Community-based Falls Prevention Program for the Elderly
Background: Falls are the leading cause of injury among older adults in Singapore, but falls among the elderly can be preventable and the risks are predictable. Translating this understanding of falls etiology into an integrated clinical and public health program that is accessible to the elderly is a critical health services delivery challenge.
Hypothesis: An evidence-based program of screening, risk modification and physical therapy delivered in a community setting will reduce recurrent falls incidence among a high-risk group of elderly recently discharged to the community.
Methodology: This randomized controlled trial targets patients seen at Emergency Department (ED) for a fall or fall-related injuries who are at least 65 years old and will be discharged to home. Upon signing the informed consent form, the participants will be followed up for nine months from the baseline assessment during which the participants are randomized into either a control or the intervention group. The participants in the intervention group will be provided with a multifactorial program of screening, risk modification and physical therapy focused on progressive strength, balance, and gait training either as an individualized program or a group setting in the community for the first three months from the date of randomization. The number of recurrent falls will be monitored via a falls prevention diary maintained by (or for) each participant.
|Study Design:||Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Single Blind (Outcomes Assessor)
Primary Purpose: Prevention
|Official Title:||Multifactorial, Evidence-based Program of Screening, Risk Modification and Physical Therapy to Prevent Falls Among Vulnerable Elderly Recently Discharged From Hospital to the Community.|
- The number of fallers who have fallen at least once during the 9-month study period [ Time Frame: 9 months ] [ Designated as safety issue: No ]
- The number of injurious falls and healthcare utilization [ Time Frame: 9 months ] [ Designated as safety issue: No ]Injurious falls are the falls that resulted in participants' seeking medical attention or restricting their daily activities for at least 48 hours.
|Study Start Date:||December 2012|
|Primary Completion Date:||April 2015 (Final data collection date for primary outcome measure)|
Experimental: Intervention Group
The intervention consists of a tailored physical therapy focused on progressive strength, balance and gait training for a period of 3 months.
Other: physical therapy
Tailored physical therapy sessions to modify impairments in balance and/or gait and to transition high-risk participants to an evidence-based group exercise program.
Other Name: Falls Prevention
No Intervention: Control Group
Usual care by physician.
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Please refer to this study by its ClinicalTrials.gov identifier: NCT01713543
|Changi General Hospital|
|Singapore, Singapore, 529889|
|Singapore General Hospital|
|Singapore, Singapore, 169608|
|Principal Investigator:||David B Matchar, MD||Duke-NUS Graduate Medical School|