Caphri - Care and Public Health Research Institute and Department of Epidemiology Maastricht University, Leukerbad, Netherlands.
HES-SO Valais-Wallis, School of Health Sciences, Physiotherapy, Rathausstrasse 8, Leukerbad, VS, Switzerland.
BMC Geriatr. 2019 Jan 14;19(1):13. doi: 10.1186/s12877-018-1021-y.
Fall prevention interventions with home-based exercise programmes are effective to reduce the number and the rate of falls, by reducing risk factors. They improve balance, strength, function, physical activity, but it is known that older adults' exercise adherence declines over time. However, it is unclear which delivery-modalities of the home-based exercise programmes show the best adherence and the largest effect. We created a new home-based exercise programme, the Test-and-Exercise (T&E) programme, based on the concepts of self-efficacy and empowerment. Patients learn to build their own exercise programme with a mobile application, a brochure and cards, as well as with eight coaching sessions by physiotherapists. The main objective of this study is to compare the T&E programme with the Otago Exercise Programme and the recommendation-booklet and exercise-cards of Helsana regarding incidence of falls. Other outcomes are severity of falls, functional capacities, quality of life and exercise-adherence.
The design of this study is a Swiss multicentre assessor blind randomized controlled trial. A block-randomization, stratified in groups for age and risk of fall categories, will be used to allocate the participants to three groups. The targeted study sample consists of 405 older adults, ≥ 65 years of age, living in the community and evaluated as at "risk of falling". Experimental group will receive the T&E programme (N = 162). Second group will receive the Otago programme (N = 162) and the third group will receive the Helsana programme (N = 81). All interventions last six months. Blinded assessors will assess participants three times: at baseline before the start of the intervention, after six months of intervention and a final assessment after twelve months (six months of follow up).
Although home-based exercises programmes show positive effects in fall prevention in elderly persons, existing programmes do often not include patients in the decision-making process about exercise selection. In our programme the physiotherapist and the older adult work together to select the exercises; this collaboration helps to increase health literacy, pleasure of exercising, and empowers patients to be more autonomy.
ClinicalTrials.gov: NCT02926105 , First Posted: October 6, 2016, Last Update: November 11, 2016: Enrolment of the first participant.
通过降低风险因素，基于家庭的运动项目的防跌倒干预措施可以有效减少跌倒的数量和发生率。它们可以改善平衡、力量、功能和身体活动，但已知老年人的运动依从性会随着时间的推移而下降。然而，目前尚不清楚哪种基于家庭的运动项目的传递模式具有最佳的依从性和最大的效果。我们根据自我效能和赋权的概念，创建了一个新的基于家庭的运动项目，即测试与锻炼（T&E）项目。患者可以使用移动应用程序、小册子和卡片以及八次物理治疗师的辅导课程来学习制定自己的锻炼计划。本研究的主要目的是比较 T&E 项目与奥塔哥锻炼计划以及 Helsana 的推荐手册和锻炼卡在跌倒发生率方面的效果。其他结果包括跌倒的严重程度、功能能力、生活质量和运动依从性。
这项研究的设计是一项瑞士多中心评估者盲法随机对照试验。采用分组随机、按年龄和跌倒风险类别分层的方法，将参与者分配到三组。目标研究样本包括 405 名年龄在 65 岁及以上、居住在社区并被评估为“有跌倒风险”的老年人。实验组将接受 T&E 项目（N=162）。第二组将接受奥塔哥项目（N=162），第三组将接受 Helsana 项目（N=81）。所有干预措施持续六个月。盲法评估者将在基线（开始干预前）、干预六个月后和 12 个月后（六个月随访）进行三次评估。
虽然基于家庭的运动项目在预防老年人跌倒方面显示出积极的效果，但现有的项目通常不包括患者参与运动选择的决策过程。在我们的项目中，物理治疗师和老年人一起选择运动；这种合作有助于提高健康素养、锻炼的乐趣，并使患者更加自主。
ClinicalTrials.gov：NCT02926105，首次注册：2016 年 10 月 6 日，最后更新：2016 年 11 月 11 日：首例参与者的登记。
