Exercise Therapy For Prevention Of Falls In People With Parkinsons Disease: A Randomised Controlled Trial.
Funder
National Health and Medical Research Council
Funding Amount
$598,820.00
Summary
Despite optimal medication regimes, people with Parkinson's disease frequently and recurrently experience falls. Up to 68% of the 100,000 people living in Australia with Parkinson's disease fall every year and fall-related injuries are the most common reason why people with Parkinson's disease are admitted to hospital. This project will implement an exercise program targeting risk factors for falls and will determine the efficacy and the cost effectiveness of the program.
Falls Prevention For Stroke Patients Following Discharge Home: Contributory Factors And A Randomised Trial Intervention.
Funder
National Health and Medical Research Council
Funding Amount
$549,440.00
Summary
Falls are common after stroke, with over 50% of people being discharged home from hospital after stroke experiencing one or more falls in the subsequent six months. Despite a large focus on falls prevention in the community generally, and increasing research that a range of activities (such as exercise, medication review, home hazard modification) are effective in reducing falls among older people generally, there have been no randomised trials evaluating the effectiveness of falls prevention ac ....Falls are common after stroke, with over 50% of people being discharged home from hospital after stroke experiencing one or more falls in the subsequent six months. Despite a large focus on falls prevention in the community generally, and increasing research that a range of activities (such as exercise, medication review, home hazard modification) are effective in reducing falls among older people generally, there have been no randomised trials evaluating the effectiveness of falls prevention activities for people with stroke. This research will evaluate whether a detailed assessment and program of falls prevention activities (exercise, falls prevention information, bone strength recommendations, and other activities based on the assessment findings) will reduce falls in stroke patients with increased risk of falling. Two additional issues associated with falls among people with stroke will also be investigated. Detailed analysis of walking and stepping over obstacles will be evaluated to determine long term problems which might increase the risk of falling, and the effect of the falls prevention program will also be evaluated on the walking and stepping over the obstacle tasks. A third study will investigate the development of fear of falling firstly as a result of the stroke and resultant walking difficulties, and then how this changes when a fall occurs. The interaction between falls, fear of falling, and reduced activity and walking will be explored. The outcomes of this project will improve the understanding by health professionals of key factors contributing to increased risk of falling following stroke, and provide clear direction and resources for general application of the program in other stroke rehabilitation programs nationally. The main anticipated outcome is 33% reduction in falls, and improved balance, walking, and confidence for people returning home after stroke.Read moreRead less
Epidemiology Of Osteoporotic Fractures In The Very Frail Elderly: Risk Factors, Quality Of Life And Mortality
Funder
National Health and Medical Research Council
Funding Amount
$340,550.00
Summary
Osteoporosis, a disease characterised by skeletal fragility, is a major public health problem. The direct costs alone of treating osteoporotic fractures have been estimated at more than $800 million in Australia. Hip fractures are the most costly to treat and are due to a fall or injury in over 90% of cases. The frail elderly are at particular risk of osteoporotic fractures but little is known about risk fractures in this 'at risk' group or the effect of fracture on quality of life. This study i ....Osteoporosis, a disease characterised by skeletal fragility, is a major public health problem. The direct costs alone of treating osteoporotic fractures have been estimated at more than $800 million in Australia. Hip fractures are the most costly to treat and are due to a fall or injury in over 90% of cases. The frail elderly are at particular risk of osteoporotic fractures but little is known about risk fractures in this 'at risk' group or the effect of fracture on quality of life. This study is examining risk factors for fractures in the frail and institutionalised older person by asessment of quantitative bone ultrasound, falls risk, vitamin D status and other biochemical markers of bone in an attempt to identify predictors that can be modified to reduce fractures, improve quality of life and reduce mortality due to osteoporotic fractures.Read moreRead less
The Effectiveness Of A Community Based Program For Reducing The Incidence Of Falls Among The Elderly:A Randomized Trial.
Funder
National Health and Medical Research Council
Funding Amount
$206,604.00
Summary
Falls are the leading cause of hospitalization due to injury in elderly people, and are associated with substantial medical and rehabilitation costs, as well as social isolation and premature institutionalization for a significant number of people who fall. This study aims to reduce the economic and social burden of falls. A randomized controlled trial will evaluate the impact of a community based falls prevention program (C-BF) with an at-risk elderly population. The intervention is designed to ....Falls are the leading cause of hospitalization due to injury in elderly people, and are associated with substantial medical and rehabilitation costs, as well as social isolation and premature institutionalization for a significant number of people who fall. This study aims to reduce the economic and social burden of falls. A randomized controlled trial will evaluate the impact of a community based falls prevention program (C-BF) with an at-risk elderly population. The intervention is designed to improve elderly people's capacity to follow through with effective falls prevention strategies and to manage risks in their everyday lives, and hence to reduce the rate at which they experience falls. The outcome of this project will be a user friendly manual that will document the program in enough detail so that it can be easily implemented by health care professionals.Read moreRead less
Dynamic Postural Stability And Falls Prediction In Older People During Walking In Real-world Environments.
