Perturbation Training Compared to Balance and Strengthening Exercise, for Elderly at Risk of Falling

Clalit Health Services250 enrolled

Overview

One third of adults over 65 and 50% of adults above 80 years old fall at list once a year. In some cases, falls result in fractures, hospitalization, functional limitations, depression, morbidity and mortality. Strong evidence support exercise training programs for fall prevention, while several studies examined the effect of perturbation training on risk of fall. The aim of this study is to evaluate the effectiveness of a perturbation training program with unexpected perturbation using balance tutor on falls and injuries among elderly at risk of falling, compared to balance and strengthening exercise.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Enrollment

250

Conditions

Fall Prevention

Interventions

Balance Tutor Biofeedback Rehabilitation System

Balance Tutor system is a unique technology which allows for several postural control ability assessments as well as reactive response training in both standing and walking using controlled perturbation in simple task or multitask performance. Together with proactive training the system allows for optimal rehabilitation outcome and recovery

Eligibility

Sex: ALLMin age: 65 YearsMax age: 85 Years

Medical Language ↔ Plain English

Inclusion Criteria:at least one fall during the last 12 months; age 65-85; mini-mental state examination score 24 and above allowing cognitive ability to understand simple instructions ; Time Up and Go (TUG), assessing balance, walking ability and fall risk, scored 13 and above ; ability to read Hebrew or Arabic; and the ability to walk independently 10 meters. \- Exclusion Criteria:progressive neurological conditions (Parkinson, Multiple sclerosis, CVA); severe orthopedic conditions including lower limb or spine fractures and surgeries in the past 12 months prior to baseline; blindness; Arrhythmia; uncontrolled chronic disease (i.e., hypertension, diabetes, ischemic heart disease); diagnosed severe osteoporosis with a history of fracture during the past 3 years prior to baseline; active cancer during the past three years prior to baseline; lack of availability in the coming two months for completing the treatment protocol \-

Locations (3)

Clalit HealthCare services

Beersheba, Israel

RECRUITING

Clalit Healthcare Services

Holon, Israel

RECRUITING

Clalit HealthCare Services

Nazareth, Israel

RECRUITING

Outcomes

Primary Outcomes

rate of falls and fallers

Time frame: falls and fallers rates during 12-months following end of treatment

hip fractures and hospitalizations rates due to falls

Time frame: hip fractures and hospitalizations rates due to falls during12-months following end of treatment

Secondary Outcomes

Mini-BESTest

Balance assessment according to Balance Evaluation Systems Test. The Mini-BESTest is a 14 item test scored on a 3-level ordinal scale. The total score is 28 while a lower score indicates severe balance impairment

Time frame: end of treatment-last visit in physical therapy clinic

Activities-Specific Balance Confidence Scale (ABC scale)

The ABC scale is a 16-item self-report measure in which patients rate their balance confidence for performing activities. Items are rated on a rating scale that ranges from 0-100; 0 represents "no confidence" and 10 represents "complete confidence".

Time frame: 12 months after end of treatment

Physical Activity Scale for the Elderly (PASE)

The PASE measures the level of self-reported physical activity in individuals aged 65 years or older and is comprised of items regarding occupational, household, and leisure activities during the previous 7-days period

Time frame: 12 months after end of treatment

Central Contacts

Anat Shashua, PhD

CONTACT

972-50-8803223 Anatsh6@clalit.org.il

Igal Levran, MHA BPT

CONTACT

972-50-6262223 ilevran@clalit.org.il