Fall Prevention Among Community Living Elderly

Fall Prevention by Assistant Nurses Among Community Living Elderly With Risk of Falling - a Randomized Controlled Trial

The purpose of this study is to assess effects of a home exercise program, supervised by assistant nurses with the aim of preventing falls.

Community living persons 65 years of age or older having a risk of falling were invited to participate. Participants were randomized to either training or control.

The training program was individually designed by a physiotherapist and the 5-month program performance was supervised in the partcipants home by eight home visits from an assistant nurse.

All participants received a visit from an occupational therapist who assessed the home and, if necessary, gave advice.

Study Overview

• Status: Completed
• Conditions: Accidental Falls/Prevention and Control
• Intervention / Treatment: Other: Complete intervention; Other: Basic intervention

Detailed Description

Falls among elderly are a major public health problem, but preventive interventions containing physical exercise and home improvement are available.

In this study the crucial question was to test whether unlicensed staff, assistant nurses, could be used for preventive work.

Estimation of study power gave that 170 participants in each group would be needed to detect a difference in days with falls, the main outcome measure.

• Study Type: Interventional
• Enrollment (Actual): 148
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Sweden
  • Orebro, Sweden, 701 16
    • Family medicine research center

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 65 years and older (Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• community living persons at least 65 years old
• independent walking ability with or without walking aid
• experienced at least one fall during the last 12 months
• ability to communicate and cooperate with study staff

Exclusion Criteria:

• ongoing physiotherapy treatment
• ongoing participation in exercise/acitivity containing balance and strength enhancing components
• a dementia diagnose
• mental disorder that affects possibility to communicate and cooperate
• other medical reason making participation inte the study inappropriate.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Training; Complete intervention i.e. basic intervention + individual training program.	Other: Complete intervention; The basic intervention, an occupational therapist assessed the home environment and gave advice, if necessary. Then participants were assessed by a physiotherapist concerning health and function pre and post intervention. The intervention consisted of an individually designed home exercise program aiming at improving balance, muscle strength and walking ability. The program, which was made by the physiotherapist, should be performed three times a week. A minimum of 30 minutes of walking per week was recommended, encouring further walking on an individual basis. An assistant nurse made eight home visits to supervise, help and encourage performance of activities.
Active Comparator: Control; Basic intervention.	Other: Basic intervention; The basic interventions was an occupational therapist assessed the home environment and gave advice, if necessary. Then participants were assessed by a physiotherapist concerning health and function pre and post intervention.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Number of days with fall	Self reported calendar data	12 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Exercise	Self reported calendar data	12 months

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Strength	Chair stand test	Pre and post intervention, 5 months
Balance	Falls efficacy scale (FES)	Pre and post intervention, 5 months
Balance	Bergs balance scale	Pre and post intervention, 5 months
Walking 3 metres test		Pre and post intervention, 5 months
Health related quality of life	Self reported interview data, SF-36	Pre and post intervention, 5 months
Activities of daily living	ADL	Pre and post intervention, 5 months
Walking	Minutes of walking per day, self reported calendar data.	12 months
Hospital days	Hospital register data	12 months
Hospital visits	Hospital register data	12 months
Fractures or other harms	Hospital register data	12 months
Strength	Timed Up and Go, TUG	Pre and post assessment, 5 months

Collaborators and Investigators

• Sponsor: Gunilla Fahlstrom
• Collaborators: Örebro County Council; Örebro University, Sweden
• Investigators: Principal Investigator: Gunilla Fahlstrom, PhD, Örebro County Council

Study record dates

Study Major Dates

• Study Start: January 1, 2007
• Primary Completion (Actual): December 1, 2009
• Study Completion (Actual): December 1, 2009

Study Registration Dates

• First Submitted: October 9, 2012
• First Submitted That Met QC Criteria: October 11, 2012
• First Posted (Estimate): October 12, 2012

Study Record Updates

• Last Update Posted (Estimate): October 12, 2012
• Last Update Submitted That Met QC Criteria: October 11, 2012
• Last Verified: October 1, 2012

More Information

Terms related to this study

• Keywords: prevention; fall
• Other Study ID Numbers: OLLGF01; OLLGF0112 (Other Identifier: Orebro county council)