HOLOBalance 远程康复系统与标准护理相比用于有跌倒风险的老年人的可行性和可接受性：HOLOBalance 评估员盲法平行随机对照研究。

Feasibility and acceptability of the HOLObalance telerehabilitation system compared with standard care for older adults at risk of falls: the HOLOBalance assessor blinded pilot randomised controlled study.

机构信息

Centre for Human and Applied Physiological Sciences, King's College London, London, UK.

Ear Institute, University College London, London, UK.

出版信息

Age Ageing. 2024 Oct 1;53(10). doi: 10.1093/ageing/afae214.

DOI:10.1093/ageing/afae214

PMID:39373575

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11457341/

Abstract

BACKGROUND

Falls have high socioeconomic costs. Information and communication technologies may support provision and monitoring of multisensory (MSR) physiotherapy programmes. The HOLOBalance platform used augmented reality holograms to provide patient-centred, individualised MSR.

OBJECTIVES

To determine the platform's safety, acceptability and feasibility, investigate functional gait and dynamic balance benefits and provide data for a definitive trial.

DESIGN AND SETTING

Single-blinded pilot randomised controlled feasibility study. Interventions were conducted at clinical sites or participants' homes in three European countries.

PARTICIPANTS

Community-dwelling older adults (median age 73 years; 64.2% female) at risk of falls were enrolled (May 2020-August 2021).

METHODS

Participants were randomised to an 8-week clinic or home-based telerehabilitation MSR or OTAGO (control group) programme. Compliance, satisfaction, and adverse events determined feasibility. Clinical outcomes, assessed (blinded) within one-week prior to and post-intervention, included functional gait assessment (FGA), Mini BESTest and cognitive function.

RESULTS

Randomisation to completion rate was 76.15% with 109 participants recruited (n = 289 screened). Drop-out rate was similar between groups. Adverse events were reported (n = 3) in the control group. Sixty-nine percent would recommend the HOLOBalance intervention. Findings were similar for the home and clinic-based arms of each intervention; data was combined for analysis. FGA (95%CI [1.63, 4.19]) and Mini-BESTest (95%CI [1.46, 3.93]) showed greater improvement in the HOLOBalance group with a clinically meaningful change of 4/30 noted for the FGA.

CONCLUSIONS

HOLObalance was feasible to implement and acceptable to older adults at risk of falls, with FGA and Mini-BEST improvements exceeding those for the OTAGO programme. A definitive trial is warranted.

摘要

背景

跌倒会带来很高的社会经济成本。信息和通信技术可以支持多感觉（MSR）物理治疗方案的提供和监测。HOLOBalance 平台使用增强现实全息图为患者提供以中心为导向的个性化 MSR。

目的

确定该平台的安全性、可接受性和可行性，研究功能性步态和动态平衡的益处，并为确证性试验提供数据。

设计和设置

单盲试点随机对照可行性研究。干预措施在三个欧洲国家的临床地点或参与者家中进行。

参与者

有跌倒风险的社区居住老年人（中位年龄 73 岁；64.2%为女性）参与了研究（2020 年 5 月至 2021 年 8 月）。

方法

参与者被随机分配到为期 8 周的诊所或家庭远程康复 MSR 或 OTAGO（对照组）方案。依从性、满意度和不良事件确定了可行性。临床结果在干预前和干预后一周内（盲法评估）进行评估，包括功能性步态评估（FGA）、Mini BESTest 和认知功能。

结果

随机分组完成率为 76.15%，共招募 109 名参与者（共筛查 289 名）。各组的退出率相似。对照组报告了 3 例不良事件。69%的参与者会推荐 HOLOBalance 干预措施。家庭和诊所的干预组结果相似，数据进行了合并分析。FGA（95%CI [1.63, 4.19]）和 Mini-BESTest（95%CI [1.46, 3.93]）显示 HOLOBalance 组的改善更大，FGA 观察到 4/30 的临床有意义的变化。