Reminiscence Technology Balance and Mobility

Study Overview
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Brief Summary
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This study evaluates the feasibility of a larger randomized controlled trial to examine the effect of reminiscence aided physical activity on the balance and mobility of older adults living in long term care. The study uses the jDome BikeAround system, which is a stationary bicycle with a projector screen that runs google earth, as the user bicycles, the map progresses giving the appearance that the user is bicycling through the environment chosen. Half of the participants will use the system during the first 6 week campaign, there will then be a 6 week washout period. Following the washout period, there will be a second 6 week campaign when the other half of the participants will use the jDome BikeAround system.

Detailed Description
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Physical activity has been shown to have numerous benefits for physical well-being and function. Stationary cycling is one example of physical activity that can provide opportunities for residents who are inactive, living in long term care and are at high risk for falls. The use of jDome BikeAround provides older adults in long term care an opportunity to engage in a motivating reminiscence activity that is coupled with physical activity. Participants will be divided into two groups, one group will take part in jDome BikeAround sessions 3x per week for 6 weeks in addition to The Glebe Centre's Fall Prevention program, while the second group will just participant in Fall Prevention program. There will be a 6 week wash out, then the second cohort will participant in the jDome Bike Around sessions 3x a week in addition to the Fall Prevention program while the first cohort will just participate in the Fall Prevention Program. Participants will have their balance, mobility, leg strength, endurance tested as well as a tracking of fall risks at the beginning and end of each of the jDome BikeAround sessions (4 measurement points). Feasibility will be determined by the ability to enroll an adequate number of participants, protocol completion by participants, and the number of adverse events.

Official Title
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Using Motivating Reminiscence Technology to Encourage Physical Activity and Improve Balance and Mobility for Residents in Long Term Care

Conditions
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Adults Living in Long Term Care

Intervention / Treatment
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* Other: Motivating reminiscence technology


