Pilot Outcomes of a Multicomponent Fall Risk Program Integrated Into Daily Lives of Community-Dwelling Older Adults

Objectives: To evaluate whether a fall prevention intervention reduces fall risk in older adults who have previously fallen. Design: Randomized controlled pilot trial. Setting: Participants’ homes. Intervention: LIVE-LiFE, adapted from Lifestyle-Intervention Functional Exercise (LiFE) integrates strength and balance training into daily habits in eight visits over 12 weeks. The adaptations to LiFE were to also provide (a) US$500 in home safety changes, (b) vision contrast screening and referral, and (c) medication recommendations. Control condition consisted of fall prevention materials and individualized fall risk summary. Measurement: Timed Up and Go (TUG) and Tandem stand. Falls efficacy, feasibility, and acceptability of the intervention. Results: Sample ( N = 37) was 65% female, 65% White, and average 77 years. Compared with the control group, each outcome improved in the intervention. The LIVE-LiFE intervention had a large effect (1.1) for tandem stand, moderate (0.5) in falls efficacy, and small (0.1) in the TUG. Conclusion: Simultaneously addressing preventable fall risk factors is feasible.

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PREVENTING FALLS AMONG OLDER FALLERS: LIVE-LIFE

Innovation in Aging ◽

10.1093/geroni/igz038.3329 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S913-S913

Author(s):

Sarah L Szanton ◽

Lindy Clemson ◽

Minhui Liu ◽

Laura N Gitlin ◽

David L Roth ◽

...

Keyword(s):

Fall Prevention ◽

Fall Risk ◽

Pilot Trial ◽

Balance Training ◽

Primary Care Providers ◽

Control Group ◽

Care Providers ◽

Timed Up And Go ◽

Prevention Intervention ◽

Fall Prevention Intervention

Abstract OBJECTIVES: To evaluate whether a fall prevention intervention, adapted from the LiFE program, reduces fall risk in older adults who have previously fallen. DESIGN: Randomized controlled pilot trial SETTING: Participants’ homes INTERVENTION: LIVE-LIFE is an occupational therapy delivered fall prevention intervention that integrates strength and balance training into daily habits in 8 visits over 12 weeks. The intervention also provides 1) up to $500 in home safety changes prioritized by the participants 2) vision contrast screening and referral, and 3) personalized fall risk medication recommendations to Primary Care Providers (PCP) from a Pharmacist. This multi-component intervention was compared to a control condition consisting of CDC fall prevention materials and an individualized fall risk summary. MEASUREMENT: Primary outcome: Fall risk measured by Timed Up and Go (TUG) and Tandem stand. Secondary outcomes: Falls efficacy, feasibility and acceptability of the intervention. RESULTS: The sample of 37 people was 65% female, 65% white and an average 77 years old. Two were lost to follow up (95% retention). Compared to the control group, the mean of each outcome improved in the intervention. The LIVE-LiFE intervention had a large effect size (1.1) for amount of time study participants could hold a tandem stand, a moderate effect (0.5) in falls efficacy, and a small effect (0.1) in the TUG. CONCLUSION: LIVE-LIFE was acceptable to participants, feasible to provide, and averaged large to small effect sizes. Simultaneously addressing preventable fall risk factors is feasible and should be investigated due to the growing population at risk for falls.

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Comparing the Effects of Single-Task versus Dual-Task Balance Training on Gait Smoothness and Functional Balance in Community-Dwelling Older Adults: A Randomized Controlled Trial

Journal of Aging and Physical Activity ◽

10.1123/japa.2020-0523 ◽

2021 ◽

pp. 1-8

Author(s):

Samira Javadpour ◽

Ehsan Sinaei ◽

Reza Salehi ◽

Shahla Zahednejad ◽

Alireza Motealleh

Keyword(s):

