Adults Living in Long Term Care
Conditions
Keywords
Long Term Care, Motivating Reminiscence Technology, Feasibility
Brief summary
This study evaluates the feasibility of a larger randomized controlled trial to examine the effect of reminiscence aided physical activity on the balance and mobility of older adults living in long term care. The study uses the jDome BikeAround system, which is a stationary bicycle with a projector screen that runs google earth, as the user bicycles, the map progresses giving the appearance that the user is bicycling through the environment chosen. Half of the participants will use the system during the first 6 week campaign, there will then be a 6 week washout period. Following the washout period, there will be a second 6 week campaign when the other half of the participants will use the jDome BikeAround system.
Detailed description
Physical activity has been shown to have numerous benefits for physical well-being and function. Stationary cycling is one example of physical activity that can provide opportunities for residents who are inactive, living in long term care and are at high risk for falls. The use of jDome BikeAround provides older adults in long term care an opportunity to engage in a motivating reminiscence activity that is coupled with physical activity. Participants will be divided into two groups, one group will take part in jDome BikeAround sessions 3x per week for 6 weeks in addition to The Glebe Centre's Fall Prevention program, while the second group will just participant in Fall Prevention program. There will be a 6 week wash out, then the second cohort will participant in the jDome Bike Around sessions 3x a week in addition to the Fall Prevention program while the first cohort will just participate in the Fall Prevention Program. Participants will have their balance, mobility, leg strength, endurance tested as well as a tracking of fall risks at the beginning and end of each of the jDome BikeAround sessions (4 measurement points). Feasibility will be determined by the ability to enroll an adequate number of participants, protocol completion by participants, and the number of adverse events.
Interventions
OTHERMotivating reminiscence technology
The jDome BikeAround uses Google Street View, a stationary bike and a domed screen. Residents are seated in front of the screen; their destination is typed into the computer and when loaded the image appears on the screen. Using pedals on the bike they can propel themselves down the street, steer and change direction as they wish.
Sponsors
Bruyère Health Research Institute.
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Masking description
All outcome measures will be collected by the physiotherapy team at The Glebe Centre. The physiotherapy team will be blinded to the group allocation of each participant.
Intervention model description
This study has 2 six week campaigns with a six week washout in between the 2 campaigns. During the first campaign half of the participants will use the motivating reminiscence technology while receiving the standard fall prevention programming, while the second half will receive just the standard fall prevention programming. During the 6 week washout period all participants will just receive the standard fall prevention programming. After the washout period, there will be the second campaign where the other half of the participants will use the motivating reminiscence technology while receiving the standard fall prevention programming, whereas the remaining participants will just receive the standard fall prevention programming.
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
* Scott fall risk of 2-17 (this is the current range used by the Glebe Centre, there have been 0 falls during transportation to the equipment and during each session of the BikeAround system) * Sufficient visual abilities to observe images on the domed screen * Able to comprehend and communicate in English. * Adequate attentional capacity to remain focused on the pedalling task. * Minimum height requirement of 5'2 or 157cm in order to successfully fit the BikeAround system's stationary bike.
Exclusion criteria
* Physical limitations (as determined by the Glebe Centre healthcare/physiotherapy team) that prevent use of the jDome bike. * Cognitive impairment (as determined by the Glebe Centre healthcare/physiotherapy team) Inability to sustain attention Inability to follow one-step commands. * Known behavioural abnormalities (e.g. overly aggressive behavior) that in the opinion of the clinical care team might impede any meaningful participation in the project * Those who are in the opinion of attending physician or clinical team too unwell to participate in the project * Fully unable to complete outcome measures indicated (Section 7, Outcomes)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of Participants Recruited | Baseline | Determine the feasibility of a future randomized controlled trial to evaluate the impact on balance and mobility of motivating reminiscence technology using the jDome BikeAround system for adults in long term care. Feasibility will be determined by the ability to recruit 30 residents (based on the LTC population base at The Glebe Centre). |
| Protocol Adherence | Week 18 | Determine the feasibility of a future randomized controlled trial to evaluate the impact on balance and mobility of motivating reminiscence technology using the jDome BikeAround system for adults in long term care. Feasibility will be determined by the number of residents to complied with the protocol during their respective campaign by using the jDome BikeAround system 3 times a week. |
| Number of Participants Who Experience an Adverse Events While Using the jDome BikeAround (System) | Week 18 | The number of adverse events while directly interacting with the jDome BikeAround system will be tracked to help determine feasibility of this kind of randomized trial. |
| Performance Oriented Mobility Assessment | Baseline | The Performance Oriented Mobility Assessment Tool is a simple, easily administered test that measures a resident's gait and balance. The test is scored on the resident's ability to perform specific tasks as either 0, 1 or 2 where a score of 0 represents the most impaired while a score of 2 represents independence. The total is calculated by adding the score for each individual activity, the lowest possible score is 0 and the highest possible score is 28. The higher the score the better the more mobile the participant is. This will give us a baseline value for the participants. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| 2 Minute Walk Test | Baseline | Distance participant can walk without assistance for 2 minutes measured from the starting position. |
| Knee Range of Motion Test | Baseline | Test that asses the range of motion of a participant's knee |
Countries
Canada
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| System + Fall Prevention First, Then Fall Prevention Participants in this arm will be invited to use the jDome BikeAround system for up to 30 minute sessions up to 3 times a week during the first 6 week campaign. During this campaign the participants will also participant in the standard fall prevention program. Following the 6 week washout period, the participants in this arm will just participate in the Fall Prevention program alone.
