Chen Szu-Wei, Somerville Emily, Devine Megen, Stark Susan
Washington University in St. Louis, School of Medicine, Program in Occupational Therapy, 4444 Forest Park Ave., St. Louis, MO 63108.
Br J Occup Ther. 2022;86(5):349-58. doi: 10.1177/03080226221126901.
People aging with long-term physical disabilities (PAwLTPD) are living longer and experiencing the challenges of aging, including the onset of secondary and age-related health conditions. PAwLTPD are at high risk of falls, fall injuries, diminished functional abilities, and compromised participation. However, no available programs support PAwLTPD to participate safely at home and in the community. The proposed study is to examine the feasibility and efficacy of an adapted intervention: Removing Environmental Barriers to Independent Living (REBIL).
METHOD/DESIGN: A single-blinded randomized controlled trial (RCT) will be conducted. Participants who are 45-65 years old; self-report difficulty with ≥2 daily activities; have had a physical disability for ≥5 years; and live within 60 miles of the research lab are eligible. All participants will receive an initial in-home evaluation before randomization. The treatment group will receive REBIL (total five visits), which is tailored. The waitlist control group will be offered the same intervention after 6-month follow-up. Expected outcomes are high acceptability, fidelity, and adherence; low safety risk; improved community participation and daily activities performance; and fewer environmental barriers and fall hazards.
Findings will serve as preliminary evidence for occupational therapy community practice. Outcomes will also inform future large, pragmatic trials.
ClinicalTrials.gov identifier NCT04589988.
患有长期身体残疾的老年人（PAwLTPD）寿命延长，同时面临衰老带来的挑战，包括继发性和与年龄相关的健康问题的出现。PAwLTPD跌倒、跌倒受伤、功能能力下降和参与受限的风险很高。然而，目前没有可用的项目支持PAwLTPD在家中和社区安全参与。拟进行的研究旨在检验一种适应性干预措施的可行性和有效性：消除独立生活的环境障碍（REBIL）。
方法/设计：将进行一项单盲随机对照试验（RCT）。符合条件的参与者年龄在45-65岁之间；自我报告在≥2项日常活动中有困难；身体残疾≥5年；居住在距研究实验室60英里范围内。所有参与者在随机分组前将接受一次初始的家庭评估。治疗组将接受量身定制的REBIL（共五次家访）。等待名单对照组将在6个月随访后接受相同的干预。预期结果是高可接受性、保真度和依从性；低安全风险；改善社区参与和日常活动表现；减少环境障碍和跌倒风险。
研究结果将作为职业治疗社区实践的初步证据。研究结果也将为未来大规模、务实的试验提供参考。
ClinicalTrials.gov标识符NCT04589988。