Older Adults ◽

Dual Task ◽

Controlled Trial ◽

Balance Training ◽

Community Dwelling ◽

Control Group ◽

Timed Up And Go ◽

Training Groups ◽

Significant Difference ◽

Community Dwelling Older Adults

To compare the effects of single- versus dual-task balance training on the gait smoothness and balance of community-dwelling older adults, 69 volunteers were randomized to single-, dual-task training, and control (no intervention) groups. Exercises were received in 18 sessions through 6 weeks. The gait smoothness was measured by the harmonic ratio of trunk accelerations using a triaxial accelerometer. Balance performance was assessed through the Fullerton Advanced Balance scale, Timed Up and Go test, Activities-specific Balance Confidence, and gait speed. After the trial, all variables improved significantly in the training groups. Moreover, differences in the mean change of all variables, except the Timed Up and Go test, were statistically significant between the interventional groups and the control group, but no significant difference was reported between the two training groups. This study suggests that balance training can improve gait smoothness as well as balance status in healthy older adults.

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Effect of Tai Chi Fall Prevention Program for Community-dwelling Older Adults on Physical and Psychological Fall Risk Factors

10.14257/astl.2016.132.17 ◽

2016 ◽

Author(s):

Young-Ju Jee

Keyword(s):

Risk Factors ◽

Older Adults ◽

Fall Prevention ◽

Prevention Program ◽

Fall Risk ◽

Tai Chi ◽

Community Dwelling ◽

Fall Prevention Program ◽

Fall Risk Factors ◽

Community Dwelling Older Adults

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Community Fall Prevention Programs: Comparing Three InSTEP Models by Level of Intensity

Journal of Aging and Physical Activity ◽

10.1123/japa.2012-0344 ◽

2014 ◽

Vol 22 (3) ◽

pp. 372-379 ◽

Cited By ~ 3

Author(s):

B. Josea Kramer ◽

Beth Creekmur ◽

Michael N. Mitchell ◽

Debra J. Rose ◽

Jon Pynoos ◽

...

Keyword(s):

Older Adults ◽

Fall Prevention ◽

Fall Risk ◽

Community Dwelling ◽

Medical Risk ◽

Fall Risk Factors ◽

Within Subjects ◽

Prevention Center ◽

Gait Function ◽

Community Dwelling Older Adults

The Fall Prevention Center of Excellence designed three progressive-intensity fall prevention program models, Increasing Stability Through Evaluation and Practice (InSTEP), to reduce risk in community-dwelling older adults. Each model included physical activity, medical risk, and home safety components and was implemented as a 12-week program for small class sizes (12–15 people) in community and senior centers. Change in fall rates and fall risk factors was assessed using a battery of performance tests, self-reports of function, and fall diaries in a 3-group within-subjects (N = 200) design measured at baseline, immediately postintervention, and at 3 and 9 months postintervention. Overall, participants experienced a reduction in falls, improved self-perception of gait and balance, and improved dynamic gait function. The medium-intensity InSTEP model signifcantly (p = .003) reduced self-reported falls in comparison with the other models. InSTEP is a feasible model for addressing fall risk reduction in community-dwelling older adults.

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127 Older Adults' Knowledge and Perceptions of Falls: A Mixed Methods Study

Age and Ageing ◽

10.1093/ageing/afz164.127 ◽

2019 ◽

Vol 48 (Supplement_4) ◽

pp. iv28-iv33

Author(s):

Cheah Ping Ng ◽

Devinder Kaur Ajit Singh ◽

Maw Pin Tan ◽

Saravana Kumar

Keyword(s):

