Aging With Long Term Physical Disabilities

Physical Disability Clinical Trial

Official title:

Building Capacity to Improve Community Participation for People Aging With Long-Term Disability Through Evidence-Based Strategies

Clinical Trial Details — Status: Active, not recruiting

Administrative data

• NCT number: NCT04589988
• Other study ID #: 201710186
• Status: Active, not recruiting
• Phase: N/A
• Start date: November 4, 2020
• Est. completion date: March 2024

Study information

• Verified date: July 2023
• Source: Washington University School of Medicine
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The purpose of this study is to determine the feasibility and efficacy of an adapted evidence-based program (REBIL) to reduce barriers to community participation and remove fall hazards at home for adults aging with physical disabilities.

Description:

Investigators will test the working hypothesis that the adapted program, focused on resolving environmental barriers, removing fall hazards, and building self-management skills in the home and community, will be feasible and superior to usual care for daily activity performance and participation outcomes in adults aging with physical disabilities.

Recruitment information / eligibility

• Status: Active, not recruiting
• Enrollment: 50
• Est. completion date: March 2024
• Est. primary completion date: March 2024
• Accepts healthy volunteers: No
• Gender: All
• Age group: 45 Years to 65 Years

Eligibility

Inclusion Criteria:

• Age 45-65 years

• Self-report of difficulty with at least 2 daily activities using the Older Adult Retirement Survey Activities of Daily Living (OARS ADL) scale

• onset of a physical disability 5 years prior to participation (e.g., spinal cord injury (SCI), cerebral palsy, post-polio syndrome, stroke, amputation).

• live within 60 miles of the research lab

Exclusion Criteria:

• Currently institutionalized.

Related Conditions & MeSH terms

• Physical Disability

Intervention

Behavioral:
• Removing Environmental Barriers to Independent Living (REBIL)
REBIL is a complex intervention with two essential components: (1) removing environmental barriers and home hazards in the home tailored to the participant's unique abilities and limitations and (2) strategy training with the participant to help participant to be able to identify barriers in the home and community and identify potential resources and strategies to remove the barriers. Treatment includes one assessment session and four 75-minute visits in the home with an occupational therapist over 8 weeks, followed by a 6 -month assessment session by a blinded rater.
• Waitlist Attentional Control
The waitlist attentional control group will receive an initial assessment session then four 75 minute interview visits from an occupational therapy graduate assistant, followed by a 6-month assessment session by a blinded rater. After the 6-month follow-up is completed this group will receive the REBIL intervention.

Locations

Country	Name	City	State
United States	Washington University School of Medicine	Saint Louis	Missouri

Sponsors (2)

Lead Sponsor	Collaborator
Washington University School of Medicine	National Institute on Disability, Independent Living, and Rehabilitation Research

Country where clinical trial is conducted

United States, 

References & Publications (1)

Chen, S. W., Somerville, E., Devine, M., & Stark, S. (2022). A protocol for removing environmental barriers to independent living (REBIL): An adapted evidence-based occupational therapy intervention to increase community participation for individuals aging with long-term physical disabilities. British Journal of Occupational Therapy, 03080226221126901.

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	In-Home Occupational Performance Evaluation (I-HOPE)	The In-Home Occupational Performance Evaluation will be used to measure current activity patterns of participants, identify activities that are difficult but important to them, and identify the environmental barriers that influence those activities (person-environment fit). Activity score: minimum value .5, maximum value 1, where a higher score indicates fewer problematic activities. Barrier scores: minimum value 0, maximum value 5, with higher scores indicating greater influence of barriers on activity.	Change from baseline to 6-month follow up
Primary	Reintegration to Normal Living Index (RNLI)	The Reintegration to Normal Living Index is a disability-related quality-of life-instrument that will be used to measure participants' satisfaction with their home and community participation and has been validated on a population of community-dwelling individuals with chronic conditions. It uses an 11-item, 10 point visual analog scale with higher scores indicating greater reintegration to normal living.	Change from baseline and 6-month follow-up
Primary	Westmead Home Safety Assessment (WeHSA) Short Form	Environmental fall hazards	Change from baseline to 6-month follow up
Secondary	Fall Prevention Strategy Survey (FPSS)	The Fall Prevention Strategy Survey is a self-report instrument addressing protective behaviors related to fall risk among adults. It is an 11-item survey, scores range from 0 to 22 with higher scores indicating use of more fall prevention strategies.	Change from baseline and 6-month follow-up
Secondary	Nine Participation Domain Measures	Descriptive information on activity participation and types of help needed; activities in four areas of participation (routines, recreation, responsibilities, and relationships)	Change from baseline and 6-month follow-up
Secondary	Falls	Participants will report monthly on the number of falls they had.	6 months