Motivating reminiscence technology: The jDome BikeAround uses Google Street V | 14 |
| Fall Prevention First, Then System +Fall Prevention Participants in this arm will participate in the Fall Prevention program alone during the first 6 week campaign. Following the 6 week washout period the participants will be invited to use the jDome BikeAround system for up to 30 minute sessions up to 3 times a week during the second 6 week campaign. During this campaign the participants will also participant in the standard fall prevention program
Motivating reminiscence technology: The jDome BikeAround uses Google Street V | 14 |
| Total | 28 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Washout | Change in health condition | 0 | 1 |
Baseline characteristics
| Characteristic | Fall Prevention First, Then System +Fall Prevention | Total | System + Fall Prevention First, Then Fall Prevention |
|---|---|---|---|
| Age, Continuous | 79.9 Years STANDARD_DEVIATION 9.1 | 84.0 Years STANDARD_DEVIATION 10.1 | 87.7 Years STANDARD_DEVIATION 9.9 |
| Cognitive Performance Scale (CPS) | 3 units on a scale STANDARD_DEVIATION 1.3 | 3 units on a scale STANDARD_DEVIATION 1.1 | 3 units on a scale STANDARD_DEVIATION 0.8 |
| Index for Social Engagement (ISE) | 5 units on a scale STANDARD_DEVIATION 1.2 | 5 units on a scale STANDARD_DEVIATION 1.3 | 5 units on a scale STANDARD_DEVIATION 1.3 |
| Race and Ethnicity Not Collected | — | 0 Participants | — |
| Region of Enrollment Canada | 13 participants | 27 participants | 14 participants |
| Scott Fall Risk | 8.9 units on a scale STANDARD_DEVIATION 5.3 | 8.0 units on a scale STANDARD_DEVIATION 5 | 7.1 units on a scale STANDARD_DEVIATION 4.7 |
| Sex: Female, Male Female | 11 Participants | 22 Participants | 11 Participants |
| Sex: Female, Male Male | 3 Participants | 6 Participants | 3 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 14 | 0 / 13 |
| other Total, other adverse events | 0 / 14 | 0 / 13 |
| serious Total, serious adverse events | 0 / 14 | 0 / 13 |
Outcome results
Primary
Number of Participants Recruited
Determine the feasibility of a future randomized controlled trial to evaluate the impact on balance and mobility of motivating reminiscence technology using the jDome BikeAround system for adults in long term care. Feasibility will be determined by the ability to recruit 30 residents (based on the LTC population base at The Glebe Centre).
Time frame: Baseline
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| System + Fall Prevention First, Then Fall Prevention | Number of Participants Recruited | 14 Participants |
| Fall Prevention First, Then System +Fall Prevention | Number of Participants Recruited | 14 Participants |
Primary
Number of Participants Who Experience an Adverse Events While Using the jDome BikeAround (System)
The number of adverse events while directly interacting with the jDome BikeAround system will be tracked to help determine feasibility of this kind of randomized trial.
Time frame: Week 18
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| System + Fall Prevention First, Then Fall Prevention | Number of Participants Who Experience an Adverse Events While Using the jDome BikeAround (System) | 0 Participants |
| Fall Prevention First, Then System +Fall Prevention | Number of Participants Who Experience an Adverse Events While Using the jDome BikeAround (System) | 0 Participants |
Primary
Performance Oriented Mobility Assessment
The Performance Oriented Mobility Assessment Tool is a simple, easily administered test that measures a resident's gait and balance. The test is scored on the resident's ability to perform specific tasks as either 0, 1 or 2 where a score of 0 represents the most impaired while a score of 2 represents independence. The total is calculated by adding the score for each individual activity, the lowest possible score is 0 and the highest possible score is 28. The higher the score the better the more mobile the participant is. This measure will be taken after the first campaign has been completed.
