Home Based Exercise in Preventing Fall and Improving Balance in Older People

Study Overview
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Brief Summary
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Prior studies have shown multifaceted falls prevention program with home-based exercise reduced falls significantly in the community setting. The Otago exercise program has been tested in four separated controlled trials of community living people in New Zealand. Falls were the main outcome in each trail and were defined as unintentionally coming to rest on the ground, floor or other lower level. Not only this combination strengthening and balance training exercise could reduce fall but also could benefit in cost-effectiveness for fall prevention and decrease mortality in those 80 and older. However the limitation of Otago exercise program is that the program was needed to be trained by skill nurses or physical therapists. There are 17 steps levels to adhere the program. As some studies have shown that fall prevention program adherence could be as low as 10-40%. In Thailand the lack of medical staffs are continued the problem in the community. Therefore to establish fall prevention guideline that will be suitable and translated into the real setting, this study is aimed to test the effectiveness of simple program home-based exercise comparing to non-simple program home based exercise in preventing fall and improve muscle strength and balance dysfunction in older people with mild to moderate balance dysfunction. The method is the randomized controlled trails.

Official Title
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Effectiveness of a Simple Designed Programme of Home Based Exercise in Preventing Fall and Improving Balance and Strength in Older People With Mild to Moderate Balance Dysfunction: A Randomized Controlled Trials

Conditions
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Patient Fall, Muscle Balance, Fear of Falling, Quality of Life

Intervention / Treatment
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* Behavioral: Home based exercise
* Other: fall prevention education and counseling


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Thai elderly aged 65 years or older able to communicate and follow the home-based exercise programme mild to moderate balance dysfunctions as followings: functional reach test score less than 26 cm. five time sit to stand test more than 17.9 seconds able to walk independently or walk with only single cane non diagnosed with moderate to severe dementia or depression non diagnosed with parkinson disease non diagnosed with cerebrovascular disease with less than grade 4 hemiparesis. non diagnosed with acute arthritis or recent diagnosed within 6 months. informed and consent to participate in the study not participate in regular Tai-chi or Yoga exercise training. Exclusion criteria: Participants would like to withdraw from the study. severe injury occured after following simple designed exercise program eg. tendon injuries.

Ages Eligible for Study
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Minimum Age: 65 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: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Home based exercise<br>simple designed home based exercise program | Behavioral: Home based exercise<br>* modified Otago exercise program to simple designed home based exercise program<br>* Other names: combination strengthening and balance training program;Other: fall prevention education and counseling<br> <br> |
| Active Comparator: fall prevention education and counseling<br>fall prevention education & counseling : home modification, vision screening, avoid sedative drugs use, proper shoes, report dizziness and fall to doctors | Other: fall prevention education and counseling<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| number of falls | Number of falls were measured at baseline, 12 weeks, 24 weeks and 1 year. At baseline, the participants will be interviewed the number of falls that occurred in the past 1 year period before enrollment. | 1 year | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| muscle strength | There are two Measurements as following: Five time sit to stand test The participant stood up and sat down as quickly as possible from standard chair (47 cm high) 5 times, with arms folded across the chest. Timed up and go test The time required to rise from a chair, walk 3 meters distance, turn around, walk back and sit down. | baseline, 12 weeks and 24 weeks | 
| Balance | The participants will be tested their balances by using Short form of Berg Balance scale (7 items, 0-28 scores.) | Baseline, 12 weeks and 24 weeks |