Clinical trial NCT00187317: Evaluation of a Balance-recovery Specific Falls Prevention Exercise Program
Official title: Development and Evaluation of a Perturbation-based Balance-training Program for Older Adults
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: PHASE1
Conditions: Accidental Falls
Keywords: Exercise
Rehabilitation
Postural Balance
Accidental Falls
Geriatrics
Lead sponsor: Sunnybrook Health Sciences Centre
Sponsor class: OTHER
Collaborators: name: Canadian Institutes of Health Research (CIHR)
First posted: 2005-09-16
Enrollment: 37
Sex: ALL
Minimum age (years): 64
Maximum age (years): 80
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: This study aims to investigate the potential to train compensatory stepping and grasping reactions for the prevention of falls.

Detailed description: Physical activity and exercise have been shown to prevent falling in older adults, although the exact mechanisms by which exercise prevents falls is unclear. Compensatory stepping and grasping reactions are frequently used to prevent a fall to the ground following a loss of balance. Age-related impairment in these reactions may be related to an increased risk of falling. Therefore, the purpose of this study is to investigate means for reversing age-related impairment in compensatory stepping and grasping reactions. A training program involving perturbation-evoked reactions will be evaluated.

Comparison(s): Balance recovery ability before and after a 6-week training program will be assessed. Performance of the training group will be compared to a control group not receiving stepping and grasping training.

Eligibility criteria: Inclusion Criteria:

* Community dwelling
* History of falls (at least 1 fall in the past 12 months) or poor balance
* Functional mobility (no dependence on mobility aids)

Exclusion Criteria:

* Neurological or musculoskeletal disorder
* Cognitive disorder (e.g. dementia)
* Osteoporosis

Primary outcomes:
measure: Ability to recover balance by stepping and grasping
timeFrame: Before and after 6-week intervention
Secondary outcomes:
measure: Fall frequency; clinical measures related to balance and fall risk (e.g. FallScreen, Community Balance and Mobility Scale, balance confidence)
timeFrame: One year post-intervention
Other outcomes:
Locations:
city: Toronto
country: Canada
facility: Centre for Studies in Aging, Sunnybrook Health Sciences Centre
state: Ontario
Study officials:
affiliation: Sunnybrook & Women's College Health Sciences Centre; University of Toronto
name: Brian Maki, PhD, PEng
role: PRINCIPAL_INVESTIGATOR
References:
citation: Maki BE, McIlroy WE, Perry SD. Influence of lateral destabilization on compensatory stepping responses. J Biomech. 1996 Mar;29(3):343-53. doi: 10.1016/0021-9290(95)00053-4.
citation: Province MA, Hadley EC, Hornbrook MC, Lipsitz LA, Miller JP, Mulrow CD, Ory MG, Sattin RW, Tinetti ME, Wolf SL. The effects of exercise on falls in elderly patients. A preplanned meta-analysis of the FICSIT Trials. Frailty and Injuries: Cooperative Studies of Intervention Techniques. JAMA. 1995 May 3;273(17):1341-7.
citation: Rogers MW, Johnson ME, Martinez KM, Mille ML, Hedman LD. Step training improves the speed of voluntary step initiation in aging. J Gerontol A Biol Sci Med Sci. 2003 Jan;58(1):46-51. doi: 10.1093/gerona/58.1.m46.
citation: McIlroy WE, Maki BE. Age-related changes in compensatory stepping in response to unpredictable perturbations. J Gerontol A Biol Sci Med Sci. 1996 Nov;51(6):M289-96. doi: 10.1093/gerona/51a.6.m289.
citation: Maki BE, McIlroy WE. Change-in-support balance reactions in older persons: an emerging research area of clinical importance. Neurol Clin. 2005 Aug;23(3):751-83, vi-vii. doi: 10.1016/j.ncl.2005.01.002. No abstract available.
citation: Maki BE, Cheng KC, Mansfield A, Scovil CY, Perry SD, Peters AL, McKay S, Lee T, Marquis A, Corbeil P, Fernie GR, Liu B, McIlroy WE. Preventing falls in older adults: new interventions to promote more effective change-in-support balance reactions. J Electromyogr Kinesiol. 2008 Apr;18(2):243-54. doi: 10.1016/j.jelekin.2007.06.005. Epub 2007 Sep 4.
citation: Mansfield A, Peters AL, Liu BA, Maki BE. A perturbation-based balance training program for older adults: study protocol for a randomised controlled trial. BMC Geriatr. 2007 May 31;7:12. doi: 10.1186/1471-2318-7-12.
citation: Mansfield A, Peters AL, Liu BA, Maki BE. Effect of a perturbation-based balance training program on compensatory stepping and grasping reactions in older adults: a randomized controlled trial. Phys Ther. 2010 Apr;90(4):476-91. doi: 10.2522/ptj.20090070. Epub 2010 Feb 18.