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 (Preprint)

2018 ◽  
Author(s):  
Trinidad Valenzuela ◽  
Husna Razee ◽  
Daniel Schoene ◽  
Stephen Ronald Lord ◽  
Kim Delbaere
Keyword(s):  
Older Adults ◽  
Fall Prevention ◽  
Technology Use ◽  
Fall Risk ◽  
Perceived Barriers ◽  
Exercise Programs ◽  
Home Based ◽  
Prevention Interventions ◽  
Qualitative Descriptive ◽  
At Home

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.

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
Keyword(s):  
Older Adults ◽  
Training Program ◽  
Fall Risk ◽  
Descriptive Study ◽  
Home Based ◽  
Qualitative Descriptive

scholarly journals 111 Disparities between Actual and Perceived Fall Risk Affect Participation in 5 Fall Prevention Interventions

2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv18-iv27
Author(s):  
Pey June Tan ◽  
Silvia Sim ◽  
Noor Hafizah Ismail ◽  
Jagadish Mallya ◽  
Angelique Chan ◽  
...  
Keyword(s):  
Older Adults ◽  
Fall Prevention ◽  
Fall Risk ◽  
Help Seeking ◽  
Fear Of Falling ◽  
Community Dwelling ◽  
Falls Prevention ◽  
Risk Level ◽  
Prevention Interventions ◽  
Aware Group

Abstract Introduction Older adults have been found to under- or overestimate their fall risk. However, no studies have investigated implications on help-seeking behaviours in falls prevention. This study examines how disparities between actual and perceived fall risk affects participation in 5 fall prevention interventions among community-dwelling older adults in Singapore. Methods This was a cross-sectional survey of a nationally representative sample of community-dwelling adults aged ≥60 years in Singapore identified by stratified random sampling. Having previous falls in the past 12 months (faller/non-faller) indicated actual fall risk. Level of fear-of-falling (cut-off ≥23 on 16-item Falls Efficacy Scale International) was used as perceived fall risk (high/low). Four profiles based on combinations of actual and perceived risk were associated with participation in 5 fall prevention interventions in a multiple logistic regression. The model was adjusted for age, gender, ≥2 comorbidities and knowledge that the intervention is to prevent falls. Results Final analysis included 549 older adults (mean age 70.6±6.9 years, 61% females). Majority (46%) were in the Vigorous group (no falls, low fear), 35% Anxious (no falls, high fear), 11% Frail Aware (falls, high fear) and 8% Stoics (falls, low fear). Only those in Anxious and Frail Aware group were significantly more likely to have talked to a healthcare professional on strategies to avoid falls [OR 1.8 (1.1-3.1) and 3.2 (1.6-6.4) respectively] and made home modifications [OR 1.9 (1.3-2.8) and 2.0 (1.1-3.6)] after adjustments. No association was found for participation in exercise, medication review and falls education. Discussion Individual profiles with high fear-of-falling component have different help-seeking behaviours compared to those with low fear regardless of history of falls. However, individuals in Frail Aware group have higher likelihood to uptake the interventions compared to Anxious group. Future research should examine other drivers of behaviour that will influence participation in other interventions.

scholarly journals Implications of Older Adult Attitudes Toward the Preventability of Falls for Health Promotion

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 774-774
Author(s):  
Gwen Bergen ◽  
Janice Mark ◽  
Ankita Henry
Keyword(s):  
Older Adults ◽  
Health Promotion ◽  
Fall Prevention ◽  
Fall Risk ◽  
Stage Of Change ◽  
Descriptive Statistics ◽  
Evidence Based ◽  
Preventive Actions ◽  
Prevention Interventions ◽  
Action Stage

Abstract Older adults’ behavioral stage of change for adopting fall prevention interventions, and their use of evidence-based interventions are not well understood. A survey was administered to older adults (65 years+) (n=1063) to understand their stage of change and fall prevention behaviors. Descriptive statistics were calculated and logistic regression conducted to determine factors most related to stage. The distribution of subjects by stage was precontemplation (17%), contemplation (2%), preparation (5%), action (15%), and maintenance (61%). The strongest variable related to being in an action stage (preparation, action, maintenance) was screening positively for fall risk (Risk Ratio: 8.7, 95% CI: 5.4, 14.1). The most common preventive actions for those in an action stage were taking Vitamin D (37%), and having vision tested (30%). Older adults at risk for a fall are ready to take action to prevent falls; health promotion should focus on increasing knowledge and use of different evidence-based interventions.

scholarly journals Identifying Fall Risk Predictors by Monitoring Daily Activities at Home Using a Depth Sensor Coupled to Machine Learning Algorithms

