Khow Kareeann Sok-Fun, Dollard Joanne, Bray Kathy, Smyth Carla, Chehade Mellick, Theou Olga, Visvanathan Renuka
National Health and Medical Research Council Centre for Research Excellence in Frailty and Healthy Ageing, Adelaide, South Australia Australia.
2Adelaide Geriatrics Training and Research with Aged Care (G-TRAC Centre), Discipline of Medicine, Adelaide Medical School, University of Adelaide, 61 Silkes Road Paradise, Adelaide, South Australia SA 5075 Australia.
Pilot Feasibility Stud. 2018 Nov 17;4:173. doi: 10.1186/s40814-018-0366-5. eCollection 2018.
Sedentary behaviour and falls are important interrelated health issues in older people. One in three people aged 65 years and above fall at least once a year and sedentary behaviour has been identified as one of the risk factors for falls. Studies have shown that the duration of sedentary time increases with age. These dual problems need to be addressed effectively as the ageing population grows. Accelerometers enable accurate measurement of sedentary time. This study aims to establish the feasibility and effect of an individualized goal-setting health coaching intervention using feedback initially from an accelerometer and then pedometer over a period of 12 weeks (intervention) compared with providing a one-off advice through a brochure (control), on sedentary time in older people with a recent fall or at risk of one.
A single-blinded randomized controlled feasibility trial involving 80 community-dwelling people aged 65 years and above will be conducted with 40 randomized to the intervention and another 40 to control. Primary outcomes will be the feasibility of the intervention and change in total sedentary time at 12 and 24 weeks. Secondary outcomes include a change in fear of falling based on the falls efficacy scale, gait speed, self-reported sedentary time, the proportion of fallers and number of falls. Four focus groups (two from each arm) will be conducted at the end of the study to evaluate the feasibility and effectiveness of this intervention. Feasibility findings will be primarily descriptive. Mean group differences will be examined using independent samples test for normally distributed data and nonparametric tests (Kruskal-Wallis and Mann-Whitney ) for non-normally distributed data. Differences in frequency of variables will be compared using chi-square test. Analysis of variance (ANOVA) will be used to test the post-intervention difference between the two groups at 12 and 24 weeks.
The trial will address a key gap in evidence about sedentary behaviour and falls amongst older people and will evaluate the feasibility of an intervention that could be implemented within the primary health care settings.
Australian New Zealand Clinical Trials Registry 12617001186347, Registered 11 August 2017.
久坐行为和跌倒在老年人中是重要的相互关联的健康问题。65岁及以上的人群中,每三人就有一人每年至少跌倒一次,久坐行为已被确定为跌倒的风险因素之一。研究表明,久坐时间会随着年龄增长而增加。随着老年人口的增加,这两个双重问题需要得到有效解决。加速度计能够准确测量久坐时间。本研究旨在确定一种个性化目标设定的健康指导干预措施的可行性和效果,该干预措施最初使用加速度计反馈,然后在12周(干预期)内使用计步器反馈,与通过宣传册提供一次性建议(对照组)相比,对近期有跌倒或有跌倒风险的老年人的久坐时间的影响。
将进行一项单盲随机对照可行性试验,纳入80名65岁及以上的社区居民,其中40人随机分配至干预组,另外40人分配至对照组。主要结局将是干预措施的可行性以及12周和24周时总久坐时间的变化。次要结局包括基于跌倒效能量表的跌倒恐惧变化、步态速度、自我报告的久坐时间、跌倒者比例和跌倒次数。研究结束时将进行四个焦点小组(每组两个),以评估该干预措施的可行性和有效性。可行性研究结果将主要是描述性的。对于正态分布数据,将使用独立样本t检验来检验组间均值差异;对于非正态分布数据,将使用非参数检验(Kruskal-Wallis和Mann-Whitney检验)。变量频率差异将使用卡方检验进行比较。方差分析(ANOVA)将用于检验两组在12周和24周干预后的差异。
该试验将填补老年人久坐行为和跌倒方面证据的关键空白,并将评估可在初级卫生保健环境中实施的干预措施的可行性。
澳大利亚新西兰临床试验注册中心12617001186347,2017年8月11日注册。