scholarly journals An Interactive Home-Based Cognitive-Motor Step Training Program to Reduce Fall Risk in Older Adults: Qualitative Descriptive Study of Older Adults’ Experiences and Requirements

JMIR Aging ◽  
10.2196/11975 ◽  
2018 ◽  
Vol 1 (2) ◽  
pp. e11975 ◽  
Author(s):  
Trinidad Valenzuela ◽  
Husna Razee ◽  
Daniel Schoene ◽  
Stephen Ronald Lord ◽  
Kim Delbaere
2018 ◽  
Author(s):  
Trinidad Valenzuela ◽  
Husna Razee ◽  
Daniel Schoene ◽  
Stephen Ronald Lord ◽  
Kim Delbaere

BACKGROUND Falls are a major contributor to the burden of disease in older adults. Home-based exercise programs are effective in reducing the rate and risk of falls in older adults. However, adherence to home-based exercise programs is low, limiting the efficacy of interventions. The implementation of technology-based exercise programs for older adults to use at home may increase exercise adherence and, thus, the effectiveness of fall prevention interventions. More information about older adults’ experiences when using technologies at home is needed to enable the design of programs that are tailored to older adults’ needs. OBJECTIVE This study aimed to (1) explore older adults’ experiences using SureStep, an interactive cognitive-motor step training program to reduce fall risk unsupervised at home; (2) explore program features that older adults found encouraged program uptake and adherence; (3) identify usability issues encountered by older adults when using the program; and (4) provide guidance for the design of a future technology-based exercise program tailored to older adults to use at home as a fall prevention strategy. METHODS This study was part of a larger randomized controlled trial. The qualitative portion of the study and the focus of this paper used a qualitative descriptive design. Data collectors conducted structured, open-ended in-person interviews with study participants who were randomly allocated to use SureStep at home for 4 months. All interviews were audiotaped and ranged from 45 to 60 min. Thematic analysis was used to analyze collected data. This study was guided by Pender’s Health Promotion Model. RESULTS Overall, 24 older adults aged 70 to 97 years were interviewed. Findings suggest older adults are open to use technology-based exercise programs at home, and in the context of optimizing adherence to home-based exercise programs for the prevention of falls, findings suggest that program developers should develop exercise programs in ways that provide older adults with a fun and enjoyable experience (thus increasing intrinsic motivation to exercise), focus on improving outcomes that are significant to older adults (thus increasing self-determined extrinsic motivation), offer challenging yet attainable exercises (thus increasing perceived self-competence), provide positive feedback on performance (thus increasing self-efficacy), and are easy to use (thus reducing perceived barriers to technology use). CONCLUSIONS This study provides important considerations when designing technology-based programs so they are tailored to the needs of older adults, increasing both usability and acceptability of programs and potentially enhancing exercise participation and long-term adherence to fall prevention interventions. Program uptake and adherence seem to be influenced by (1) older adults’ perceived benefits of undertaking the program, (2) whether the program is stimulating, and (3) the perceived barriers to exercise and technology use. Older adults shared important recommendations for future development of technologies for older adults to use at home.


2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Meghan Ambrens ◽  
Melinda Stanners ◽  
Trinidad Valenzuela ◽  
Husna Razee ◽  
Jessica Chow ◽  
...  

1994 ◽  
Vol 69 (4) ◽  
pp. 316-320 ◽  
Author(s):  
Alan E. Mikesky ◽  
Robert Topp ◽  
Janet K. Wigglesworth ◽  
David M. Harsha ◽  
Jeffrey E. Edwards

Author(s):  
F. Saucedo ◽  
E.A. Chavez ◽  
H.R. Vanderhoof ◽  
J.D. Eggleston

Background: Falling is the second leading cause of injury-related death worldwide and is a leading cause of injury among older adults. Whole-body vibration has been used to improve fall risk factors in older adults. No study has assessed if vibration benefits can be retained over time. Objectives: The aims of this study were to examine if six-weeks of whole-body vibration could improve fall risk factors and to assess if benefits associated with the training program could be sustained two months following the final training session. Design and Setting: Repeated measures randomized controlled design. Participants: Twenty-four independent living older adults were recruited and were randomly assigned to the WBV or control group. Intervention: Participants performed three sessions of whole-body vibration training per week with a vibration frequency of 20Hz or with only an audio recording of the vibration noise. An assessment of fall risk factors was performed prior to, immediately following, and two-months after the completion of the training program. Main Outcome Measures: Fall risk factors including functional capacity, mobility, strength, and walking speed were assessed pre-training, post-training, and two-months post-training. Results: Seventeen participants completed the study. No improvements (p<0.05) between groups were found in the measures of physical performance. Conclusions: Findings revealed that six weeks of whole-body vibration is not effective in improving fall risk factors or producing benefits post-training.