Sensors ◽  
2021 ◽  
Vol 21 (6) ◽  
pp. 1957
Author(s):  
Amandine Dubois ◽  
Titus Bihl ◽  
Jean-Pierre Bresciani
Keyword(s):  
Machine Learning ◽  
Fall Prevention ◽  
Fall Risk ◽  
Learning Algorithms ◽  
Step Length ◽  
Machine Learning Algorithms ◽  
Daily Activities ◽  
Sitting Time ◽  
Behavioral Parameters ◽  
At Home

Because of population ageing, fall prevention represents a human, economic, and social issue. Currently, fall-risk is assessed infrequently, and usually only after the first fall occurrence. Home monitoring could improve fall prevention. Our aim was to monitor daily activities at home in order to identify the behavioral parameters that best discriminate high fall risk from low fall risk individuals. Microsoft Kinect sensors were placed in the room of 30 patients temporarily residing in a rehabilitation center. The sensors captured the patients’ movements while they were going about their daily activities. Different behavioral parameters, such as speed to sit down, gait speed or total sitting time were extracted and analyzed combining statistical and machine learning algorithms. Our algorithms classified the patients according to their estimated fall risk. The automatic fall risk assessment performed by the algorithms was then benchmarked against fall risk assessments performed by clinicians using the Tinetti test and the Timed Up and Go test. Step length, sit-stand transition and total sitting time were the most discriminant parameters to classify patients according to their fall risk. Coupling step length to the speed required to stand up or the total sitting time gave rise to an error-less classification of the patients, i.e., to the same classification as that of the clinicians. A monitoring system extracting step length and sit-stand transitions at home could complement the clinicians’ assessment toolkit and improve fall prevention.

scholarly journals Perceptions of Care Among Older Adults Identified as Fall Risk During a Hospital Stay

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 139-139
Author(s):  
Barbara King
Keyword(s):  
Older Adults ◽  
Hospital Stay ◽  
Older Adult ◽  
Fall Prevention ◽  
Fall Risk ◽  
Medical Center ◽  
Academic Medical Center ◽  
Common Strategy ◽  
Open Coding ◽  
Perceptions Of Care

Abstract In-hospital falls are a significant clinical, legal and regulatory problem. The Centers for Medicare and Medicaid no longer reimburse hospitals for falls that result in injury, adding increase pressure on acute care settings to prevent falls. Additionally, evidence-based practice recommendations for fall prevention in hospitals do not exist, thus leaving administrators to create their own programs. One common strategy used by hospital providers to prevent falls is to restrict patient mobility. Little information on how older adult patients experience fall prevention during a hospital stay has been published. The purpose of this study was to understand perceptions of care among older adults identified as fall risk during a hospital stay. This qualitative study utilized inductive content analysis. Older adults (N=20) from a large academic medical center in the Midwest were recruited to participate in one-to one in-depth interviews. Open coding, categorization and abstraction was used to analyze the data. Three main categories were identified that summarized the older adult patient perception of hospitalization: Act of Caring, something they received from staff, provide to staff or provided to self; Being Restricted in movement resulting in either accepting or rejecting the restriction and Being Freed at discharge, often being told “just be careful”. Older adult identified as fall risk described being restricted in movement during a hospital stay. Many passively accepted this restriction even though they felt a lack of movement would be harmful to them. Additional research on the patient experience with fall prevention is needed.

scholarly journals Student-Led Fall Prevention Care Management Reduced Fall Risks at Assisted Living Facilities

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 238-238
Author(s):  
Hiroko Kiyoshi-Teo ◽  
Claire McKinley-Yoder ◽  
Erin Lemon ◽  
Olivia Ochoa
Keyword(s):  
Older Adults ◽  
Assisted Living ◽  
Fall Prevention ◽  
Fall Risk ◽  
Care Management ◽  
Assisted Living Facilities ◽  
Care Needs ◽  
Term Care ◽  
Fall Risks ◽  
The Impact

