Effects of a Fall Preventive Exercise Program on Intrinsic Fall Risk Factors in Healthy Older Adults.
Condition: Fall Risk Factors; Fall Prevention
Study type: Interventional

Summary: 
      Background With increasing age neuromuscular deficits (e.g., sarcopenia) may result in
      impaired physical performance and an increased risk for falls. Prominent intrinsic fall-risk
      factors are age-related decreases in balance and strength / power performance as well as
      cognitive decline. Additional studies are needed to develop specifically tailored exercise
      programs for older adults that can easily be implemented into clinical practice. Thus, the
      objective of the present trial is to assess the effects of a fall prevention program that was
      developed by an interdisciplinary expert panel on measures of balance, strength / power, body
      composition, cognition, psychosocial well-being, and falls self-efficacy in healthy older
      adults. Additionally, the time-related effects of detraining are tested.

      Methods/Design Healthy old people (N = 66) between the age of 65 to 80 years will participate
      in this trial. The testing protocol comprises tests for the assessment of static / dynamic
      steady-state balance (i.e., Sharpened Romberg Test, instrumented gait analysis), proactive
      balance (i.e., Functional Reach Test; Timed Up and Go Test), reactive balance (i.e.,
      perturbation test during bipedal stance; Push and Release Test), strength (i.e., hand grip
      strength test; Chair Stand Test), and power (i.e., Stair Climb Power Test). Further, body
      composition will be analysed using a bioelectrical impedance analysis system. In addition,
      questionnaires for the assessment of psychosocial (i.e., World Health Organisation Quality of
      Life Assessment-Bref), cognitive (i.e., Mini Mental State Examination), and fall risk
      determinants (i.e., Fall Efficacy Scale - International) will be included in the study
      protocol. Participants will be randomized into two intervention groups or the control /
      waiting group. After baseline measures, participants in the intervention groups will conduct
      a 12-week balance and strength / power exercise intervention 3 times per week, with each
      training session lasting 30 min (without warm-up and cool-down). One intervention group will
      complete a supervised training program (2x supervised training per week / 1x home training
      per week), while the other intervention group will complete a training after the same
      protocol that is home-based (3x home training per week) and controlled by phone calls every
      two weeks. Post-tests will be conducted right after the intervention period. Additionally,
      detraining effects will be measured 12 weeks after program cessation. The control group /
      waiting group will not participate in any specific intervention during the experimental
      period, but will receive the extensive supervised program after the experimental period.

      Discussion It is expected that particularly the supervised combination of balance and
      strength / power training will improve performance in variables of balance, strength / power,
      body composition, cognitive function, psychosocial well-being, and falls self-efficacy of
      older adults. In addition, information regarding fall risk assessment, detraining effects,
      and supervision of training will be provided. Further, training-induced health-relevant
      changes, such as improved performance in activities of daily living, cognitive function, and
      quality of life, as well as a reduced risk for falls may help to lower costs in the health
      care system. Finally, practitioners, therapists, and instructors will be provided with a
      scientifically evaluated, feasible, safe, and easy-to-administer exercise program for fall
      prevention.
    


Intervention name(s): Exercise with supervision; Home-based without supervision
Intervention type(s): Behavioral; Behavioral
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment