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European Review of Aging and Physical Activity
Published in: European Review of Aging and Physical Activity 1/2015

Open Access 01-12-2015 | Research article

ICT-based system to predict and prevent falls (iStoppFalls): results from an international multicenter randomized controlled trial

Authors: Yves J. Gschwind, Sabine Eichberg, Andreas Ejupi, Helios de Rosario, Michael Kroll, Hannah R. Marston, Mario Drobics, Janneke Annegarn, Rainer Wieching, Stephen R. Lord, Konstantin Aal, Daryoush Vaziri, Ashley Woodbury, Dennis Fink, Kim Delbaere

Published in: European Review of Aging and Physical Activity | Issue 1/2015

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Abstract

Background

Falls and fall-related injuries are a serious public health issue. Exercise programs can effectively reduce fall risk in older people. The iStoppFalls project developed an Information and Communication Technology-based system to deliver an unsupervised exercise program in older people’s homes. The primary aims of the iStoppFalls randomized controlled trial were to assess the feasibility (exercise adherence, acceptability and safety) of the intervention program and its effectiveness on common fall risk factors.

Methods

A total of 153 community-dwelling people aged 65+ years took part in this international, multicentre, randomized controlled trial. Intervention group participants conducted the exercise program for 16 weeks, with a recommended duration of 120 min/week for balance exergames and 60 min/week for strength exercises. All intervention and control participants received educational material including advice on a healthy lifestyle and fall prevention. Assessments included physical and cognitive tests, and questionnaires for health, fear of falling, number of falls, quality of life and psychosocial outcomes.

Results

The median total exercise duration was 11.7 h (IQR = 22.0) over the 16-week intervention period. There were no adverse events. Physiological fall risk (Physiological Profile Assessment, PPA) reduced significantly more in the intervention group compared to the control group (F1,127 = 4.54, p = 0.035). There was a significant three-way interaction for fall risk assessed by the PPA between the high-adherence (>90 min/week; n = 18, 25.4 %), low-adherence (<90 min/week; n = 53, 74.6 %) and control group (F2,125 = 3.12, n = 75, p = 0.044). Post hoc analysis revealed a significantly larger effect in favour of the high-adherence group compared to the control group for fall risk (p = 0.031), postural sway (p = 0.046), stepping reaction time (p = 0.041), executive functioning (p = 0.044), and quality of life (p for trend = 0.052).

Conclusions

The iStoppFalls exercise program reduced physiological fall risk in the study sample. Additional subgroup analyses revealed that intervention participants with better adherence also improved in postural sway, stepping reaction, and executive function.

