Partially supervised exercise programmes for fall prevention improve physical performance of older people at risk of falling: a three-armed multi-centre randomised controlled trial
Abstract Background Falls have a major impact on individual patients, their relatives, the healthcare system and related costs. Physical exercise programmes that include multiple categories of exercise effectively reduce the rate of falls and risk of falling among older adults. Methods This 12-month...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2024-04-01
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| Series: | BMC Geriatrics |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12877-024-04927-0 |
| _version_ | 1797219612788523008 |
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| author | Anne-Gabrielle Mittaz Hager Nicolas Mathieu Sophie Carrard Alice Bridel Christina Wapp Roger Hilfiker |
| author_facet | Anne-Gabrielle Mittaz Hager Nicolas Mathieu Sophie Carrard Alice Bridel Christina Wapp Roger Hilfiker |
| author_sort | Anne-Gabrielle Mittaz Hager |
| collection | DOAJ |
| description | Abstract Background Falls have a major impact on individual patients, their relatives, the healthcare system and related costs. Physical exercise programmes that include multiple categories of exercise effectively reduce the rate of falls and risk of falling among older adults. Methods This 12-month, assessor-blinded, three-armed multicentre randomised clinical trial was conducted in adults aged ≥ 65 years identified as at risk of falling. Four hundred and five participants were randomly allocated into 3 groups: experimental group (n = 166) with the Test&Exercise partially supervised programme based on empowerment delivered with a tablet, illustrated manual and cards, reference group (n = 158) with the Otago partially supervised programme prescribed by a physiotherapist delivered with an illustrated manual and control group (n = 81) with the Helsana self-administrated programme delivered with cards. Experimental and reference groups received partially supervised programmes with 8 home sessions over 6 months. Control group received a self-administered program with a unique home session. The 3 groups were requested to train independently 3 times a week for 12 months. Primary outcome was the incidence rate ratio of self-reported falls over 12 months. Secondary outcomes were fear of falling, basic functional mobility and balance, quality of life, and exercise adherence. Results A total of 141 falls occurred in the experimental group, 199 in the reference group, and 42 in the control group. Incidence rate ratios were 0.74 (95% CI 0.49 to 1.12) for the experimental group and 0.43 (95% CI 0.25 to 0.75) for the control group compared with the reference group. The Short Physical Performance Battery scores improved significantly in the experimental group (95% CI 0.05 to 0.86; P = 0.027) and in the reference group (95% CI 0.06 to 0.86; P = 0.024) compared with the control group. Conclusion The self-administered home-based exercise programme showed the lowest fall incidence rate, but also the highest dropout rate of participants at high risk of falling. Both partially supervised programmes resulted in statistically significant improvements in physical performance compared with the self-administered programme. Trial registration NCT02926105. ClinicalTrials.gov. Date of registration: 06/10/2016. |
| first_indexed | 2024-04-24T12:36:25Z |
| format | Article |
| id | doaj.art-a58d2e8333a34b409f1839e1664efd91 |
| institution | Directory Open Access Journal |
| issn | 1471-2318 |
| language | English |
| last_indexed | 2024-04-24T12:36:25Z |
| publishDate | 2024-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Geriatrics |
| spelling | doaj.art-a58d2e8333a34b409f1839e1664efd912024-04-07T11:29:43ZengBMCBMC Geriatrics1471-23182024-04-0124111110.1186/s12877-024-04927-0Partially supervised exercise programmes for fall prevention improve physical performance of older people at risk of falling: a three-armed multi-centre randomised controlled trialAnne-Gabrielle Mittaz Hager0Nicolas Mathieu1Sophie Carrard2Alice Bridel3Christina Wapp4Roger Hilfiker5School of Health Sciences, HES-SO Valais-Wallis, University of Applied Sciences and Arts Western SwitzerlandSchool of Health Sciences, HES-SO Valais-Wallis, University of Applied Sciences and Arts Western SwitzerlandSchool of Health Sciences, HES-SO Valais-Wallis, University of Applied Sciences and Arts Western SwitzerlandBern University of Applied Sciences, Department of Health ProfessionsARTORG Center for Biomedical Engineering Research, University of BernSchool of Health Sciences, HES-SO Valais-Wallis, University of Applied Sciences and Arts Western SwitzerlandAbstract Background Falls have a major impact on individual patients, their relatives, the healthcare system and related costs. Physical exercise programmes that include multiple categories of exercise effectively reduce the rate of falls and risk of falling among older adults. Methods This 12-month, assessor-blinded, three-armed multicentre randomised clinical trial was conducted in adults aged ≥ 65 years identified as at risk of falling. Four hundred and five participants were randomly allocated into 3 groups: experimental group (n = 166) with the Test&Exercise partially supervised programme based on empowerment delivered with a tablet, illustrated manual and cards, reference group (n = 158) with the Otago partially supervised programme prescribed by a physiotherapist delivered with an illustrated manual and control group (n = 81) with the Helsana self-administrated programme delivered with cards. Experimental and reference groups received partially supervised programmes with 8 home sessions over 6 months. Control group received a self-administered program with a unique home session. The 3 groups were requested to train independently 3 times a week for 12 months. Primary outcome was the incidence rate ratio of self-reported falls over 12 months. Secondary outcomes were fear of falling, basic functional mobility and balance, quality of life, and exercise adherence. Results A total of 141 falls occurred in the experimental group, 199 in the reference group, and 42 in the control group. Incidence rate ratios were 0.74 (95% CI 0.49 to 1.12) for the experimental group and 0.43 (95% CI 0.25 to 0.75) for the control group compared with the reference group. The Short Physical Performance Battery scores improved significantly in the experimental group (95% CI 0.05 to 0.86; P = 0.027) and in the reference group (95% CI 0.06 to 0.86; P = 0.024) compared with the control group. Conclusion The self-administered home-based exercise programme showed the lowest fall incidence rate, but also the highest dropout rate of participants at high risk of falling. Both partially supervised programmes resulted in statistically significant improvements in physical performance compared with the self-administered programme. Trial registration NCT02926105. ClinicalTrials.gov. Date of registration: 06/10/2016.https://doi.org/10.1186/s12877-024-04927-0Older peopleHome-based exercise programmeFallsFunctional mobilityBalance |
| spellingShingle | Anne-Gabrielle Mittaz Hager Nicolas Mathieu Sophie Carrard Alice Bridel Christina Wapp Roger Hilfiker Partially supervised exercise programmes for fall prevention improve physical performance of older people at risk of falling: a three-armed multi-centre randomised controlled trial BMC Geriatrics Older people Home-based exercise programme Falls Functional mobility Balance |
| title | Partially supervised exercise programmes for fall prevention improve physical performance of older people at risk of falling: a three-armed multi-centre randomised controlled trial |
| title_full | Partially supervised exercise programmes for fall prevention improve physical performance of older people at risk of falling: a three-armed multi-centre randomised controlled trial |
| title_fullStr | Partially supervised exercise programmes for fall prevention improve physical performance of older people at risk of falling: a three-armed multi-centre randomised controlled trial |
| title_full_unstemmed | Partially supervised exercise programmes for fall prevention improve physical performance of older people at risk of falling: a three-armed multi-centre randomised controlled trial |
| title_short | Partially supervised exercise programmes for fall prevention improve physical performance of older people at risk of falling: a three-armed multi-centre randomised controlled trial |
| title_sort | partially supervised exercise programmes for fall prevention improve physical performance of older people at risk of falling a three armed multi centre randomised controlled trial |
| topic | Older people Home-based exercise programme Falls Functional mobility Balance |
| url | https://doi.org/10.1186/s12877-024-04927-0 |
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