Time frame: Week 6
Population: To complete this test, the participant must have a certain level of mobility. Out of the 14 participants in the Motivating reminiscence technology + Fall Prevention cohort, 3 couldn't complete the test.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| System + Fall Prevention First, Then Fall Prevention | Performance Oriented Mobility Assessment | 16.8 units on a scale | Standard Deviation 6.5 |
| Fall Prevention First, Then System +Fall Prevention | Performance Oriented Mobility Assessment | 19.6 units on a scale | Standard Deviation 6.7 |
Primary
Performance Oriented Mobility Assessment
The Performance Oriented Mobility Assessment Tool is a simple, easily administered test that measures a resident's gait and balance. The test is scored on the resident's ability to perform specific tasks as either 0, 1 or 2 where a score of 0 represents the most impaired while a score of 2 represents independence. The total is calculated by adding the score for each individual activity, the lowest possible score is 0 and the highest possible score is 28. The higher the score the better the more mobile the participant is. This measure will be taken just before the second campaign is to begin.
Time frame: Week 12
Population: To complete this test, the participant must have a certain level of mobility. Out of the 14 participants in the System + Fall Prevention First, then Fall Prevention cohort, 5 couldn't complete the test and 2 participant out of the 13 participants in the 'Fall Prevention first, then System +Fall Prevention' cohort that could not complete the test.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| System + Fall Prevention First, Then Fall Prevention | Performance Oriented Mobility Assessment | 16.5 units on a scale | Standard Deviation 7.6 |
| Fall Prevention First, Then System +Fall Prevention | Performance Oriented Mobility Assessment | 19.7 units on a scale | Standard Deviation 7.6 |
Primary
Performance Oriented Mobility Assessment
The Performance Oriented Mobility Assessment Tool is a simple, easily administered test that measures a resident's gait and balance. The test is scored on the resident's ability to perform specific tasks as either 0, 1 or 2 where a score of 0 represents the most impaired while a score of 2 represents independence. The total is calculated by adding the score for each individual activity, the lowest possible score is 0 and the highest possible score is 28. The higher the score the better the more mobile the participant is. This measure will be taken after the second campaign has been completed.
Time frame: Week 18
Population: To complete this test, the participant must have a certain level of mobility. Out of the 14 participants in the System + Fall Prevention First, then Fall Prevention cohort, 5 couldn't complete the test and 1 participant out of the 13 in the 'Fall Prevention first, then System +Fall Prevention' cohort that could not complete the test.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| System + Fall Prevention First, Then Fall Prevention | Performance Oriented Mobility Assessment | 17 units on a scale | Standard Deviation 6.8 |
| Fall Prevention First, Then System +Fall Prevention | Performance Oriented Mobility Assessment | 19 units on a scale | Standard Deviation 7.6 |
Primary
Performance Oriented Mobility Assessment
The Performance Oriented Mobility Assessment Tool is a simple, easily administered test that measures a resident's gait and balance. The test is scored on the resident's ability to perform specific tasks as either 0, 1 or 2 where a score of 0 represents the most impaired while a score of 2 represents independence. The total is calculated by adding the score for each individual activity, the lowest possible score is 0 and the highest possible score is 28. The higher the score the better the more mobile the participant is. This will give us a baseline value for the participants.
Time frame: Baseline
Population: To complete this test, the participant must have a certain level of mobility. Out of the 14 participants in the System + Fall Prevention First, then Fall Prevention cohort, 4 couldn't complete the test.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| System + Fall Prevention First, Then Fall Prevention | Performance Oriented Mobility Assessment | 19.6 units on a scale | Standard Deviation 2.9 |
| Fall Prevention First, Then System +Fall Prevention | Performance Oriented Mobility Assessment | 21.6 units on a scale | Standard Deviation 3.7 |
Primary
Protocol Adherence
Determine the feasibility of a future randomized controlled trial to evaluate the impact on balance and mobility of motivating reminiscence technology using the jDome BikeAround system for adults in long term care. Feasibility will be determined by the number of residents to complied with the protocol during their respective campaign by using the jDome BikeAround system 3 times a week.