2020 ◽  
Author(s):  
Xiao Liu ◽  
Jean Wei Ting Seah ◽  
Benedict Wei Jun Pang ◽  
Mary Ann Tsao ◽  
Falong Gu ◽  
...  

Abstract Background: Frailty is a common geriatric syndrome, characterized by reduced physiologic reserve and increased vulnerability to stressors, due to cumulative decline in multiple physiological systems. We studied the feasibility of a community-delivered Baduanjin (BDJ) training program among pre-frail/frail community-dwelling older people. We examined 1) safety (adverse events), physical and psychological effects; and 2) feasibility of recruitment, retention, adherence; recruitment efforts and any program challenges, so as to inform future studies.Methods: Our study was a single arm pre-post study in a community setting. Sixteen week group BDJ training (2x/week in the first 4 weeks, and 3x/week thereafter) co-designed and implemented by community-based providers in Singapore. Recruitment, attendance and adverse events were recorded throughout the training. A participants’ survey was also administered after the training program. Effects of the intervention on physical and functional outcomes (hand grip strength, knee extension strength, Time Up and Go (TUG), Physiological Profile Assessment (PPA), 30-second Sit-to-Stand test, 6-meter fast gait speed test), frailty outcomes (frailty score and status), and other outcomes (Maastricht Questionnaire (MQ), Fall Efficacy Scale (FES), Montreal Cognitive Assessment (MoCA), Geriatric Depression Scale (GDS), and EQ-5D-5L) were examined before and after the program.Results: Of 31 older adults screened to be frail, 15 met inclusion criteria and 3 refused participation, resulting in 12 older adults (9 women) enrolled into the program. During the program, one participant was hospitalized (unrelated to BDJ training) and the other 11 (aged 77±6 years; 2 frail, 9 prefrail at baseline) completed the program with average overall attendance of 89%. Most (89%) of the 44 training sessions had attendance >80%. The program received positive feedback with no training-related adverse events. Participants either reversed (n=2) or maintained (n=9) their frailty statuses. There post-training outcomes in hand grip strength, knee extension strength, TUG , MQ , FES , MoCA , GDS and EQ-5D-5L index score appeared to be better. The reduction of frailty and PPA fall risk scores were of moderate-to-large effect size. Conclusions: Community-delivered BDJ training program was safe and feasible for prefrail/frail older adults with the potential to improve physical and cognitive function, reduce fall risk, improve psychological well-being, and reverse frailty status.


2020 ◽  
Author(s):  
Xiao Liu ◽  
Jean Wei Ting Seah ◽  
Benedict Wei Jun Pang ◽  
Mary Ann Tsao ◽  
Falong Gu ◽  
...  

Abstract Background Frailty is a common geriatric syndrome, characterized by reduced physiologic reserve and increased vulnerability to stressors, due to cumulative decline in multiple physiological systems. Our study examined the feasibility and effects of a community-delivered BDJ training program among pre-frail/frail community-dwelling older people in preparation for a randomised control implementation study.Methods Our study was a single arm feasibility study in community setting. Eleven participants (aged 77 ± 6 years; 2 frail, 9 prefrail at baseline) completed the program. Sixteen week group BDJ training co-designed and implemented by community-based providers in Singapore. Recruitment, attendance and adverse events were recorded throughout the training. A participants’ survey was also administered after the training program. Effects of the intervention on physical and functional outcomes (hand grip strength, knee extension strength, Time Up and Go (TUG), Physiological Profile Assessment (PPA), 30-second Sit-to-Stand test, 6-meter fast gait speed test), frailty outcomes (frailty score and status), and other outcomes (Maastricht Questionnaire (MQ), Fall Efficacy Scale (FES), Montreal Cognitive Assessment (MoCA), Geriatric Depression Scale (GDS), and EQ-5D-5L) were examined before and after the program.Results Of 31 older adults screened to be frail, 15 met inclusion criteria and 3 refused participation resulting in 12 older adults enrolled in the program. One participant was hospitalized (unrelated to BDJ training) and the other 11 completed the program with average overall attendance of 89%. Most (89%) of the 44 training sessions had attendance > 80%. The program received positive feedback with no training-related adverse events. Participants either reversed (n = 2) or maintained (n = 9) their frailty statuses. There were significant within-group post-training improvements in hand grip strength (p = 0.013), knee extension strength (p = 0.048), TUG (p = 0.018), MQ (p = 0.001), FES (p = 0.022), MoCA (p = 0.014), GDS (p = 0.028), EQ-5D-5L index score (p = 0.029). The reduction of frailty score and PPA fall risk score showed moderate-to-large effect size.Conclusions Community-delivered BDJ training program was safe and feasible for prefrail/frail older adults with the potential to improve physical and cognitive function, reduce fall risk, improve psychological well-being, and reverse frailty status.


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