Balancing Act: Impact on Falls in Older Adults with Vision Impairment

平衡法：对视力障碍老年人跌倒的影响

• 批准号: 8707305
• 负责人: MARILYN R GUGLIUCCI
• 金额: $ 17.17万
• 依托单位: UNIVERSITY OF MAINE ORONO
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-08-01 至 2016-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8707305
• 关键词: Accident and Emergency department; Accidental Falls; Adherence; Adopted; Adoption; Adverse effects; Affect; Age; Age related macular degeneration; Age-Years; Aging; Area; Balance training; Centers for Disease Control and Prevention (U.S.); Cessation of life; Characteristics; Communities; Control Groups; Data; Diabetic Retinopathy; Effectiveness; Elderly; Equilibrium; Equipment; Evidence based intervention; Exercise; Eye diseases; Face; Fall prevention; Gait; Generations; Geriatrics; Glaucoma; Goals; Hip Fractures; Home environment; Impairment; Independent Living; Individual; Injury; Institutionalization; Intervention; Lead; Maine; Measures; Medical; Mental Depression; Modeling; New England; Older Population; Osteopathic Medicine; Outcome; Pain; Participant; Physical activity; Pilot Projects; Population; Prevention program; Proprioception; Public Health; Randomized Controlled Trials; Reporting; Research; Risk; Risk Factors; Rural; Sampling; Services; Social Network; Social support; Subgroup; Testing; Time; Training; Training Programs; Transportation; Universities; Vision; Visual Acuity; Visual impairment; age related; balance testing; base; clinical practice; college; cost; design; equilibration disorder; evidence base; experience; fall risk; falls; fear of falling; group intervention; improved; injury prevention; innovation; member; modifiable risk; premature; prevent; programs; public health relevance; rural area; tool; user-friendly

DESCRIPTION (provided by applicant): Falls are a significant issue for older adults with vision impairment. Medical conditions such as glaucoma and age-related macular degeneration that result in vision impairment negatively impact balance. Falling is 1.7 times more likely among older adults with vision impairment. In 2010 there were 9,146,026 older adults treated in emergency rooms for unintentional falls and injuries from falls are expected to cost the nation an estimated $54.9 billion dollars by 2020. Falls can lead to death, depression, and loss of independence. However, impaired balance is a modifiable risk factor for falls. A practical yet innovative falls prevention program has been developed that is designed to enhance balance and proprioception among older adults. This program, U- ExCEL Balancing Act, consists of simple exercises that can be done at home (15 minutes duration-3 times a week) during normal daily activities, requires only one brief training session, and no equipment. This study aims to establish an evidence base documenting the positive impact of Balancing Act exercises on balance and fall prevention for older adults with vision impairment. A randomized controlled trial of older adults with vision impairment (best corrected vision of 20/70 or worse) will be conducted over a 6-month period (control group n = 35 and Balancing Act intervention group n = 35) to determine the impact of Balancing Act on falls, fear of falling, pain, and activity levels. Factors that can be expected to affect its adoption and sustained use such as cost in the community and social support networks in the home will also be investigated. It is hypothesized that the Balancing Act intervention will decrease the number of falls experienced by older adults who have vision impairment by improving their gait and balance, reducing their fear of falling, increasing their physical activity, and reducing their pain. The specific aims of the research are to: 1) Evaluate the impact of Balancing Act on standing balance control and proprioception for older adults who have vision impairment, using the Tinetti Gait & Balance Test, a validated tool for evaluating gait and balance and predicting fall risk; 2) Evaluate the impact of Balancing Act for older adults with vision impairment on falls, fear of falling, physical activity, and pain; and3) Improve adherence to the Balancing Act exercise program by facilitating social networks. Data will be analyzed through: 1) a descriptive assessment of the baseline demographic characteristics of sample members, covariates, and outcome variables, as well as 2) a repeated measures design examining the impact of the intervention on study participants.

描述（由申请人提供）：跌倒是视力障碍的老年人的重要问题。诸如青光眼和年龄相关的黄斑变性等医学状况会导致视力障碍对平衡产生负面影响。有视力障碍的老年人的下降可能是1.7倍。 2010年，在急诊室接受了9,146,026名老年人的无意下跌倒，预计到2020年，跌倒的伤害预计将使该国造成549亿美元的损失。跌倒会导致死亡，抑郁和失去独立。但是，余额受损是跌倒的可修改风险因素。已经开发了一项实用而创新的预防计划，旨在增强老年人的平衡和本体感受。该计划，即u-excel平衡法，包括简单的练习，可以在正常的日常活动中在家中（每周15分钟-3次）进行，只需要一个简短的培训课程，而无需设备。这项研究旨在建立一个证据基础，以记录平衡行为对平衡和预防跌倒的积极影响，对视力障碍的老年人。将在6个月（对照组n = 35和平衡行为n = 35）中进行视力障碍的老年人的随机对照试验（最佳校正视力为20/70或更糟），以确定平衡行为对跌倒的影响，害怕跌倒，疼痛和活动水平。因素 这可以预期会影响其采用和持续使用，例如社区中的成本和家庭的社会支持网络。假设平衡行为干预将减少老年人经历的跌倒数量，这些老年人通过改善步态和平衡而遭受视力障碍，减少对跌倒，增加身体活动并减轻疼痛的恐惧。该研究的具体目的是：1）使用Tinetti步态与平衡测试，评估平衡法对具有视力障碍的老年人的平衡控制和本体感受的影响，这是评估步态和平衡和预测跌倒风险的经过验证的工具； 2）评估平衡行为对视力障碍的老年人对跌倒，恐惧，体育锻炼和疼痛的影响； 3）通过促进社交网络来提高对平衡ACT练习计划的遵守。数据将通过：1）对样本成员，协变量和结果变量的基线人口特征的描述性评估，以及2）重复测量设计，研究了干预对研究参与者的影响。