Funder
National Health and Medical Research Council
Funding Amount
$680,793.00
Summary
The increased occurrence of falls with advancing age (33-50% of people aged >65 years) is a significant cause of mortality (1014 deaths in 1998), morbidity, and disability, affecting not only the individuals concerned, but the health care system (45,069 fall related hospitalizations in 1998 in Australia) and the broader community (National falls Prevention Initiative, 2004). Although there are a number of falls risk tests, most rely on determination of body sway while standing when the body i ....The increased occurrence of falls with advancing age (33-50% of people aged >65 years) is a significant cause of mortality (1014 deaths in 1998), morbidity, and disability, affecting not only the individuals concerned, but the health care system (45,069 fall related hospitalizations in 1998 in Australia) and the broader community (National falls Prevention Initiative, 2004). Although there are a number of falls risk tests, most rely on determination of body sway while standing when the body is static rather than in motion. Given that up to 70% of falls occur during walking and performing transfers, there is a clear need to develop tests of falls risk prediction that incorporate indices of postural stability measured during more dynamic activities. Test development needs to be underpinned by clear evidence of how age-related sensory and motor deficits affect postural stability during walking. The studies outlined in this application will develop and utilise new accelerometer-based technologies to determine the fundamental mechanisms underlying balance control during walking in older people. Specifically, this project will aim to develop a clear understanding of how changes in factors as vision, neuromuscular function (strength, stiffness) and proprioception contribute to the overall decline in stability and balance during walking in older people. Combined with physiological assessment measures developed by the research team, the research will allow the development of a more definitive predictive test of stability and falls risk. This test will be able to be used by health professionals for assessment of older people to determine the most effective therapeutic and-or exercise interventions to target those individuals at risk. This technology will also be adaptable to a biofeedback device to allow individuals to monitor their own stability.Read moreRead less
A reduced capacity to recover balance following an imbalance episode contributes to the high incidence of falls in older adults. The goal of the present study is to determine how age-related differences in lower extremity neuromuscular and biomechanical properties are related to balance recovery capacity and falls incidence. A detailed understanding of this relationship is necessary for the development of efficacious exercise-based interventions for the prevention of falls.
Improving Vision To Prevent Falls: A Randomized Trial
Funder
National Health and Medical Research Council
Funding Amount
$403,892.00
Summary
More than 30% of older Australians fall over at least once a year. Poor eyesight, another very common problem among older Australians, increases the risk of falling. In fact, recent evidence from the Blue Mountains Eye Study suggests that poor vision is one of the strongest risk factors for falls and fractures yet identied. Our project is designed to assess whether improving vision will decrease the chance of falls and fractures. We will recruit 1200 people aged 75 years and over from among thos ....More than 30% of older Australians fall over at least once a year. Poor eyesight, another very common problem among older Australians, increases the risk of falling. In fact, recent evidence from the Blue Mountains Eye Study suggests that poor vision is one of the strongest risk factors for falls and fractures yet identied. Our project is designed to assess whether improving vision will decrease the chance of falls and fractures. We will recruit 1200 people aged 75 years and over from among those attending community-based aged care services in the inner western suburbs of Sydney. If they consent to participate, people will be randomly allocated to either an intervention or control group. Those in the intervention group will receive a simple, yet comprehensive, series of vision and eye tests. These tests will be done by an optometrist, either in subjects' homes or at the study centre. Our previous research suggests that nearly 50% of subjects will benefit from having new glasses and 10% might require cataract surgery. If necessary, treatment will be paid for from study funds. Some vision problems cannot be fixed. In these cases, an occupational therapist will arrange appropriate home modifications to improve vision-related function. Subjects will be followed-up for 12 months to assess the frequency of falls in the intervention and control groups. We hope to find a 33% reduction in falls in the intervention group. We will follow subjects for a further year to identify fractures.Read moreRead less
Randomised Controlled Trial Of Multimedia Patient Education Approaches To Preventing In-hospital Falls
Funder
National Health and Medical Research Council
Funding Amount
$524,137.00
Summary
In hospital falls are one of the most frequently occurring adverse events in Australian hospitals. They are the cause of considerable patient morbidity, stress to family members and care givers, and health care resource use. However, there are many potential causes of in-hospital falls which has made minimising them a difficult task for hospitals around the country. Recent evidence has indicated that a patient intervention strategy is useful for preventing in-hospital falls as a part of a multi- ....In hospital falls are one of the most frequently occurring adverse events in Australian hospitals. They are the cause of considerable patient morbidity, stress to family members and care givers, and health care resource use. However, there are many potential causes of in-hospital falls which has made minimising them a difficult task for hospitals around the country. Recent evidence has indicated that a patient intervention strategy is useful for preventing in-hospital falls as a part of a multi-factorial falls prevention program. This research aims to investigate the effectiveness and economic benefit of two approaches to providing patient education for the prevention of in-hospital falls. Patients at high risk for falls will be recruited from the Princess Alexandra Hospital and be randomly allocated to either a DVD + 4 sessions of face-to-face education with an occupational therapist program, to a DVD alone education program, or to a usual care with no additional education control condition. Patients will be followed up until their discharge from hospital and the number of in-hospital falls they incur will be compared between groups. It is expected that both the DVD + 4 sessions of face-to-face education with an occupational therapist program, to a DVD alone education program will be effective in reducing falls and that the DVD alone education program will demonstrate the greater cost-effectiveness in reducing falls. Stemming from this research, it is anticipated that a cost-effective resource for preventing in-hospital falls will be developed and evaluated such that it can be used in hospitals Australia wide.Read moreRead less