Functional gait rehabilitation in elderly people following a fall-related hip fracture using a treadmill with visual context: design of a randomized controlled trial

BMC Geriatrics

Peter J Beek²  Thomas W Janssen¹  Jan Visschedijk³  Marga Trekop³  Melvyn Roerdink²  Mariëlle W van Ooijen¹ 

[1] Amsterdam Rehabilitation Research Center

[2]  Reade, Overtoom 283, Amsterdam, 1054 HW, The Netherlands;MOVE Research Institute Amsterdam, Faculty of Human Movement Sciences, VU University Amsterdam, Van der Boechorststraat 9, Amsterdam, 1081 BT, The Netherlands;PW Janssen, Zorggroep Solis, Hermelijn 2, Deventer, 7423 EJ, The Netherlands

关键词: Exercise;    Treadmill;    Hip fracture;    Older adults;    Falling;    Gait adaptability;   

Others  :  857763
DOI  :  10.1186/1471-2318-13-34

 received in 2012-10-13, accepted in 2013-04-09,  发布年份 2013

【 摘 要 】

Background

Walking requires gait adjustments in order to walk safely in continually changing environments. Gait adaptability is reduced in older adults, and (near) falls, fall-related hip fractures and fear of falling are common in this population. Most falls occur due to inaccurate foot placement relative to environmental hazards, such as obstacles. The C-Mill is an innovative, instrumented treadmill on which visual context (e.g., obstacles) is projected. The C-Mill is well suited to train foot positioning relative to environmental properties while concurrently utilizing the high-intensity practice benefits associated with conventional treadmill training. The present protocol was designed to examine the efficacy of C-Mill gait adaptability treadmill training for improving walking ability and reducing fall incidence and fear of falling relative to conventional treadmill training and usual care. We hypothesize that C-Mill gait adaptability treadmill training and conventional treadmill training result in better walking ability than usual care due to the enhanced training intensity, with superior effects for C-Mill gait adaptability treadmill training on gait adaptability aspects of walking given the concurrent focus on practicing step adjustments.

Methods/design

The protocol describes a parallel group, single-blind, superiority randomized controlled trial with pre-tests, post-tests, retention-tests and follow-up. Hundred-twenty-six older adults with a recent fall-related hip fracture will be recruited from inpatient rehabilitation care and allocated to six weeks of C-Mill gait adaptability treadmill training (high-intensity, adaptive stepping), conventional treadmill training (high-intensity, repetitive stepping) or usual care physical therapy using block randomization, with allocation concealment by opaque sequentially numbered envelopes. Only data collectors are blind to group allocation. Study parameters related to walking ability will be assessed as primary outcome pre-training, post-training, after 4 weeks retention and 12 months follow-up. Secondary study parameters are measures related to fall incidence, fear of falling and general health.

Discussion

The study will shed light on the relative importance of adaptive versus repetitive stepping and practice intensity for effective intervention programs directed at improving walking ability and reducing fall risk and fear of falling in older adults with a recent fall-related hip fracture, which may help reduce future fall-related health-care costs.

Trial registration

The Netherlands Trial Register (http://NTR3222 webcite).

【 授权许可】

   
2013 van Ooijen et al.; licensee BioMed Central Ltd.

【 图 表 】

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