期刊论文详细信息
BMC Geriatrics
A novel dynamic exercise initiative for older people to improve health and well-being: study protocol for a randomised controlled trial
Pazit Levinger1  Tuire Karaharju-Huisman1  Keith D. Hill3  Remco Polman2  Myrla Patricia Reis Sales1 
[1] Institute of Sport, Exercise & Active Living (ISEAL), College of Sport and Exercise Science, Victoria University, Melbourne 8001, VIC, Australia;Department of Psychology, Bournemouth University, Poole House P104a, Talbot Campus, Fern Barrow, Poole BH12 5BB, UK;School of Physiotherapy and Exercise Science, Curtin University, Perth Western 6845, Australia
关键词: Effectiveness;    Social interaction;    Exercise park;    Older adults;    Falls prevention;   
Others  :  1218302
DOI  :  10.1186/s12877-015-0057-5
 received in 2015-03-13, accepted in 2015-05-15,  发布年份 2015
PDF
【 摘 要 】

Background

Exercise is an important and effective approach to preventing falls in older people, but adherence to exercise participation remains a persistent problem. A unique purpose-built exercise park was designed to provide a fun but physically challenging environment to support exercise in a community setting. This project is a randomised controlled trial designed to evaluate the effectiveness of an exercise intervention using an exercise park specifically designed for older people in reducing the risk of falls.

Methods/Design

This study will be a parallel randomised control trial with pre and post intervention design. One hundred and twenty people aged between 60 and 90 years old will be recruited from Melbourne suburbs and will be randomly allocated to either an exercise park intervention group (EPIG) or a control group (CG). The CG will receive social activities and an educational booklet on falls prevention. The BOOMER balance test will be used as the primary outcome measure. Secondary outcome measures will include hand grip strength, two minute walk test, lower limb strength test, spatio-temporal walking parameters, health related quality of life, feasibility, adherence, safety, and a number of other psychosocial measures. Outcome assessment will be conducted at baseline and at 18 and 26 weeks after intervention commencement. Participants will inform their falls and physical activity history for a 12-month period via monthly calendars. Mixed linear modelling incorporating intervention and control groups at the baseline and two follow up time points (18 weeks and 26 weeks after intervention commencement) will be used to assess outcomes.

Discussion

This planned trial will be the first to provide evidence if the exercise park can improve functional and physiological health, psychological and well-being. In addition, this study will provide empirical evidence for effectiveness and explore the barriers to participation and the acceptability of the senior exercise park in the Australian older community.

Trial registration

This trial is registered with the Australian New Zealand Clinical Trials Registry - Registry No. ACTRN12614000700639 registered on Jul 3rd 2014.

【 授权许可】

   
2015 Sales et al.

【 预 览 】
附件列表
Files Size Format View
20150710045228261.pdf 1209KB PDF download
Fig. 2. 54KB Image download
Figure 5. 27KB Image download
【 图 表 】

Figure 5.

Fig. 2.

