TY - JOUR
T1 - Action Seniors! - secondary falls prevention in community-dwelling senior fallers
T2 - Study protocol for a randomized controlled trial
AU - Liu-Ambrose, Teresa
AU - Davis, Jennifer C.
AU - Hsu, Chun Liang
AU - Gomez, Caitlin
AU - Vertes, Kelly
AU - Marra, Carlo
AU - Brasher, Penelope M.
AU - Dao, Elizabeth
AU - Khan, Karim M.
AU - Cook, Wendy
AU - Donaldson, Meghan G.
AU - Rhodes, Ryan
AU - Dian, Larry
N1 - Funding Information:
TLA wrote the grant application that was funded by the Canadian Institute for Health Research and jointly drafted the Action Seniors! Protocol. JCD contributed to writing the grant application that was funded by the Canadian Institute for Health Research and jointly drafted the Action Seniors! Protocol. CLH, CG, KV, and ED are part of the Action Seniors! Research team and critically reviewed the manuscript. CM and PMB contributed to writing the grant application that was funded by the Canadian Institute for Health Research and critically reviewed the Action Seniors! Protocol. WC critically reviewed the grant application that was funded by the Canadian Institute for Health Research and critically reviewed the Action Seniors! Protocol. KMK contributed to writing the grant application that was funded by the Canadian Institute for Health Research. MGD and RR critically reviewed the grant application that was funded by the Canadian Institute for Health Research. LD is the geriatrician at the Falls Prevention Clinic and part of the Action Seniors! Research team. LD critically reviewed the manuscript. The grant application formed the bases for the manuscript. All authors have read and approved the final manuscript.
Funding Information:
This study is funded by the Canadian Institute for Health Research. TLA is a Canada Research Chair in Physical Activity, Mobility, and Cognitive Neuroscience, a Michael Smith Foundation for Health Research (MSFHR) Scholar, a Canadian Institutes of Health Research (CIHR) New Investigator, and a Heart and Stroke Foundation of Canada’s Henry JM Barnett’s Scholarship recipient. JCD was funded by a CIHR and MSFHR Postdoctoral Fellowship. ED is funded by a CIHR Doctoral Award - Frederick Banting and Charles Best Canada Graduate Scholarship. CLH is funded by a PhD Alzheimer Society Research Program Award. These funding agencies did not play a role in study design. We obtained approval from UBC Clinical Ethics Review Board.
Publisher Copyright:
© Liu-Ambrose et al.; licensee BioMed Central.
PY - 2015/4/10
Y1 - 2015/4/10
N2 - Background: Falls are a 'geriatric giant' and are the third leading cause of chronic disability worldwide. About 30% of community-dwellers over the age of 65 experience one or more falls every year leading to significant risk for hospitalization, institutionalization, and even death. As the proportion of older adults increases, falls will place an increasing demand and cost on the health care system. Exercise can effectively and efficiently reduce falls. Specifically, the Otago Exercise Program has demonstrated benefit and cost-effectiveness for the primary prevention of falls in four randomized trials of community-dwelling seniors. Although evidence is mounting, few studies have evaluated exercise for secondary falls prevention (that is, preventing falls among those with a significant history of falls). Hence, we propose a randomized controlled trial powered for falls that will, for the first time, assess the efficacy and efficiency of the Otago Exercise Program for secondary falls prevention. Methods/Design: A randomized controlled trial among 344 community-dwelling seniors aged 70 years and older who attend a falls prevention clinic to assess the efficacy and the cost-effectiveness of a 12-month Otago Exercise Program intervention as a secondary falls prevention strategy. Participants randomized to the control group will continue to behave as they did prior to study enrolment. The economic evaluation will examine the incremental costs and benefits generated by using the Otago Exercise Program intervention versus the control. Discussion: The burden of falls is significant. The challenge is to make a difference - to discover effective, ideally cost-effective, interventions that prevent injurious falls that can be readily translated to the population. Our proposal is very practical - the exercise program requires minimal equipment, the physical therapist expertise is widely available, and seniors in Canada and elsewhere have adopted the program and complied with it. Our innovation includes applying the intervention to a targeted high-risk population, aiming to provide the best value for money. Given society's limited financial resources and the known and increasing burden of falls, there is an urgent need to test this feasible intervention which would be eminently ready for roll out.
AB - Background: Falls are a 'geriatric giant' and are the third leading cause of chronic disability worldwide. About 30% of community-dwellers over the age of 65 experience one or more falls every year leading to significant risk for hospitalization, institutionalization, and even death. As the proportion of older adults increases, falls will place an increasing demand and cost on the health care system. Exercise can effectively and efficiently reduce falls. Specifically, the Otago Exercise Program has demonstrated benefit and cost-effectiveness for the primary prevention of falls in four randomized trials of community-dwelling seniors. Although evidence is mounting, few studies have evaluated exercise for secondary falls prevention (that is, preventing falls among those with a significant history of falls). Hence, we propose a randomized controlled trial powered for falls that will, for the first time, assess the efficacy and efficiency of the Otago Exercise Program for secondary falls prevention. Methods/Design: A randomized controlled trial among 344 community-dwelling seniors aged 70 years and older who attend a falls prevention clinic to assess the efficacy and the cost-effectiveness of a 12-month Otago Exercise Program intervention as a secondary falls prevention strategy. Participants randomized to the control group will continue to behave as they did prior to study enrolment. The economic evaluation will examine the incremental costs and benefits generated by using the Otago Exercise Program intervention versus the control. Discussion: The burden of falls is significant. The challenge is to make a difference - to discover effective, ideally cost-effective, interventions that prevent injurious falls that can be readily translated to the population. Our proposal is very practical - the exercise program requires minimal equipment, the physical therapist expertise is widely available, and seniors in Canada and elsewhere have adopted the program and complied with it. Our innovation includes applying the intervention to a targeted high-risk population, aiming to provide the best value for money. Given society's limited financial resources and the known and increasing burden of falls, there is an urgent need to test this feasible intervention which would be eminently ready for roll out.
KW - Executive Functions
KW - Falls
KW - Older Adults
KW - Otago Exercise Program
KW - Resistance Training
UR - http://www.scopus.com/inward/record.url?scp=84928264557&partnerID=8YFLogxK
U2 - 10.1186/s13063-015-0648-7
DO - 10.1186/s13063-015-0648-7
M3 - Journal article
C2 - 25873254
AN - SCOPUS:84928264557
SN - 1745-6215
VL - 16
JO - Trials
JF - Trials
IS - 1
M1 - 144
ER -