Risk Factors ◽

Older Adults ◽

Fall Prevention ◽

Fall Risk ◽

Community Dwelling ◽

Limited Information ◽

Older Individuals ◽

Fall Risk Factors ◽

Global Issue ◽

Risk Of Falls

Abstract Introduction Falls is a global issue due to its devastating consequences and costs associated with fall injuries in older adults. There is limited information regarding knowledge and perceptions about falls among older individuals in Malaysia. The aim of this study was to assess knowledge and perceptions of falls among older adults. Methods A total of twenty-five (n=25) community dwelling older adults were invited to participate in this study (age range 61-83, median=73). Focus group discussions were conducted to explore older adults’ perceptions on falls, while the Fall Risk Assessment Questionnaire (FRAQ) was used to assess their knowledge on falls. Results Three themes emerged from the qualitative data, which were ‘Ageing and its association with falls’, ‘Reactions to a fall’ and ‘Knowledge of fall interventions’. The quantitative results showed that more than half of the participants considered themselves at the risk of falls (n=15, 60%). Older adults had better knowledge on behavioral and environmental (percentage of errors: 19.4%; 35.2%) compared to medical and medication related fall risk factors (percentage of errors: 55.2%; 57.33%). Discussion Older adults had both positive and negative views on ageing and falls. Some of the fall prevention strategies highlighted were in line with evidence-based recommendations. However, majority exhibit fall prevention behaviors that were largely based on their personal experiences. Older adults lacked the knowledge on medical related fall risk factors as these require understanding of various medical conditions and the related medications. Conclusion Education intervention emphasizing on ageing, medical and medication related fall risk factors should now be evaluated.

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Multisensory integration involved in the body perception of community-dwelling older adults

Scientific Reports ◽

10.1038/s41598-021-81121-x ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

M. Hide ◽

Y. Ito ◽

N. Kuroda ◽

M. Kanda ◽

W. Teramoto

Keyword(s):

Older Adults ◽

Multisensory Integration ◽

Fall Risk ◽

Community Dwelling ◽

The Body ◽

Risk Of Falling ◽

Body Perception ◽

Rubber Hand ◽

Timed Up And Go ◽

Community Dwelling Older Adults

AbstractThis study investigates how the multisensory integration in body perception changes with increasing age, and whether it is associated with older adults’ risk of falling. For this, the rubber hand illusion (RHI) and rubber foot illusion (RFI) were used. Twenty-eight community-dwelling older adults and 25 university students were recruited. They viewed a rubber hand or foot that was stimulated in synchrony or asynchrony with their own hidden hand or foot. The illusion was assessed by using a questionnaire, and measuring the proprioceptive drift and latency. The Timed Up and Go Test was used to classify the older adults into lower and higher fall-risk groups. No difference was observed in the RHI between the younger and older adults. However, several differences were observed in the RFI. Specifically, the older adults with a lower fall-risk hardly experienced the illusion, whereas those with a higher fall-risk experienced it with a shorter latency and no weaker than the younger adults. These results suggest that in older adults, the mechanism of multisensory integration for constructing body perception can change depending on the stimulated body parts, and that the risk of falling is associated with multisensory integration.

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Towards Using the Instrumented Timed Up-and-Go Test for Screening of Sensory System Performance for Balance Control in Older Adults

Sensors ◽

10.3390/s19030622 ◽

2019 ◽

Vol 19 (3) ◽

pp. 622 ◽

Cited By ~ 3

Author(s):

Thomas Gerhardy ◽

Katharina Gordt ◽

Carl-Philipp Jansen ◽

Michael Schwenk

Keyword(s):

Older Adults ◽

System Performance ◽

Fall Risk ◽

Balance Control ◽

Sensory System ◽

Sensory Systems ◽

Community Dwelling ◽

Functional Mobility ◽

Timed Up And Go ◽

Community Dwelling Older Adults

Background: Decreasing performance of the sensory systems’ for balance control, including the visual, somatosensory and vestibular system, is associated with increased fall risk in older adults. A smartphone-based version of the Timed Up-and-Go (mTUG) may allow screening sensory balance impairments through mTUG subphases. The association between mTUG subphases and sensory system performance is examined. Methods: Functional mobility of forty-one community-dwelling older adults (>55 years) was measured using a validated mTUG. Duration of mTUG and its subphases ‘sit-to-walk’, ‘walking’, ‘turning’, ‘turn-to-sit’ and ‘sit-down’ were extracted. Sensory systems’ performance was quantified by validated posturography during standing (30 s) under different conditions. Visual, somatosensory and vestibular control ratios (CR) were calculated from posturography and correlated with mTUG subphases. Results: Vestibular CR correlated with mTUG total time (r = 0.54; p < 0.01), subphases ‘walking’ (r = 0.56; p < 0.01), and ‘turning’ (r = 0.43; p = 0.01). Somatosensory CR correlated with mTUG total time (r = 0.52; p = 0.01), subphases ‘walking’ (r = 0.52; p < 0.01) and ‘turning’ (r = 0.44; p < 0.01). Conclusions: Supporting the proposed approach, results indicate an association between specific mTUG subphases and sensory system performance. mTUG subphases ‘walking’ and ‘turning’ may allow screening for sensory system deterioration. This is a first step towards an objective, detailed and expeditious balance control assessment, however needing validation in a larger study.

