Postural Balance Clinical Trial
Official title:
Feasibility of a Tablet-based Fall Prevention Program for Older Adults
There are many exercise approaches that have demonstrated effectiveness in reducing falls and fall risk in community-dwelling older adults. The Otago Exercise Program is one such program. The Otago Exercise Program has been tested in four randomized controlled trials and one controlled multi-center trial and was found to reduce falls in older men and women. The focus of the Otago Exercise Program is on improving strength and balance with a home-based balance exercise program. The goal of the current study is to evaluate whether a self-administered, tablet-based version of the Otago fall prevention program is both feasible and effective for reducing fall risk and improving balance in community-dwelling older adults.
Twenty community-dwelling older adults who satisfy the study criteria will be recruited to
participate in this study. This group of participants will be selected to represent the
general community-dwelling older adults as much as possible. They will demonstrate a range of
ability in terms of their balance and mobility in which some are non-fallers and some
fallers. All adults who meet the inclusion/exclusion criteria and have access to the internet
via wireless connection will be included.
Participants will be consented for the research study and will be assessed initially, after 1
month of exercise and at the end of 2 months of exercise. Assessment will include
questionnaires about health history, including falls, physical activity, balance confidence
and system usability. Participants will also complete strength, balance and mobility physical
performance tests. Age, sex, presence of comorbidities, medication list, functional
abilities, balance confidence, fear of fall behavior and fall history will be assessed by
questionnaire. Usability of the tablet-based questionnaire will be assessed by questionnaire.
Participants will be tested with standard clinical tests of balance and gait.
Participants will be closely supervised by a Doctor of Physical Therapy (DPT) student during
training in how to use the exercise program. Participants will complete a full set of
exercises with the tablet in the presence of the DPT student. The DPT student will determine
whether participants are safe with the program before allowing them to perform the program on
their own at home. If the research team determines that a participant is unable to exercise
safely on his/her own he/she will be withdrawn from the study.
The tablet-based, video game exercise program is called Health in Motion and was developed by
Blue Marble Game Company. Health in Motion was tested in a pilot study and found to reduce
fall risk in 8 of 15 older participants without any adverse events. Participants will
complete 2 months of the home-based balance exercise program using the Health in Motion app.
Participants will be asked to perform the exercises for 30 minutes 3x/week. Participants will
be asked to perform the exercise program for 2 months.
Performance scores from the clinical gait and balance measures obtained during the initial
visit will be compared to the performance scores obtained after 1 month and 2 months of
performing the exercise program. We hypothesize that balance and gait will improve following
2 months of performing the tablet-based fall prevention exercise program at home. The
assessments performed by the DPT students and by the participant using the app will be
compared. We hypothesize that the scores from self-assessment will closely correlate to the
students' assessment. The system usability score will be examined to understand issues
associated with using technology. We hypothesize that older adults will enjoy performing the
exercises using the tablet format.
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