 6 month intervention. |
Countries
United States
Outcome results
None listed