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Beneficial Effects of Interactive Physical-Cognitive Game-Based Training on Fall Risk and Cognitive Performance of Older Adults

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17176079 ◽

2020 ◽

Vol 17 (17) ◽

pp. 6079

Author(s):

Kochaphan Phirom ◽

Teerawat Kamnardsiri ◽

Somporn Sungkarat

Keyword(s):

Older Adults ◽

Cognitive Performance ◽

Fall Risk ◽

Intervention Group ◽

Significant Risk ◽

Community Dwelling ◽

Cognitive Outcome ◽

Timed Up And Go ◽

Cognitive Improvement ◽

Risk Factors For Falls

Physical and cognitive declines are significant risk factors for falls. Promising evidence suggests that combined physical-cognitive training would be an effective fall risk reduction and cognitive improvement intervention. However, a limited number of studies have been conducted and findings have been inconclusive. This study investigated the effects of interactive physical-cognitive game-based training on the fall risk and cognitive performance of older adults. Forty participants were randomly allocated to the intervention (n = 20) and control (n = 20) groups. Participants in the intervention group performed a 1 h session, 3 times a week for 12 weeks of the interactive physical-cognitive game-based training program. Fall risk (Physiological Profile Assessment, PPA; and Timed Up and Go, TUG) and cognitive outcome (Montreal Cognitive Assessment, MoCA) were assessed at pre- and post-intervention. Thirty-nine participants (mean age = 69.81 ± 3.78 years) completed the study (97.5%). At the end of the trial, participants in the intervention group demonstrated significant improvement in the PPA fall risk score (p = 0.015), postural sway (p = 0.005), MoCA score (p = 0.001), and TUG-dual task (p = 0.045) compared to controls. In conclusion, the interactive physical-cognitive, game-based training was effective in reducing physiological fall risk and improving cognitive function in community-dwelling older adults.

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EXPERIENCES AND FACILITATORS OF FALLS PREVENTION AMONG ETHNICALLY DIVERSE OLDER ADULTS: A QUALITATIVE STUDY

Innovation in Aging ◽

10.1093/geroni/igz038.3142 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S854-S854

Author(s):

Ladda Thiamwong ◽

Norma E Conner

Keyword(s):

Older Adults ◽

Fall Prevention ◽

Fall Risk ◽

Fear Of Falling ◽

Ethnically Diverse ◽

Role Identity ◽

Community Dwelling ◽

Falls Prevention ◽

Facilitators And Barriers ◽

And Behaviors

Abstract Background: Falls increase as people age and decrease the quality of life. Even though fall interventions have received great attention, fall incidence rates have still arisen. In order for older adults to reap the benefits of evidence-based fall interventions, a challenge of implementation in the real world and right context must be met. Understanding experiences, facilitators, and barriers of fall prevention among four major ethnic groups in the Unites States could be extremely valuable. Objective: The aim of this study was to describe experiences and highlight facilitators and barriers on fall and fear of falling interventions among ethnically diverse community-dwelling older adults. Methods: Four ethnically specified (African American, Asian, Hispanic and Non-Hispanic White) focus groups were conducted. A total of 28 older adults and four family caregivers were interviewed. Interviews covered experiences on falls and fear of falling, attitudes, factors, consequences, risk assessment, and interventions. Data were organized and analyzed with the NViVo software. Results: Falls related experiences and behaviors were multifaceted and varied. Three themes related to falls experiences and behaviors were identified, 1) falls prevention versus fear of falling amplification; 2) role identity, culture and family considerations; and 3) take care of you, take care of me. Facilitators of fall prevention were integration of individual learning within a group meeting, providing appropriate assistive devices and promoting environmental safety. Barriers were inconsistent fall risk assessments, low fall risk awareness and acknowledgment, and balance and visual impairment.

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