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Scott fall risk of 2-17 (this is the current range used by the Glebe Centre, there have been 0 falls during transportation to the equipment and during each session of the BikeAround system) Sufficient visual abilities to observe images on the domed screen Able to comprehend and communicate in English. Adequate attentional capacity to remain focused on the pedalling task. Minimum height requirement of 5'2 or 157cm in order to successfully fit the BikeAround system's stationary bike. Exclusion Criteria: Physical limitations (as determined by the Glebe Centre healthcare/physiotherapy team) that prevent use of the jDome bike. Cognitive impairment (as determined by the Glebe Centre healthcare/physiotherapy team) Inability to sustain attention Inability to follow one-step commands. Known behavioural abnormalities (e.g. overly aggressive behavior) that in the opinion of the clinical care team might impede any meaningful participation in the project Those who are in the opinion of attending physician or clinical team too unwell to participate in the project Fully unable to complete outcome measures indicated (Section 7, Outcomes)
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Crossover Assignment
Interventional Model Description: This study has 2 six week campaigns with a six week washout in between the 2 campaigns. During the first campaign half of the participants will use the motivating reminiscence technology while receiving the standard fall prevention programming, while the second half will receive just the standard fall prevention programming. During the 6 week washout period all participants will just receive the standard fall prevention programming. After the washout period, there will be the second campaign where the other half of the participants will use the motivating reminiscence technology while receiving the standard fall prevention programming, whereas the remaining participants will just receive the standard fall prevention programming.
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: System + Fall Prevention First, then Fall Prevention<br>Participants in this arm will be invited to use the jDome BikeAround system for up to 30 minute sessions up to 3 times a week during the first 6 week campaign. During this campaign the participants will also participant in the standard fall prevention program. Following the 6 week washout period, the participants in this arm will just participate in the Fall Prevention program alone. Fall Prevention Program focuses on reducing the incidence of residents' falls and mitigating risks of falls through a resident focused, team approach which ensures that a resident's environment and social, physical, cognitive and emotional strengths are supported. This is an interdisciplinary program involving nursing and program staff, physician/pharmacist, dietician, physiotherapist, housekeeping staff and the resident/POA. They communicate regarding their planned interventions and evaluation of resident progress and outcomes in falls prevention through documentation. | Other: Motivating reminiscence technology<br>* The jDome BikeAround uses Google Street View, a stationary bike and a domed screen. Residents are seated in front of the screen; their destination is typed into the computer and when loaded the image appears on the screen. Using pedals on the bike they can propel themselves down the street, steer and change direction as they wish.<br>* Other names: jDome BikeAround System;|
| Experimental: Fall Prevention first, then System +Fall Prevention<br>Participants in this arm will participate in the Fall Prevention program alone during the first 6 week campaign. Following the 6 week washout period the participants will be invited to use the jDome BikeAround system for up to 30 minute sessions up to 3 times a week during the second 6 week campaign. During this campaign the participants will also participant in the standard fall prevention program Fall Prevention Program focuses on reducing the incidence of residents' falls and mitigating risks of falls through a resident focused, team approach which ensures that a resident's environment and social, physical, cognitive and emotional strengths are supported. This is an interdisciplinary program involving nursing and program staff, physician/pharmacist, dietician, physiotherapist, housekeeping staff and the resident/POA. They communicate regarding their planned interventions and evaluation of resident progress and outcomes in falls prevention through documentation. | Other: Motivating reminiscence technology<br>* The jDome BikeAround uses Google Street View, a stationary bike and a domed screen. Residents are seated in front of the screen; their destination is typed into the computer and when loaded the image appears on the screen. Using pedals on the bike they can propel themselves down the street, steer and change direction as they wish.<br>* Other names: jDome BikeAround System;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of Participants Recruited | Determine the feasibility of a future randomized controlled trial to evaluate the impact on balance and mobility of motivating reminiscence technology using the jDome BikeAround system for adults in long term care. Feasibility will be determined by the ability to recruit 30 residents (based on the LTC population base at The Glebe Centre). | Baseline | 
| Protocol Adherence | Determine the feasibility of a future randomized controlled trial to evaluate the impact on balance and mobility of motivating reminiscence technology using the jDome BikeAround system for adults in long term care. Feasibility will be determined by the number of residents to complied with the protocol during their respective campaign by using the jDome BikeAround system 3 times a week. | Week 18 | 
| Number of Participants Who Experience an Adverse Events While Using the jDome BikeAround (System) | The number of adverse events while directly interacting with the jDome BikeAround system will be tracked to help determine feasibility of this kind of randomized trial. | Week 18 | 
| Performance Oriented Mobility Assessment | The Performance Oriented Mobility Assessment Tool is a simple, easily administered test that measures a resident's gait and balance. The test is scored on the resident's ability to perform specific tasks as either 0, 1 or 2 where a score of 0 represents the most impaired while a score of 2 represents independence. The total is calculated by adding the score for each individual activity, the lowest possible score is 0 and the highest possible score is 28. The higher the score the better the more mobile the participant is. This will give us a baseline value for the participants. | Baseline | 
| Performance Oriented Mobility Assessment | The Performance Oriented Mobility Assessment Tool is a simple, easily administered test that measures a resident's gait and balance. The test is scored on the resident's ability to perform specific tasks as either 0, 1 or 2 where a score of 0 represents the most impaired while a score of 2 represents independence. The total is calculated by adding the score for each individual activity, the lowest possible score is 0 and the highest possible score is 28. The higher the score the better the more mobile the participant is. This measure will be taken after the first campaign has been completed. | Week 6 | 
| Performance Oriented Mobility Assessment | The Performance Oriented Mobility Assessment Tool is a simple, easily administered test that measures a resident's gait and balance. The test is scored on the resident's ability to perform specific tasks as either 0, 1 or 2 where a score of 0 represents the most impaired while a score of 2 represents independence. The total is calculated by adding the score for each individual activity, the lowest possible score is 0 and the highest possible score is 28. The higher the score the better the more mobile the participant is. This measure will be taken just before the second campaign is to begin. | Week 12 | 
| Performance Oriented Mobility Assessment | The Performance Oriented Mobility Assessment Tool is a simple, easily administered test that measures a resident's gait and balance. The test is scored on the resident's ability to perform specific tasks as either 0, 1 or 2 where a score of 0 represents the most impaired while a score of 2 represents independence. The total is calculated by adding the score for each individual activity, the lowest possible score is 0 and the highest possible score is 28. The higher the score the better the more mobile the participant is. This measure will be taken after the second campaign has been completed. | Week 18 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| 2 Minute Walk Test | Distance participant can walk without assistance for 2 minutes measured from the starting position. | Baseline | 
| 2 Minute Walk Test | Distance participant can walk without assistance for 2 minutes measured from the starting position. | 6 Week | 
| 2 Minute Walk Test | Distance participant can walk without assistance for 2 minutes measured from the starting position. | 12 Week | 
| 2 Minute Walk Test | Distance participant can walk without assistance for 2 minutes measured from the starting position. | 18 Week | 
| Knee Range of Motion Test | Test that asses the range of motion of a participant's knee | Baseline | 
| Knee Range of Motion Test | Test that asses the range of motion of a participant's knee | 6 weeks | 
| Knee Range of Motion Test | Test that asses the range of motion of a participant's knee | 12 weeks | 
| Knee Range of Motion Test | Test that asses the range of motion of a participant's knee | 18 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Long Term Care, Motivating Reminiscence Technology, Feasibility