【 参考文献 】
  • [1]Chang J, Morton S, Rubenstein L, Mojica W, Maglione M, Suttorp M, et al.: Interventions for the prevention of falls in older adults: systematic review and meta-analysis of randomised clinical trials. Br Med J 2004, 328:680.
  • [2]Gillespie LD, Robertson MC, Gillespie WJ, Sherrington C, Gates S, Clemson LM, et al. Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2012;9:CD007146.
  • [3]Australian Bureau of Statistics: Population by age and sex, regions of Australia. 2013.
  • [4]Hua F, et al. Falls prevention in older age in Western Pacific Asia Region. http://www.who.int/ageing/projects/falls_prevention_older_age/en/ webcite
  • [5]Australia Institute of Health and Welfare. Hospitalised injuries in older Australians: 2011–12. Injury research and statistics series 90. Cat. no. INJCAT 166. Canberra: 2014.
  • [6]Meessen J, Pisani S, Gambino ML, Bonarrigo D, van Schoor NM, Fozzato S, et al.: Assessment of mortality risk in elderly patients after proximal femoral fracture. Orthopedics 2014, 37:e194-200.
  • [7]Bentler SE, Liu L, Obrizan M, Cook EA, Wright KB, Geweke JF, et al.: The aftermath of hip fracture: discharge placement, functional status change, and mortality. Am J Epidemiol 2009, 170:1290-9.
  • [8]Deandrea S, Lucenteforte E, Bravi F, Foschi R, La Vecchia C, Negri E, et al.: Risk factors for falls in community-dwelling older people: a systematic review and meta-analysis. Epidemiology 2010, 21:658-68.
  • [9]Tinetti ME, Speechley M, Ginter SF: Risk factors for falls among elderly persons living in the community. N Engl J Med 1988, 319:1701-7.
  • [10]Sherrington C, Tiedemann A, Fairhall N, Close JC, Lord SR: Exercise to prevent falls in older adults: an updated meta-analysis and best practice recommendations. N S W Public Health Bull 2011, 22:78-83.
  • [11]Kannus P, Sievänen H, Palvanen M, Järvinen T, Parkkari J: Prevention of falls and consequent injuries in elderly people. Lancet 2005, 366:1885-93.
  • [12]Sherrington C, Whitney JC, Lord SR, Herbert RD, Cumming RG, Close JC: Effective exercise for the prevention of falls: a systematic review and meta‐analysis. J Am Geriatr Soc 2008, 56:2234-43.
  • [13]Merom D, Pye V, Macniven R, van der Ploeg H, Milat A, Sherrington C, et al.: Prevalence and correlates of participation in fall prevention exercise/physical activity by older adults. Prev Med 2012, 55:613-7.
  • [14]World Health Organization. WHO global report on falls prevention in older age. Switzerland; 2007.
  • [15]de Vreede PL, Tak ECPM. National report on assessment instruments for physical activity and physical functioning in older people in the Netherlands. TNO report. KvL/P&Z 2007.075. http://eunaapa.org/media/dutch_national_report_assessment_instruments.pdf webcite
  • [16]Moher D, Hopewell S, Schulz KF, Montori V, Gøtzsche PC, Devereaux P, et al.: CONSORT 2010 explanation and elaboration: updated guidelines for reporting parallel group randomised trials. J Clin Epidemiol 2010, 63:e1-37.
  • [17]Schulz KF, Altman DG, Moher D: CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. BMC Med 2010, 8:18. BioMed Central Full Text
  • [18]Preference Collaborative Review Group. Patients’ preferences within randomised trials: systematic review and patient level meta-analysis. BMJ: Br Med J. 2008;337:a1864.
  • [19]Torgerson DJ, Klaber-Moffett J, Russell IT: Patient preferences in randomised trials: threat or opportunity? J Health Serv Res 1996, 1:194-7.
  • [20]Torgerson DJ, Sibbald B: Understanding controlled trials. What is a patient preference trial? BMJ: Br Med J 1998, 316:360.
  • [21]Hill K, Bernhardt J, McGann A, Maltese D, Berkovits D: A new test of dynamic standing balance for stroke patients: reliability, validity and comparison with health elderly. Physiother Can 1996, 48:257-62.
  • [22]Shumway-Cook A, Brauer S, Woollacott M: Predicting the probability for falls in community-dwelling older adults using the timed up & go test. Phys Ther 2000, 80:896-903.
  • [23]Duncan PW, Weiner DK, Chandler J, Studenski S: Functional reach: a new clinical measure of balance. J Gerontol 1990, 45:M192-7.