Time frame: Week 18
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| System + Fall Prevention First, Then Fall Prevention | Protocol Adherence | 2 Participants |
| Fall Prevention First, Then System +Fall Prevention | Protocol Adherence | 4 Participants |
Secondary
2 Minute Walk Test
Distance participant can walk without assistance for 2 minutes measured from the starting position.
Time frame: Baseline
Population: Due to the inability to ambulate for 2 minutes independently, in the arm System + Fall Prevention First, then Fall Prevention 4 residents were unable to complete the test and 2 residents in the Fall Prevention first, then System +Fall Prevention were unable to complete the test.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| System + Fall Prevention First, Then Fall Prevention | 2 Minute Walk Test | 60.9 Meter | Standard Deviation 26.5 |
| Fall Prevention First, Then System +Fall Prevention | 2 Minute Walk Test | 84.7 Meter | Standard Deviation 55.1 |
Secondary
2 Minute Walk Test
Distance participant can walk without assistance for 2 minutes measured from the starting position.
Time frame: 12 Week
Population: Due to the inability to ambulate for 2 minutes independently, in the arm System + Fall Prevention First, then Fall Prevention 4 residents were unable to complete the test and 2 residents in the Fall Prevention first, then System +Fall Prevention were unable to complete the test.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| System + Fall Prevention First, Then Fall Prevention | 2 Minute Walk Test | 70.7 Meter | Standard Deviation 27.1 |
| Fall Prevention First, Then System +Fall Prevention | 2 Minute Walk Test | 68.6 Meter | Standard Deviation 31.8 |
Secondary
2 Minute Walk Test
Distance participant can walk without assistance for 2 minutes measured from the starting position.
Time frame: 18 Week
Population: Due to the inability to ambulate for 2 minutes independently, in the arm System + Fall Prevention First, then Fall Prevention 4 residents were unable to complete the test and 2 residents in the Fall Prevention first, then System +Fall Prevention were unable to complete the test.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| System + Fall Prevention First, Then Fall Prevention | 2 Minute Walk Test | 54.5 Meter | Standard Deviation 32.5 |
| Fall Prevention First, Then System +Fall Prevention | 2 Minute Walk Test | 67.6 Meter | Standard Deviation 27.1 |
Secondary
2 Minute Walk Test
Distance participant can walk without assistance for 2 minutes measured from the starting position.
Time frame: 6 Week
Population: Due to the inability to ambulate for 2 minutes independently, in the arm System + Fall Prevention First, then Fall Prevention 4 residents were unable to complete the test and 2 residents in the Fall Prevention first, then System +Fall Prevention were unable to complete the test.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| System + Fall Prevention First, Then Fall Prevention | 2 Minute Walk Test | 72.4 Meter | Standard Deviation 9.1 |
| Fall Prevention First, Then System +Fall Prevention | 2 Minute Walk Test | 67.6 Meter | Standard Deviation 27.1 |
Secondary
Knee Range of Motion Test
Test that asses the range of motion of a participant's knee
Time frame: Baseline
Population: 2 participants in the Fall Prevention first, then System +Fall Prevention could not have their knee range of motion measures.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| System + Fall Prevention First, Then Fall Prevention | Knee Range of Motion Test | Left Knee Extension | -3.2 Degrees | Standard Deviation 5.8 |
| System + Fall Prevention First, Then Fall Prevention | Knee Range of Motion Test | Right Knee Extension | -3.6 Degrees | Standard Deviation 8.5 |
| System + Fall Prevention First, Then Fall Prevention | Knee Range of Motion Test | Left Knee Flexion | 111.6 Degrees | Standard Deviation 12.4 |
| System + Fall Prevention First, Then Fall Prevention | Knee Range of Motion Test | Right Knee Flexion | 107.2 Degrees | Standard Deviation 17.8 |
| Fall Prevention First, Then System +Fall Prevention | Knee Range of Motion Test | Right Knee Flexion | 106.1 Degrees | Standard Deviation 13.7 |
| Fall Prevention First, Then System +Fall Prevention | Knee Range of Motion Test | Left Knee Extension | -2.9 Degrees | Standard Deviation 4.3 |
| Fall Prevention First, Then System +Fall Prevention | Knee Range of Motion Test | Left Knee Flexion | 109.3 Degrees | Standard Deviation 12.6 |
