Balancing Act: Impact on Falls in Older Adults With Vision Impairment

Study Overview
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Brief Summary
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Falls are a significant issue for older adults with vision impairment. Medical conditions such as glaucoma and age-related macular degeneration that result in vision impairment negatively impact balance. Falling is 1.7 times more likely among older adults with vision impairment. In 2010 there were 9,146,026 older adults treated in emergency rooms for unintentional falls and injuries from falls are expected to cost the nation an estimated $54.9 billion dollars by 2020. Falls can lead to death, depression, and loss of independence. However, impaired balance is a modifiable risk factor for falls. A practical yet innovative falls prevention program has been developed that is designed to enhance balance and proprioception among older adults. This program, UExCEL (UNE-Exercise and Conditioning for Easier Living) Balancing Act, consists of simple exercises that can be done at home (15 minutes duration-3 times a week) during normal daily activities, requires only one brief training session, and no equipment. This study aims to establish an evidence base documenting the positive impact of Balancing Act exercises on balance and falls prevention for older adults with vision impairment. A randomized controlled trial of older adults with vision impairment (best corrected vision of 20/70 or worse) will be conducted over a 6-month period (control group n = 35 and Balancing Act intervention group n = 35) to determine the impact of Balancing Act on falls, fear of falling, pain, and activity levels. Factors that can be expected to affect its adoption and sustained use such as cost in the community and social support networks in the home will also be investigated. It is hypothesized that the Balancing Act intervention will decrease the number of falls experienced by older adults who have vision impairment by improving their gait and balance, reducing their fear of falling, increasing their physical activity, and reducing their pain. The specific aims of the research are to: 1) Evaluate the impact of Balancing Act on standing balance control and proprioception for older adults who have vision impairment, using the Tinetti Gait & Balance Test, a validated tool for evaluating gait and balance and predicting fall risk; 2) Evaluate the impact of Balancing Act for older adults with vision impairment on falls, fear of falling, physical activity, and pain; and 3) Improve adherence to the Balancing Act exercise program by facilitating social networks. Data will be analyzed through: 1) a descriptive assessment of the baseline demographic characteristics of sample members, covariates, and outcome variables, as well as 2) a repeated measures design examining the impact of the intervention on study participants.

Official Title
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Balancing Act: Impact on Falls in Older Adults With Vision Impairment

Conditions
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Postural Balance

Intervention / Treatment
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* Other: Balancing Act exercise curriculum
* Other: Informational Brochure


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 62 years or older Individual resides in his/her own home/apartment Best corrected vision of 20/70 or worse Is able to follow one step commands Individual is able to provide informed consent Individual can ambulate at least 200 feet (may use assistive devices) Score on Timed Get Up and Go test is equal to or greater than 12 seconds Exclusion Criteria: Less than 62 years of age Individual does not reside in his/her own home/apartment Best corrected vision is better than 20/70 Is not able to follow one step commands Is not able to provide informed consent Individual cannot ambulate at least 200 feet Score on Timed Get Up and Go test is less than 12 seconds

Ages Eligible for Study
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Minimum Age: 62 Years

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: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Fall Prevention Exercises<br>Participant provided with Balancing Act exercise curriculum for completion at least fifteen minutes three times a week over a six month period. | Other: Balancing Act exercise curriculum<br>* Balance improvement exercise curriculum titled Balancing Act<br>Other: Informational Brochure<br>* Informational Brochure on falls prevention<br>|
| Other: Informational brochure<br>Participant receives an informational brochure and orientation to brochure contents. | Other: Informational Brochure<br>* Informational Brochure on falls prevention<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from Baseline in Tinetti Gait and Balance Score at 6 months |  | 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from Baseline in Tinetti Gait and Balance Score at 4 months |  | 4 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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balance, gait