Near-falls in Singapore community-dwelling older adults: a feasibility study

Abstract Background A near-fall is defined as a loss of balance that would result in a fall if sufficient balance recovery manoeuvres are not executed. Compared to falls, near-falls and its associated balance recovery manoeuvres have been understudied. Older adults may not recognise a near-fall or identify the use of their balance recovery manoeuvres to prevent a fall. The consensus on the methods to collect near-fall data is lacking. The primary objective of this study was to determine the feasibility of recruitment and retention. Secondary objectives were to establish evidence that Singapore community-dwelling older adults can identify near-falls and associated balance recovery manoeuvres. Texting and calling methods were explored as reporting methods. Methods This study took place in Singapore (September to October 2019). Participants were healthy, community-dwelling adults aged 65 or older. Recruitment was done through poster advertisement, and all participants gave informed consent. Participants attended a briefing session and reported their near-fall or fall incidence over 21 days using either daily texting or calling. The primary outcome measures were the recruitment rate, retention rate, preferred modes for data reporting and ability to report near-falls or falls. Secondary outcomes included the self-reported incidence of falls and near-falls. Results Thirty older adults were recruited in 5 weeks. All participants completed the study. They understood near-fall concepts and were able to report the occurrence and relevant balance recovery manoeuvres used to prevent a fall. 87% (26/30) chose to text while 13% (4/30) selected calling as their reporting method. One actual fall (0.16%) out of 630 responses was reported. Thirty-six incidents (5.7%) of near-falls were recorded. Sixteen participants (53.3%) experienced near-falls and half of this group experienced two or more near-falls. The use of reach-to-grasp strategy (36%), compensatory stepping (52.8%), and other body regions (11.2%) were used to prevent the fall. Conclusions The study provided evidence that studying near-falls in Singapore community-dwelling older adults is feasible and can be applied to a large-scale study. Recruitment and retention rates were good. Older adults were able to identify near-falls and balance recovery manoeuvres. Both texting and calling were feasible reporting methods, but texting was preferred. Trial registration ClinicalTrials identifier: NCT04087551. Registered on September 12, 2019

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Near-Falls in Singapore Community-Dwelling Older Adults: A Feasibility Study

10.21203/rs.3.rs-20883/v2 ◽

2020 ◽

Author(s):

SHAWN LENG-HSIEN SOH ◽

CHEE-WEE TAN ◽

JUDITH LANE ◽

TING-TING YEH ◽

BENJAMIN SOON

Keyword(s):

Older Adults ◽

Retention Rate ◽

Community Dwelling ◽

Retention Rates ◽

Reach To Grasp ◽

Balance Recovery ◽

Recruitment And Retention ◽

Body Regions ◽

Near Falls ◽

Community Dwelling Older Adults

Abstract BackgroundA near-fall is defined as a loss of balance that would result in a fall if sufficient balance recovery manoeuvres are not executed. Compared to falls, near-falls and its associated balance recovery manoeuvres have been understudied. Older adults may not recognise a near-fall or identify the use of their balance recovery manoeuvres to prevent a fall. The consensus on the methods to collect near-fall data is lacking. The primary objective of this study was to determine the feasibility of recruitment and retention. Secondary objectives were to establish evidence that Singapore community-dwelling older adults can identify near-falls and associated balance recovery manoeuvres. Texting and calling methods were explored as reporting methods.MethodsThis study took place in Singapore (September to October 2019). Participants were healthy, community-dwelling adults aged 65 or older. Recruitment was done through poster advertisement, and all participants gave informed consent. Participants attended a briefing session and reported their near-fall or fall incidence over 21 days using either daily texting or calling. The primary outcome measures were the recruitment rate, retention rate, preferred modes for data reporting and ability to report near-falls or falls. Secondary outcomes included the self-reported incidence of falls and near-falls.ResultsThirty older adults were recruited in five weeks. All participants completed the study. They understood near-fall concepts and were able to report the occurrence and relevant balance recovery manoeuvres used to prevent a fall. 87% (26/30) chose to text while 13% (4/30) selected calling as their reporting method. One actual fall (0.16%) out of 630 responses was reported. Thirty-six incidents (5.7%) of near-falls were recorded. Sixteen participants (53.3%) experienced near-falls and half of this group experienced two or more near-falls. Use of reach-to-grasp strategy (36%), compensatory stepping (52.8%), and other body regions (11.2%) were used to prevent the fall. ConclusionsThe study provided evidence that studying near-falls in Singapore community-dwelling older adults is feasible and can be applied to a large-scale study. Recruitment and retention rates were good. Older adults were able to identify near-falls and balance recovery manoeuvres. Both texting and calling were feasible reporting methods, but texting was preferred. Trial registrationClinicalTrials identifier: NCT04087551. Registered 12th September 2019

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Near Falls in the Singapore Community-Dwelling Older Adults: A Feasibility Study

10.21203/rs.3.rs-20883/v1 ◽

2020 ◽

Author(s):

SHAWN LENG-HSIEN SOH ◽

JUDITH LANE ◽

BENJAMIN SOON ◽

TING-TING YEH ◽

CHEE-WEE TAN

Keyword(s):