  • [24]Anacker SL, Di Fabio RP: Influence of sensory inputs on standing balance in community-dwelling elders with a recent history of falling. Phys Ther 1992, 72:575-81.
  • [25]Haines T, Kuys SS, Morrison G, Clarke J, Bew P, McPhail S: Development and validation of the balance outcome measure for elder rehabilitation. Arch Phys Med Rehabil 2007, 88:1614-21.
  • [26]Kuys SS, Morrison G, Bew PG, Clarke J, Haines TP: Further validation of the balance outcome measure for elder rehabilitation. Arch Phys Med Rehabil 2011, 92:101-5.
  • [27]Di Fabio R, Anacker S: Identifying fallers in community living elders using a clinical test of sensory interaction for balance. Eur J Phys Med Rehabil 1996, 6:61-6.
  • [28]Cho B, Scarpace D, Alexander NB: Tests of stepping as indicators of mobility, balance, and fall risk in balance‐impaired older adults. J Am Geriatr Soc 2004, 52:1168-73.
  • [29]Podsiadlo D, Richardson S: The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 1991, 39:142-8.
  • [30]Vereeck L, Wuyts F, Truijen S, Van de Heyning P: Clinical assessment of balance: normative data, and gender and age effects. Int J Audiol 2008, 47:67-75.
  • [31]Tromp A, Pluijm S, Smit J, Deeg D, Bouter L, Lips P: Fall-risk screening test: a prospective study on predictors for falls in community-dwelling elderly. J Clin Epidemiol 2001, 54:837-44.
  • [32]Sallinen J, Stenholm S, Rantanen T, Heliövaara M, Sainio P, Koskinen S: Hand‐grip strength cut points to screen older persons at risk for mobility limitation. J Am Geriatr Soc 2010, 58:1721-6.
  • [33]Fess E, Moran C. Clinical assessment recommendation. Am Soc Hand Ther. 1981.
  • [34]Butland RJ, Pang J, Gross ER, Woodcock AA, Geddes DM: Two-, six-, and 12-minute walking tests in respiratory disease. Br Med J 1982, 284:1607-8.
  • [35]Gijbels D, Eijnde B, Feys P: Comparison of the 2-and 6-minute walk test in multiple sclerosis. Mult Scler J 2011, 17:1269-72.
  • [36]Kosak M, Smith T: Comparison of the 2-, 6-, and 12-minute walk tests in patients with stroke. J Rehabil Res Dev 2005, 42:103-8.
  • [37]Csuka M, McCarty DJ: Simple method for measurement of lower extremity muscle strength. Am J Med 1985, 78:77-81.
  • [38]Lord SR, Menz HB, Tiedemann A: A physiological profile approach to falls risk assessment and prevention. Phys Ther 2003, 83:237-52.
  • [39]Tinetti ME: Performance-oriented assessment of mobility problems in elderly patients. J Am Geriatr Soc 1986, 34:119-26.
  • [40]Berg KO, Wood-Dauphinee SL, Williams JI, Maki B: Measuring balance in the elderly: validation of an instrument. Can J Public Health 1992, 83:S7-11.
  • [41]Hausdorff JM, Rios DA, Edelberg HK: Gait variability and fall risk in community-living older adults: a 1-year prospective study. Arch Phys Med Rehabil 2001, 82:1050-6.
  • [42]Paterson K, Hill K, Lythgo N: Stride dynamics, gait variability and prospective falls risk in active community dwelling older women. Gait Posture 2011, 33:251-5.
  • [43]Besser MP, Kmieczak K, Schwartz L, Snyderman M, Wasko J, Selby-Silverstein L: Representation of temporal spatial gait parameters using means in adults without impairment. Gait Posture 1999, 9:113.
  • [44]Hollman JH, Childs KB, McNeil ML, Mueller AC, Quilter CM, Youdas JW: Number of strides required for reliable measurements of pace, rhythm and variability parameters of gait during normal and dual task walking in older individuals. Gait Posture 2010, 32:23-8.
  • [45]Ware JE Jr, Kosinski M, Keller SD: A 12-item short-form health survey: construction of scales and preliminary tests of reliability and validity. Med Care 1996, 34:220-33.
  • [46]Jakobsson U: Using the 12-item short form health survey (SF-12) to measure quality of life among older people. Aging Clin Exp Res 2007, 19:457-64.
  • [47]Delbaere K, Hauer K, Lord SR: Evaluation of the incidental and planned activity questionnaire (IPAQ) for older people. Br J Sports Med 2009, 44:1029-34.
  • [48]Levinger P, Menz HB, Morrow AD, Wee E, Feller JA, Bartlett JR, et al.: Lower limb proprioception deficits persist following knee replacement surgery despite improvements in knee extension strength. Knee Surg Sports Traumatol Arthrosc 2012, 20:1097-103.