Trial registration

Australian New Zealand Clinical Trials Registry Trial ID: ACTRN12614000096​651
International Standard Randomised Controlled Trial Number: ISRCTN15932647
Literature
1.
Montero-Odasso M et al. Gait and cognition: a complementary approach to understanding brain function and the risk of falling. J Am Geriatr Soc. 2012;60(11):2127–36.PubMedCentralPubMed
2.
Panel on Prevention of Falls in Older Persons, American Geriatrics Society, and British Geriatrics Society. Summary of the updated American Geriatrics Society/British Geriatrics Society clinical practice guideline for prevention of falls in older persons. J Am Geriatr Soc. 2011;59(1):148–57.CrossRef
3.
Goodwin VA et al. Multiple component interventions for preventing falls and fall-related injuries among older people: systematic review and meta-analysis. BMC Geriatr. 2014;14:15.PubMedCentralCrossRefPubMed
4.
Gillespie LD et al. Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2012;9:CD007146.PubMed
5.
6.
Jorgensen MG et al. Efficacy of Nintendo Wii training on mechanical leg muscle function and postural balance in community-dwelling older adults: a randomized controlled trial. J Gerontol Ser A Biol Med Sci. 2013;68(7):845–52.CrossRef
7.
Kim J et al. Unsupervised virtual reality-based exercise program improves hip muscle strength and balance control in older adults: a pilot study. Arch Phys Med Rehabil. 2013;94(5):937–43.CrossRefPubMed
8.
Schoene D et al. The effect of interactive cognitive-motor training in reducing fall risk in older people: a systematic review. BMC Geriatr. 2014;14:107.PubMedCentralCrossRefPubMed
9.
Silveira P et al. Tablet-based strength-balance training to motivate and improve adherence to exercise in independently living older people: a phase II preclinical exploratory trial. J Med Internet Res. 2013;15(8), e159.PubMedCentralCrossRefPubMed
10.
Kiselev J et al. Implementation of a home-based interactive training system for fall prevention: requirements and challenges. J Gerontol Nurs. 2015;41(1):14–9.CrossRefPubMed
11.
Gschwind YJ, Eichberg S, Marston HR, Ejupi A, Rosario H, Kroll M, et al. ICT-based system to predict and prevent falls (iStoppFalls): study protocol for an international multicenter randomized controlled trial. BMC Geriatr. 2014;14:91.PubMedCentralCrossRefPubMed
12.
Borson S, Scanlan J, Brush M, Vitaliano P, Dokmak A. The Mini-Cog: a cognitive ‘vital signs’ measure for dementia screening in multi-lingual elderly. Int J Geriatr Psychiatry. 2000;15(11):1021–7.CrossRefPubMed
13.
American College of Sports Medicine, Chodzko-Zajko WJ, Proctor DN, Fiatarone Singh MA, Minson CT, Nigg CR, et al. American College of Sports Medicine position stand. Exercise and physical activity for older adults. Med Sci Sports Exerc. 2009;41(7):1510–30.CrossRef
14.
Zhang W et al. Test-retest reliability of a pendant-worn sensor device in measuring chair rise performance in older persons. Sensors (Basel). 2014;14(5):8705–17.CrossRef
15.
Sherrington C et al. Exercise to prevent falls in older adults: an updated meta-analysis and best practice recommendations. N S W Public Health Bull. 2011;22(3–4):78–83.CrossRefPubMed
16.
Sherrington C et al. Effective exercise for the prevention of falls: a systematic review and meta-analysis. J Am Geriatr Soc. 2008;56(12):2234–43.CrossRefPubMed
17.
Campbell AJ et al. Randomised controlled trial of a general practice programme of home based exercise to prevent falls in elderly women. BMJ. 1997;315(7115):1065–9.PubMedCentralCrossRefPubMed
18.
Lord SR, Menz HB, Tiedemann A. A physiological profile approach to falls risk assessment and prevention. Phys Ther. 2003;83(3):237–52.PubMed
19.
20.
21.
Delbaere K, Smith ST, Lord SR. Development and initial validation of the iconographical falls efficacy scale. J Gerontol A Biol Sci Med Sci. 2011;66(6):674–80.CrossRefPubMed
22.
Delbaere K, Hauer K, Lord SR. Evaluation of the incidental and planned activity questionnaire for older people. Br J Sports Med. 2010;44(14):1029–34.CrossRefPubMed
23.
Huy C, Schneider S. Instrument for the assessment of middle-aged and older adults’ physical activity: design, eliability and application of the German-PAQ-50+. Zeitschrift Fur Gerontologie Und Geriatrie. 2008;41(3):208–16.CrossRefPubMed
24.
Wei Z et al. Chair rise transfer detection and analysis using a pendant sensor: An algorithm for fall risk assessment in older people. Conf Proc IEEE Eng Med Biol Soc. 2014;4(10):6943965.
25.
Guralnik JM, Simonsick EM, Ferrucci L, Glynn RJ, Berkman LF, Blazer DG, et al. A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol. 1994;49(2):M85–94.CrossRefPubMed
26.
Podsiadlo D, Richardson S. The timed “up & go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991;39(2):142–8.CrossRefPubMed
27.