Abstract Older adults in residential care settings are four times more likely than those not living in care facilities to experience falls. Yet, fall prevention efforts at long-term care settings are under-resourced, under-regulated, and under-studied. To address this gap, we developed and studied the impact of a specialty clinical, Fall Prevention Care Management (FPCM), for nursing students to decrease older adults’ fall risks. We enrolled assisted living residents that facility liaison identified as being high fall risk (fall rates or fall risk were not tracked at the study sites) and MOCA ≥15, in 2 assisted living facilities in Northwest USA. Participants received weekly, 1-hour, individual, semi-structured, Motivational Interviewing-based care management visits by same students over 6 visits. Changes in fall risks were measured by the CDC STEADI assessment (unsteadiness & worry), Falls Self-Efficacy Scale International-Short (FESI-S), and Falls Behavioral Scale (FAB). Twenty-five residents completed the study. Students addressed the following (multiple responses possible): emotional needs (n=23), improved motivation to prevent falls (n=21), and individualized education/coaching (i.e., exercise, mobility aids) (n=10-17). FESI-S score improved from 16.0 to 14.4 (p=.001; decreased fear. FAB score improved from 2.94 to 3.10 (p=.05; more frequent fall prevention behaviors). Frequency of those who felt steady while standing or walking increased (24% to 40%, p=.07) and those who did not worry about falling increased (20% to 36%, p=.08). FPCM clinical offered valuable opportunity to address unmet care needs of older adults to reduce fall risks.

scholarly journals A Systematic Review on Detraining Effects after Balance and Fall Prevention Interventions

2021 ◽  
Vol 10 (20) ◽  
pp. 4656
Author(s):  
Shaghayegh Modaberi ◽  
Esmaeel Saemi ◽  
Peter A. Federolf ◽  
Steven van Andel
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Fall Prevention ◽  
Intervention Programs ◽  
Positive Effects ◽  
Specific Focus ◽  
The World ◽  
Prevention Interventions ◽  
Review Study

Since the COVID-19 pandemic hit, lockdowns have been implemented to fight off infections in countries around the world. Whilst this measure is without a doubt effective against spreading infection, it might also decrease participation in exercise. For older adults, exercise is particularly important in the prevention of falls, and sudden detraining because of a lockdown or due to other causes might have detrimental consequences. This systematic review study aims to assess what is currently known on detraining effects for balance outcomes. Nine studies were included within this review. Results suggest that detraining effects could already be significant as early as 4 weeks after stopping the intervention. Programs that specifically focus on improving balance were more robust against detraining, with most positive effects still being present after 8 weeks. However, even with a specific focus on balance, studies started to show some signs of detraining. The current study is limited by the low number of included studies in the review, indicating a need to further confirm these results.

scholarly journals Feasibility and Acceptability of Remote Physical Exercise Programs to Prevent Mobility Loss in Pre-Disabled Older Adults during Isolation Periods Such as the COVID-19 Pandemic

2021 ◽  
Author(s):  
F. Buckinx ◽  
M. Aubertin-Leheudre ◽  
R. Daoust ◽  
S. Hegg ◽  
D. Martel ◽  
...  
Keyword(s):  
Older Adults ◽  
Physical Exercise ◽  
Web Technology ◽  
Total Rate ◽  
Exercise Programs ◽  
Home Program ◽  
Level Of Satisfaction ◽  
The Web ◽  
At Home

AbstractThis study aimed to assess the feasibility and acceptability of remote physical exercise (PE) to prevent mobility loss among pre-disabled older adults during the COVID-19 lockdowns.Participants followed a 12-week PE remote program in Zoom© supervised groups (Web-Ex group, n=11) or phone-supervised individual booklet-based home-program (Booklet group, n=33).The total rate of adherence was 82.5% in the Web-Ex group and 85.8% in the Booklet group. The level of satisfaction was « a lot » for 60% of the participants in the Web-ex group and for 37.9% of those included in the Booklet group. Respectively 10% and 31% of the participants rated the difficulty as « low » in the web-ex and Booklet groups.Remote physical exercise using a web technology or booklets at home with regular and personalized follow-up during the lockdown was feasible and acceptable among pre-disabled seniors.

Audiologist's Role Within the Changing Climate of Fall Prevention: Are We Ready?

2016 ◽  
Vol 1 (8) ◽  
pp. 4-13
Author(s):  
Alaina M. Bassett ◽  
Julie A. Honaker
Keyword(s):  
Older Adults ◽  
Risk Assessment ◽  
Fall Prevention ◽  
Fall Risk ◽  
Reporting System ◽  
Risk Assessments ◽  
Mandated Reporting ◽  
Medicare Beneficiaries ◽  
Medical Settings ◽  
Quality Reporting

This article is aimed to address the vestibular audiologist's role in assessing patient fall risk as tasked by Medicare. With implementation of the Physician's Quality Reporting System (PQRS), audiologists performing standard measures of the vestibular battery must report on measures #154: Falls: Risk assessment and #155: Falls: Plan of care for Medicare beneficiaries. Mandated reporting of this measure includes vestibular audiologists in the multidisciplinary medical management of fall prevention in older adults. In order for audiologists to provide the most relevant care, it is important to evaluate the current fall risk assessments in medical settings, how the implementation of these measures can be structured within the audiology clinic, and challenges audiologist may face with implementation.

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