  • [49]Levinger P, Menz HB, Wee E, Feller JA, Bartlett JR, Bergman NR: Physiological risk factors for falls in people with knee osteoarthritis before and early after knee replacement surgery. Knee Surg Sports Traumatol Arthrosc 2011, 19:1082-9.
  • [50]Mathew RS, Delbaere K, Lord SR, Beaumont P, Madigan MC: Depressive symptoms and quality of life in people with age‐related macular degeneration. Ophthalmic Physiol Opt 2011, 31:375-80.
  • [51]Kempen GI, Yardley L, van Haastregt JC, Zijlstra GA, Beyer N, Hauer K, et al.: The short FES-I: a shortened version of the falls efficacy scale-international to assess fear of falling. Age Ageing 2008, 37:45-50.
  • [52]House JS, Robbins C, Metzner HL: The association of social relationships and activities with mortality: prospective evidence from the Tecumseh community health study. Am J Epidemiol 1982, 116:123-40.
  • [53]Miller RR, Ballew SH, Shardell MD, Hicks GE, Hawkes WG, Resnick B, et al.: Repeat falls and the recovery of social participation in the year post-hip fracture. Age Ageing 2009, 38:570-5.
  • [54]Marsh HW, Martin AJ, Jackson S: Introducing a short version of the physical self description questionnaire: new strategies, short-form evaluative criteria, and applications of factor analyses. J Sport Exerc Psychol 2010, 32:438.
  • [55]Braun V, Clarke V: Using thematic analysis in psychology. Qual Res Psychol 2006, 3:77-101.
  • [56]Joffe H, Yardley L: Content and thematic analysis. In Research methods for clinical and health psychology. Edited by Marks DF, Yardley L. Sage, London; 2004.
  • [57]Tiedemann A, Sherrington C, Close JC, Lord SR: Exercise and sports science Australia position statement on exercise and falls prevention in older people. J Sci Med Sport 2011, 14:489-95.
  • [58]Borg GA: Psychophysical bases of perceived exertion. Med Sci Sports Exerc 1982, 14:377-81.
  • [59]Australian Bureau of Statistics: Australian Health Survey:Physical Activity, 2011-12. Cataloge 4364.0.55.004. http://www.abs.gov.au/AUSSTATS/abs@.nsf/Lookup/4364.0.55.004Main+Features12011-12?OpenDocument webcite
  • [60]Barton J, Griffin M, Pretty J: Exercise-, nature-and socially interactive-based initiatives improve mood and self-esteem in the clinical population. Perspect Public Health 2012, 132:89-96.
  • [61]Medical Advisory Secretariat: Social isolation in community-dwelling seniors: an evidence-based analysis Ont Health Technol Assess Ser 2008, 8:1-49.
  • [62]Leitner MJ, Leitner SF: Leisure in later life. 4th edition. Sagamore Publishing, Urbana; 2012.
  • [63]Touvier M, Bertrais S, Charreire H, Vergnaud A-C, Hercberg S, Oppert J-M: Changes in leisure-time physical activity and sedentary behaviour at retirement: a prospective study in middle-aged French subjects. Int J Behav Nutr Phys Act 2010, 7:1186. BioMed Central Full Text
  • [64]Teas J, Hurley T, Ghumare S, Ogoussan K: Walking outside improves mood for healthy postmenopausal women. Clin Med Oncol 2007, 1:35-43.
  • [65]Merrill RM, Shields EC, White GL Jr, Druce D: Climate conditions and physical activity in the United States. Am J Health Behav 2005, 29:371-81.
  • [66]McInnes E, Askie L: Evidence review on older people’s views and experiences of falls prevention strategies. Worldviews Evid-Based Nurs 2004, 1:20-37.
  • [67]West J, Hippisley-Cox J, Coupland C, Price G, Groom L, Kendrick D, et al.: Do rates of hospital admission for falls and hip fracture in elderly people vary by socio-economic status? Public Health 2004, 118:576-81.
  • [68]Australian Bureau of Statistics: 2030.2 - Melbourne... A Social Atlas, 2006. http://www.abs.gov.au/ausstats/abs@.nsf/mf/2030.2/ webcite
  • [69]Mody L, Miller DK, McGloin JM, Freeman M, Marcantonio ER, Magaziner J, et al.: Recruitment and retention of older adults in aging research. J Am Geriatr Soc 2008, 56:2340-8.
  • [70]King M, Nazareth I, Lampe F, Bower P, Chandler M, Morou M, et al.: Impact of participant and physician intervention preferences on randomized trials: a systematic review. JAMA 2005, 293:1089-99.
  文献评价指标  
  下载次数:11次 浏览次数:20次