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: 8570337
• 负责人: MARILYN R GUGLIUCCI
• 金额: $ 21.17万
• 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 2015-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8570337
• 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）：对于视力障碍的老年人来说，跌倒是一个严重的问题。青光眼和年龄相关性黄斑变性等疾病会导致视力障碍，对平衡产生负面影响。有视力障碍的老年人跌倒的可能性是普通人的 1.7 倍。 2010 年，有 9,146,026 名老年人因意外跌倒而在急诊室接受治疗，预计到 2020 年，跌倒造成的伤害将给国家造成约 549 亿美元的损失。跌倒可能导致死亡、抑郁和丧失独立性。然而，平衡受损是跌倒的一个可改变的风险因素。一项实用而创新的跌倒预防计划已经开发出来，旨在增强老年人的平衡感和本体感觉。该计划名为“U-ExCEL 平衡法”，由简单的练习组成，可以在正常的日常活动中在家进行（持续 15 分钟，每周 3 次），只需一次简短的训练，无需任何设备。本研究旨在建立一个证据基础，记录平衡法练习对视力障碍老年人的平衡和预防跌倒的积极影响。将对患有视力障碍的老年人（最佳矫正视力为 20/70 或更差）进行为期 6 个月的随机对照试验（对照组 n = 35，平衡法干预组 n = 35），以确定针对跌倒、跌倒恐惧、疼痛和活动水平采取平衡行动。因素 预计这会影响其采用和持续使用，例如社区成本和家庭社会支持网络也将受到调查。据推测，平衡法干预将通过改善视力障碍老年人的步态和平衡、减少对跌倒的恐惧、增加体力活动和减轻疼痛来减少他们跌倒的次数。该研究的具体目的是： 1) 使用 Tinetti 步态和平衡测试（一种经过验证的评估步态和平衡以及预测跌倒的工具），评估平衡法对视力障碍老年人的站立平衡控制和本体感觉的影响风险; 2) 评估平衡法对视力障碍老年人跌倒、跌倒恐惧、体力活动和疼痛的影响； 3) 通过促进社交网络提高对平衡法锻炼计划的遵守率。将通过以下方式分析数据：1) 对样本成员、协变量和结果变量的基线人口特征进行描述性评估，以及 2) 重复测量设计，检查干预措施对研究参与者的影响。