Lai Wei Xuan, Koh Vanessa, Goh Jing Wen, Tan Kok Yang, Tan Kai Zhe, Pai Sai G S, Taylor William R, Visaria Abhijit, Singh Navrag B, Chan Angelique W M, Matchar David B
Programme in Health Services and Systems Research (HSSR), Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore.
Centre for Ageing Research and Education (CARE), Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore.
BMC Public Health. 2024 Dec 18;24(1):3464. doi: 10.1186/s12889-024-20947-2.
Falls and fall-related injuries among older adults in Singapore are a serious health problem that require early intervention. In previous research, exercise interventions have been effective in improving functional outcomes and reducing falls for a broad group of older adults. However, results from multi-domain, multi-component falls prevention programs for high fall risk older adults in the community remain equivocal. One reason for these results is that there is significant heterogeneity in falls risk factors amongst high falls risk older adults which makes tailoring multicomponent interventions complex. The objective of the trial is to evaluate the effectiveness of an enhanced version of the predecessor program, SAFE. The Steps to Avoid Falls in the Elderly-a TECHnology enhanced intervention (SAFE-TECH) is designed for older adults in the community who are at high risk of falls, with candidate selection and program tailoring based on gait variables derived from wearable sensors and various questionnaire-based features.
SAFE-TECH is a 12-month randomized controlled trial involving 400 older adults at high risk of falling, who are randomly allocated to an intervention or control group in a 1:1 ratio. Participants will be assessed at baseline, 3rd-month and 12th-month for functional status, physical performance, cognitive status, quality of life, and medical history. Monthly phone calls will assess fall status, healthcare utilization, physical activity, and exercise self-efficacy. Participants in the intervention group will undergo a tailored, multi-domain, multi-component falls prevention program. The active intervention phase will last for 12-weeks with exercises focusing on strength, balance, coordination, flexibility, and aerobic endurance; and weekly educational sessions on falls risk with personalized feedback based on participant's falls risk assessments and environmental checklist.
SAFE-TECH seeks to evaluate enhanced existing falls prevention programs by addressing the heterogeneity of falls risk through rapid assessments and personalisation of exercise and education components while maintaining the efficiency of the group setting. Our findings will inform practical efforts to reduce falls and falls-related injuries among community-dwelling older adults.
ClinicalTrials.gov.
NCT06102954|| 22-10-2023.
新加坡老年人跌倒及与跌倒相关的伤害是一个严重的健康问题，需要早期干预。在以往的研究中，运动干预对改善广大老年人群的功能结局和减少跌倒有效。然而，针对社区中高跌倒风险老年人的多领域、多组分跌倒预防项目的结果仍不明确。这些结果的一个原因是，高跌倒风险老年人的跌倒风险因素存在显著异质性，这使得定制多组分干预措施变得复杂。该试验的目的是评估前一个项目SAFE的增强版的有效性。老年人避免跌倒——技术增强干预（SAFE-TECH）是为社区中跌倒风险高的老年人设计的，基于可穿戴传感器得出的步态变量和各种基于问卷的特征进行候选人筛选和项目定制。
SAFE-TECH是一项为期12个月的随机对照试验，涉及400名高跌倒风险的老年人，他们以1:1的比例随机分配到干预组或对照组。将在基线、第3个月和第12个月对参与者进行功能状态、身体表现、认知状态、生活质量和病史评估。每月通过电话评估跌倒状况、医疗保健利用情况、身体活动和运动自我效能。干预组的参与者将接受定制的、多领域、多组分的跌倒预防项目。积极干预阶段将持续12周，锻炼重点为力量、平衡、协调、灵活性和有氧耐力；以及每周一次关于跌倒风险的教育课程，并根据参与者的跌倒风险评估和环境检查表提供个性化反馈。
SAFE-TECH旨在通过快速评估以及运动和教育组分的个性化来解决跌倒风险的异质性，同时保持小组设置的效率，从而评估现有的增强跌倒预防项目。我们的研究结果将为减少社区居住老年人跌倒及与跌倒相关伤害的实际工作提供参考。
ClinicalTrials.gov。
NCT06102954||2023年10月22日。
