Shubert Consulting, Chapel Hill, North Carolina.
Reflexion Health, San Diego, California.
J Geriatr Phys Ther. 2020 Jul/Sep;43(3):120-127. doi: 10.1519/JPT.0000000000000203.
The Otago Exercise Program (OEP) is effective at preventing falls and fall-related injuries. The resources and personnel required for program delivery and challenges inherent in monitoring participant adherence and compliance pose significant barriers to increasing the number of older adults participating in the OEP. Alternative delivery systems using virtual platforms may pose a solution. The purposes of this article were to (1) describe the "Stand Tall" intervention, a virtual translation of the OEP; (2) describe Stand Tall participant characteristics and fall-related risk at baseline; and (3) identify changes in physical performance measures associated with fall risk from baseline to 8-week follow-up.
This was a quasi-experimental, single-group, pretest-posttest design. Forty-two older adults at risk for falls were recruited. Participants were oriented to Stand Tall by study personnel and then monitored and progressed virtually with face to face check-ins. Participants independently logged in and completed a prescribed a set of exercises 3 times a week for 30 minutes for a total of 8 weeks.
The average participant age was 75.0 (9.1) years and self-reported 2.3 (1.7) chronic conditions. There were more men than women (52.4%) in the study. Participants were primarily non-Hispanic white (90.5%), had a college education (61.9), 40% reported falling in the past 6 months, and 60% screened positive for mild cognitive impairment. Participants were beginning to show decline in function with average single-leg stance less than 10 seconds and 30-second chair rise scores below normative values. Participants demonstrated high adherence rates (>88%) and significant improvements in physical performance measures associated with fall risk. These results may be limited to a less frail population and the study was not powered to demonstrate a reduction in falls.
Results support that an avatar-delivered version of the OEP is effective, feasible, viable, and enjoyable for community-dwelling older adults. These types of platforms should be considered as potential mechanisms to increase availability of fall prevention programs.
奥塔戈锻炼计划（OEP）在预防跌倒和与跌倒相关的伤害方面非常有效。该计划的交付需要资源和人员，而且监测参与者的依从性和合规性也存在固有挑战，这对增加参与 OEP 的老年人数量构成了重大障碍。使用虚拟平台的替代交付系统可能是一种解决方案。本文的目的是：（1）描述“站高”干预措施，即 OEP 的虚拟翻译；（2）描述“站高”参与者的特征和基线时的跌倒相关风险；（3）确定从基线到 8 周随访时与跌倒风险相关的身体表现测量值的变化。
这是一项准实验性、单组、前后测试设计。招募了 42 名有跌倒风险的老年人。研究人员向参与者介绍“站高”，然后通过面对面的检查进行虚拟监测和进展。参与者独立登录并每周完成规定的 3 次 30 分钟的锻炼，总共 8 周。
参与者的平均年龄为 75.0（9.1）岁，自述有 2.3（1.7）种慢性疾病。研究中男性多于女性（52.4%）。参与者主要是非西班牙裔白人（90.5%），受过大学教育（61.9%），40%报告在过去 6 个月内跌倒，60%筛查出轻度认知障碍。参与者的功能开始下降，单腿站立时间不足 10 秒，30 秒内坐起次数低于正常值。参与者表现出较高的依从率（>88%），与跌倒风险相关的身体表现测量值显著改善。这些结果可能仅限于身体状况较差的人群，而且该研究没有足够的能力来证明跌倒的减少。
结果表明，OEP 的虚拟版本对社区居住的老年人是有效、可行、可行和令人愉快的。这些类型的平台应被视为增加跌倒预防计划可用性的潜在机制。