Schaubert KL, Bohannon RW. Reliability and validity of three strength measures obtained from community-dwelling elderly persons. J Strength Cond Res. 2005;19(3):717–20.PubMed
28.
Cruz-Jentoft AJ et al. Sarcopenia: European consensus on definition and diagnosis: report of the European Working Group on Sarcopenia in Older People. Age Ageing. 2010;39(4):412–23.PubMedCentralCrossRefPubMed
29.
Fritz S, Lusardi M. White paper: “walking speed: the sixth vital sign”. J Geriatr Phys Ther. 2009;32(2):46–9.PubMed
30.
Granacher U et al. Age-related effects on postural control under multi-task conditions. Gerontology. 2011;57(3):247–55.CrossRefPubMed
31.
Reitan RM. The relation of the trail making test to organic brain damage. J Consult Psychol. 1955;19(5):393–4.CrossRefPubMed
32.
Strauss E et al. A compendium of neuropsychological tests: administration, norms, and commentary. 3rd ed. Oxford: Oxford University Press; 2006. p. 1216.
33.
Wechsler D. Manual for the Wechsler Adult Intelligence Scale-III. San Antonio: Psychological Corporation; 1997.
34.
Fan J et al. Testing the efficiency and independence of attentional networks. J Cogn Neurosci. 2002;14(3):340–7.CrossRefPubMed
35.
Borsci S, Federici S, Lauriola M. On the dimensionality of the system usability scale: a test of alternative measurement models. Cogn Process. 2009;10(3):193–7.CrossRefPubMed
36.
Mullen SP et al. Measuring enjoyment of physical activity in older adults: invariance of the physical activity enjoyment scale (PACES) across groups and time. Int J Behav Nutr Phys Act. 2011;8:103.PubMedCentralCrossRefPubMed
37.
Kendzierski D, Decarlo KJ. Physical-activity enjoyment scale - two validation studies. J Sport Exerc Psychol. 1991;13(1):50–64.
38.
Amberg M, Fischer S, Schroeder M. An evaluation framework for the acceptance of web-based aptitude tests. EJISE. 2005;8(3):151–8.
39.
Schoene D et al. A randomized controlled pilot study of home-based step training in older people using videogame technology. PLoS One. 2013;8(3):e57734.PubMedCentralCrossRefPubMed
40.
Vogler CM et al. Reducing risk of falling in older people discharged from hospital: a randomized controlled trial comparing seated exercises, weight-bearing exercises, and social visits. Arch Phys Med Rehabil. 2009;90(8):1317–24.CrossRefPubMed
41.
Pichierri G, Murer K, de Bruin ED. A cognitive-motor intervention using a dance video game to enhance foot placement accuracy and gait under dual task conditions in older adults: a randomized controlled trial. BMC Geriatr. 2012;12:74.PubMedCentralCrossRefPubMed
42.
Vagetti GC et al. Association between physical activity and quality of life in the elderly: a systematic review, 2000–2012. Revista Brasileira De Psiquiatria. 2014;36(1):76–88.CrossRefPubMed
43.
Duda JL et al. Effects of a standard provision versus an autonomy supportive exercise referral programme on physical activity, quality of life and well-being indicators: a cluster randomised controlled trial. Int J Behav Nutr Phys Act. 2014;11:10.PubMedCentralCrossRefPubMed
44.
45.
Sturnieks DL et al. Sensorimotor and neuropsychological correlates of force perturbations that induce stepping in older adults. Gait Posture. 2012;36(3):356–60.CrossRefPubMed
46.
Lord SR, Fitzpatrick RC. Choice stepping reaction time: a composite measure of falls risk in older people. J Gerontol A Biol Sci Med Sci. 2001;56(10):M627–32.CrossRefPubMed
47.
Ejupi A, Brodie M, Gschwind YJ, Schoene D, Lord S, Delbaere K. Choice stepping reaction time test using exergame technology for fall risk assessment in older people. Conf Proc IEEE Eng Med Biol Soc. 2014;2014:6957–60.PubMed
48.
Simek EM, McPhate L, Haines TP. Adherence to and efficacy of home exercise programs to prevent falls: a systematic review and meta-analysis of the impact of exercise program characteristics. Prev Med. 2012;55(4):262–75.CrossRefPubMed
49.
Miller KJ et al. Effectiveness and feasibility of virtual reality and gaming system use at home by older adults for enabling physical activity to improve health-related domains: a systematic review. Age Ageing. 2014;43(2):188–95.CrossRefPubMed
Metadata
Title
ICT-based system to predict and prevent falls (iStoppFalls): results from an international multicenter randomized controlled trial
Authors
Yves J. Gschwind
Sabine Eichberg
Andreas Ejupi
Helios de Rosario
Michael Kroll
Hannah R. Marston
Mario Drobics
Janneke Annegarn
Rainer Wieching
Stephen R. Lord
Konstantin Aal
Daryoush Vaziri
Ashley Woodbury
Dennis Fink
Kim Delbaere
Publication date
01-12-2015
Publisher
BioMed Central
Published in
European Review of Aging and Physical Activity / Issue 1/2015
Print ISSN: 1813-7253
Electronic ISSN: 1861-6909
DOI
https://doi.org/10.1186/s11556-015-0155-6

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