Fall Prevention Clinical Trial
Official title:
Effects of a Fall Preventive Exercise Program on Intrinsic Fall Risk Factors in Healthy Older Adults.
Background With increasing age neuromuscular deficits (e.g., sarcopenia) may result in
impaired physical performance and an increased risk for falls. Prominent intrinsic fall-risk
factors are age-related decreases in balance and strength / power performance as well as
cognitive decline. Additional studies are needed to develop specifically tailored exercise
programs for older adults that can easily be implemented into clinical practice. Thus, the
objective of the present trial is to assess the effects of a fall prevention program that
was developed by an interdisciplinary expert panel on measures of balance, strength / power,
body composition, cognition, psychosocial well-being, and falls self-efficacy in healthy
older adults. Additionally, the time-related effects of detraining are tested.
Methods/Design Healthy old people (N = 66) between the age of 65 to 80 years will
participate in this trial. The testing protocol comprises tests for the assessment of static
/ dynamic steady-state balance (i.e., Sharpened Romberg Test, instrumented gait analysis),
proactive balance (i.e., Functional Reach Test; Timed Up and Go Test), reactive balance
(i.e., perturbation test during bipedal stance; Push and Release Test), strength (i.e., hand
grip strength test; Chair Stand Test), and power (i.e., Stair Climb Power Test). Further,
body composition will be analysed using a bioelectrical impedance analysis system. In
addition, questionnaires for the assessment of psychosocial (i.e., World Health Organisation
Quality of Life Assessment-Bref), cognitive (i.e., Mini Mental State Examination), and fall
risk determinants (i.e., Fall Efficacy Scale - International) will be included in the study
protocol. Participants will be randomized into two intervention groups or the control /
waiting group. After baseline measures, participants in the intervention groups will conduct
a 12-week balance and strength / power exercise intervention 3 times per week, with each
training session lasting 30 min (without warm-up and cool-down). One intervention group will
complete a supervised training program (2x supervised training per week / 1x home training
per week), while the other intervention group will complete a training after the same
protocol that is home-based (3x home training per week) and controlled by phone calls every
two weeks. Post-tests will be conducted right after the intervention period. Additionally,
detraining effects will be measured 12 weeks after program cessation. The control group /
waiting group will not participate in any specific intervention during the experimental
period, but will receive the extensive supervised program after the experimental period.
Discussion It is expected that particularly the supervised combination of balance and
strength / power training will improve performance in variables of balance, strength /
power, body composition, cognitive function, psychosocial well-being, and falls
self-efficacy of older adults. In addition, information regarding fall risk assessment,
detraining effects, and supervision of training will be provided. Further, training-induced
health-relevant changes, such as improved performance in activities of daily living,
cognitive function, and quality of life, as well as a reduced risk for falls may help to
lower costs in the health care system. Finally, practitioners, therapists, and instructors
will be provided with a scientifically evaluated, feasible, safe, and easy-to-administer
exercise program for fall prevention.
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