Fall Prevention for Old Community-dwelling People

Study Overview
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Brief Summary
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Fall-related injuries are a major health problem in the growing older population. Most older people are not aware of that physical training can decrease the risk of falling. The aim of tha study is to investigate the effect of the Otago home exercise programme with and without motivational interviewing in community-dwelling people 75 years or older on frequence of falls, fall-related injuries, physical capacity, fall-related self-efficacy, quality of life, mortality and health-related costs.

Detailed Description
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Participants in the two intervention groups will exercise at home with supervision from physiotherapist week one, two, four and eight. They will then be contacted for telephone follow-up month five, seven and twelve after the start of training. The control group is encouraged to live as usual. All participants are assessed at baseline, after three, 12 and 24 months from inclusion in the study.

Official Title
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Fall Prevention for Old Community-dwelling People in Uppsala, Västerås and Sörmland

Conditions
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Physical Activity

Intervention / Treatment
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* Other: Otago home exercise programme
* Other: Motivational interviewing plus Otago


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 75 years or older, community-dwelling, in need of homecare or rollator Exclusion Criteria: Cognitive impairment (below 25 on Mini Mental test) Not able to transfer independently indoors -

Ages Eligible for Study
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Minimum Age: 75 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: Otago home training programme<br>Otago home exercise programme was designed specifically to prevent fall. It consists of a set of leg muscle strengthening and balance retraining exercises progressing in difficulty, and a walking plan. The exercise are individually prescribed and increase in difficulty during a series of five home visits by a physiotherapist. | Other: Otago home exercise programme<br>* Otago home exercise program was designed specifically to prevent falls. It consists of a set of leg muscle strengthening and balance retraining exercises progressing in difficulty, and a walking plan. The exercise are individually prescribed and increase in difficulty during a series of five home visits by a physiotherapist.<br>|
| Experimental: Motivational interviewing plus Otago<br>This group is not only exercising at home but also getting motivational interviewing from the physiotherapist at he five home visits. The physiotherapists doing motivational interviewing are specially trained in motivational interviewing. | Other: Motivational interviewing plus Otago<br>* This group is not only exercising at home but also getting motivational interviewing from the physiotherapist at he five home visits. The physiotherapists doing motivational interviewing are specially trained in motivational interviewing.<br>|
| No Intervention: Control grop<br>Participants are instructed to live their ordinary lives. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Frequence of falls will be measured with a monthly fall-calender | A fall-calender with registration of falls on a monthly bases will be used to record falls. The fall-calender should be sent in each month. Falls will be followed-up with telephone interviews. | Two year | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Fall-related injuries will be measured by telephone interviews. |  | Two years | 
| Physical performance will be measured with Short Physical Performance Battery (SPPB) | SPPB measures balance, functional leg strength and walking speed. | Two years | 
| Dynamic balance will be assessed with Mini-BESTest | Mini-BESTest assess dynamic balance impairments in 14 items. The items covers a broad spectrum of performance tasks, including transitions and anticipatory postural adjustments, postural responses to to perturbation, sensory orientation and dynamic stability in gait. | Two years | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Fall prevention, Home exercise, Strength training, Balance training