Cognitive Impairment, High Fall Risk
Conditions
Keywords
neurorehabilitation, function, mobility
Brief summary
Falls represent the leading cause of hospitalization, nursing home admissions, disability and mortality for older adults with annual healthcare costs over $50 billion. Older Veterans with cognitive impairment are at an increased risk of falls and injurious fall. The purpose of this study is to test the effects of 6 weeks of a virtual tele-neurorehabilitation intervention on fall prevention, functional mobility, strength, cognition and performance of activities of daily living. Participants will be one of 28 participants in the VA Maryland Health Care System. Participation in the study is voluntary and the research will be conducted at the VA Maryland Health Care System. The entire study will take approximately 2 years to complete. Subject's participation in the study will last 3 months.
Detailed description
Falls represent the leading cause of hospitalization, nursing home admissions, disability and mortality for older adults with annual healthcare costs over $50 billion. Older Veterans with cognitive impairment are at an increased risk of falls and injurious fall. This pilot aims to determine the feasibility and effectiveness of a virtual neurorehabilitation intervention to improve functional mobility, strength, cognition and performance of activities of daily living in a cohort of 28 older Veterans with cognitive impairment. The overall goals are to improve fall risk in a population for which traditional rehabilitation programs may not be feasible. The investigators envision a neurorehabilitation model that can be readily exportable and widely implemented at other VA facilities with minimal resources as an enhancement to clinical care for fall prevention.
Interventions
BEHAVIORALVirtual Neurophysiological Rehabilitation
Combining active observation (AO) and motor imagery (MI)
Sponsors
VA Office of Research and Development
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
OTHER
Masking
NONE
Intervention model description
There will be no group assignments in this pilot study and all participants will receive the intervention.
Eligibility
Sex/Gender
ALL
Age
65 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* community dwelling * at risk for falls as indicated by answering yes to one of the following: 1) have you fallen in the last year? 2) four square step test time \> 15 seconds 3) are you worried about falling? * cognitive impairment as indicated by either 1) clinical diagnosis 2) MOCA score of 10-25 * able to provide written consent
Exclusion criteria
* MOCA \<10 or clinically diagnosed dementia * inability to participate in a virtual intervention * serious visual or hearing problems * stroke with hemiparesis or severe neurological disease * current use of medications affecting mental state * current active participation in programs related to balance or mobility
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Program Adherence | 6 weeks | Number of sessions attended |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Four Square Step Test time | 6 weeks | Time to complete the Four Square Step Test |
| Change in 30 second chair stand test | 6 weeks | Number of unassisted chair rises completed in 30 seconds |
Countries
United States
Contacts
CONTACTAlyssa D Stookey, PhD MS
CONTACTOdessa R Addison, PhD DPT
PRINCIPAL_INVESTIGATORAlyssa D Stookey, PhD MS
Baltimore VA Medical Center VA Maryland Health Care System, Baltimore, MD
Outcome results
None listed