| Fall Prevention First, Then System +Fall Prevention | Knee Range of Motion Test | Right Knee Extension | -2.7 Degrees | Standard Deviation 4.2 |
Secondary
Knee Range of Motion Test
Test that asses the range of motion of a participant's knee
Time frame: 12 weeks
Population: One participants in the System + Fall Prevention First, then Fall Prevention could not have their knee range of motion measures.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| System + Fall Prevention First, Then Fall Prevention | Knee Range of Motion Test | Left Knee Extension | 0 Degrees | Standard Deviation 6.9 |
| System + Fall Prevention First, Then Fall Prevention | Knee Range of Motion Test | Right Knee Extension | -2.3 Degrees | Standard Deviation 8.3 |
| System + Fall Prevention First, Then Fall Prevention | Knee Range of Motion Test | Left Knee Flexion | 118.8 Degrees | Standard Deviation 11 |
| System + Fall Prevention First, Then Fall Prevention | Knee Range of Motion Test | Right Knee Flexion | 116.5 Degrees | Standard Deviation 13.8 |
| Fall Prevention First, Then System +Fall Prevention | Knee Range of Motion Test | Right Knee Flexion | 116.7 Degrees | Standard Deviation 16.3 |
| Fall Prevention First, Then System +Fall Prevention | Knee Range of Motion Test | Left Knee Extension | -1.25 Degrees | Standard Deviation 4.3 |
| Fall Prevention First, Then System +Fall Prevention | Knee Range of Motion Test | Left Knee Flexion | 116.5 Degrees | Standard Deviation 15.7 |
| Fall Prevention First, Then System +Fall Prevention | Knee Range of Motion Test | Right Knee Extension | -1.7 Degrees | Standard Deviation 5.8 |
Secondary
Knee Range of Motion Test
Test that asses the range of motion of a participant's knee
Time frame: 18 weeks
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| System + Fall Prevention First, Then Fall Prevention | Knee Range of Motion Test | Left Knee Extension | 0 Degrees | Standard Deviation 0 |
| System + Fall Prevention First, Then Fall Prevention | Knee Range of Motion Test | Right Knee Extension | -0.7 Degrees | Standard Deviation 2.7 |
| System + Fall Prevention First, Then Fall Prevention | Knee Range of Motion Test | Left Knee Flexion | 110.4 Degrees | Standard Deviation 13.4 |
| System + Fall Prevention First, Then Fall Prevention | Knee Range of Motion Test | Right Knee Flexion | 111.4 Degrees | Standard Deviation 11.3 |
| Fall Prevention First, Then System +Fall Prevention | Knee Range of Motion Test | Right Knee Flexion | 108.8 Degrees | Standard Deviation 11.2 |
| Fall Prevention First, Then System +Fall Prevention | Knee Range of Motion Test | Left Knee Extension | 0 Degrees | Standard Deviation 0 |
| Fall Prevention First, Then System +Fall Prevention | Knee Range of Motion Test | Left Knee Flexion | 111.9 Degrees | Standard Deviation 10.7 |
| Fall Prevention First, Then System +Fall Prevention | Knee Range of Motion Test | Right Knee Extension | -3.5 Degrees | Standard Deviation 7.7 |
Secondary
Knee Range of Motion Test
Test that asses the range of motion of a participant's knee
Time frame: 6 weeks
Population: 2 participants in the Fall Prevention first, then System +Fall Prevention could not have their knee range of motion measures.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| System + Fall Prevention First, Then Fall Prevention | Knee Range of Motion Test | Left Knee Extension | -1.4 Degrees | Standard Deviation 5.3 |
| System + Fall Prevention First, Then Fall Prevention | Knee Range of Motion Test | Right Knee Extension | -2.1 Degrees | Standard Deviation 8 |
| System + Fall Prevention First, Then Fall Prevention | Knee Range of Motion Test | Left Knee Flexion | 114.6 Degrees | Standard Deviation 16.6 |
| System + Fall Prevention First, Then Fall Prevention | Knee Range of Motion Test | Right Knee Flexion | 115.7 Degrees | Standard Deviation 14.7 |
| Fall Prevention First, Then System +Fall Prevention | Knee Range of Motion Test | Right Knee Flexion | 116.7 Degrees | Standard Deviation 9.8 |
| Fall Prevention First, Then System +Fall Prevention | Knee Range of Motion Test | Left Knee Extension | -5 Degrees | Standard Deviation 8.5 |
| Fall Prevention First, Then System +Fall Prevention | Knee Range of Motion Test | Left Knee Flexion | 115.0 Degrees | Standard Deviation 9.5 |
| Fall Prevention First, Then System +Fall Prevention | Knee Range of Motion Test | Right Knee Extension | -4.2 Degrees | Standard Deviation 7.6 |