Older Adults ◽

Retention Rate ◽

Community Dwelling ◽

Retention Rates ◽

Reach To Grasp ◽

Balance Recovery ◽

Recruitment And Retention ◽

Body Regions ◽

Near Falls ◽

Community Dwelling Older Adults

Abstract Background A near fall is defined as a loss of balance that would result in a fall if sufficient balance recovery manoeuvres are not executed. Compared to falls, near falls and its associated balance recovery manoeuvres have been understudied. Older adults may not recognise a near fall or identify the use of their balance recovery manoeuvres to prevent a fall. The consensus on the methods to collect near fall data is lacking. The primary objective of this study was to determine the feasibility of recruitment and retention. Secondary objectives were to establish evidence that Singapore community-dwelling older adults can identify near falls and associated balance recovery manoeuvres. Texting and phoning methods were explored as reporting methods. Methods This study took place in Singapore (September to October 2019). Participants were healthy, community-dwelling adults aged 65 or older. Recruitment was done through poster advertisement, and all participants gave informed consent. Participants attended a briefing session and reported their near fall or fall incidence over 21 days using either daily texting or phoning. The primary outcome measures were the recruitment rate, retention rate, preferred modes for data reporting and ability to report near falls or falls. Secondary outcomes included the self-reported incidence of falls and near falls. Results Thirty older adults were recruited in five weeks. All participants completed the study. They understood near fall concepts and were able to report the occurrence and relevant balance recovery manoeuvres used to prevent a fall. 87% (26/30) chose to text while 13% (4/30) selected phoning as their reporting method. One actual fall (0.16%) out of 630 responses was reported. Thirty-six incidents (5.7%) of near falls were recorded. Sixteen participants (53.3%) experienced near falls and half of this group experienced two or more near falls. Use of reach-to-grasp strategy (36%), compensatory stepping (52.8%), and other body regions (11.2%) were used to prevent the fall. Conclusions The study provided evidence that studying near falls in Singapore community-dwelling older adults is feasible and can be applied to a large-scale study. Recruitment and retention rates were good. Older adults were able to identify near falls and balance recovery manoeuvres. Both texting and phoning were feasible reporting methods, but texting was preferred.

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Promoting Generalized Learning in Balance Recovery Interventions

Brain Sciences ◽

10.3390/brainsci11030402 ◽

2021 ◽

Vol 11 (3) ◽

pp. 402

Author(s):

Sara A. Harper ◽

Anne Z. Beethe ◽

Christopher J. Dakin ◽

David A. E. Bolton

Keyword(s):

Older Adults ◽

Motor Learning ◽

Daily Life ◽

Balance Training ◽

Community Dwelling ◽

Specific Training ◽

Balance Recovery ◽

Parallel Streams ◽

Postural Perturbations ◽

Community Dwelling Older Adults

Recent studies have shown balance recovery can be enhanced via task-specific training, referred to as perturbation-based balance training (PBT). These interventions rely on principles of motor learning where repeated exposure to task-relevant postural perturbations results in more effective compensatory balance responses. Evidence indicates that compensatory responses trained using PBT can be retained for many months and can lead to a reduction in falls in community-dwelling older adults. A notable shortcoming with PBT is that it does not transfer well to similar but contextually different scenarios (e.g., falling sideways versus a forward trip). Given that it is not feasible to train all conditions in which someone could fall, this limited transfer presents a conundrum; namely, how do we best use PBT to appropriately equip people to deal with the enormous variety of fall-inducing scenarios encountered in daily life? In this perspective article, we draw from fields of research that explore how general learning can be promoted. From this, we propose a series of methods, gleaned from parallel streams of research, to inform and hopefully optimize this emerging field where people receive training to specifically improve their balance reactions.

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LONELINESS AND PHYSICAL ACTIVITY IN OLDER AGE: RESULTS OF THE RANDOMISED CONTROLLED STUDY OF PHYSICAL ACTIVITY INTERVENTION FOR LONELINESS (PAIL) IN COMMUNITY-DWELLING OLDER ADULTS

SCIENCE AND SPORT: current trends ◽

10.36028/2308-8826-2020-8-4-99-107 ◽

2020 ◽

Vol 8 (4) ◽

pp. 99-107

Author(s):

Anastasia Shvedko

Keyword(s):

Physical Activity ◽

Older Adults ◽

At Risk ◽

Physical Activity Intervention ◽

Retention Rate ◽

Community Dwelling ◽

Feasibility Trial ◽

Controlled Study ◽

Study Objective ◽

Community Dwelling Older Adults

Study objective. The aim of this study was to examine the feasibility of a Physical Activity Intervention for Loneliness (PAIL) in community-dwelling older adults at risk of loneliness. Methods. Study design was a 12-week randomized controlled feasibility trial (RCT). Participants were 25 (mean age 68.5(8.05) years, range 60-92) healthy, inactive, community-dwelling older adults at risk for loneliness. The intervention consisted of group outdoor walking sessions with health education workshops once weekly, with a wait-list control condition. Estimation of recruitment, retention and adherence were feasibility outcomes. Body mass index, blood pressure, physical activity, and psychosocial variables were secondary outcomes. Results. Forty-eight participants were recruited over 4 months with a recruitment rate of 52.1% (25/48); 52% (25/48) met the inclusion criteria and 100% (25/25) were randomized into the intervention (N=12) and wait-listed (WL) control groups (N=13). At 12 weeks, 10/12 (83.3%; 95% CI 55.20 to 95.30) intervention and 10/13 (76.9%; 95% CI 49.74 to 91.82) control participants completed final assessments. The average attendance rate was 69.2% for the intervention group (range 25% – 91.7%) and 55% (range 25% – 91.7%) among controls. The a priori recruitment criteria for progression was not met. The retention rate satisfied the criteria of the study. No serious adverse events occurred. Conclusions. Community-dwelling older adults at risk of loneliness can safely participate in physical activity intervention for loneliness. However, to progress into a large-scale RCT, the design and methodology would need to be changed.

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