Effectiveness of dual-task functional power training for preventing falls in older people : Study protocol for a cluster randomised controlled trial

Journal article


Daly, Robin, Duckham, Rachel, Tait, Jamie, Rantalainen, Timo, Nowson, Caryl, Taaffe, Dennis, Sanders, Kerrie, Hill, Keith, Kidgell, Dawson and Busija, Ljoudmila. (2015). Effectiveness of dual-task functional power training for preventing falls in older people : Study protocol for a cluster randomised controlled trial. Trials (online). 16(120), pp. 1 - 15. https://doi.org/10.1186/s13063-015-0652-y
AuthorsDaly, Robin, Duckham, Rachel, Tait, Jamie, Rantalainen, Timo, Nowson, Caryl, Taaffe, Dennis, Sanders, Kerrie, Hill, Keith, Kidgell, Dawson and Busija, Ljoudmila
Abstract

Background: Falls are a major public health concern with at least one third of people aged 65 years and over falling at least once per year, and half of these will fall repeatedly, which can lead to injury, pain, loss of function and independence, reduced quality of life and even death. Although the causes of falls are varied and complex, the age-related loss in muscle power has emerged as a useful predictor of disability and falls in older people. In this population, the requirements to produce explosive and rapid movements often occurs whilst simultaneously performing other attention-demanding cognitive or motor tasks, such as walking while talking or carrying an object. The primary aim of this study is to determine whether dual-task functional power training (DT-FPT) can reduce the rate of falls in community-dwelling older people. Methods/Design: The study design is an 18-month cluster randomised controlled trial in which 280 adults aged ≥65 years residing in retirement villages, who are at increased risk of falling, will be randomly allocated to: 1) an exercise programme involving DT-FPT, or 2) a usual care control group. The intervention is divided into 3 distinct phases: 6 months of supervised DT-FPT, a 6-month ‘step down’ maintenance programme, and a 6-month follow-up. The primary outcome will be the number of falls after 6, 12 and 18 months. Secondary outcomes will include: lower extremity muscle power and strength, grip strength, functional assessments of gait, reaction time and dynamic balance under single- and dual-task conditions, activities of daily living, quality of life, cognitive function and falls-related self-efficacy. We will also evaluate the cost-effectiveness of the programme for preventing falls. Discussion: The study offers a novel approach that may guide the development and implementation of future community-based falls prevention programmes that specifically focus on optimising muscle power and dual-task performance to reduce falls risk under ‘real life’ conditions in older adults. In addition, the ‘step down’ programme will provide new information about the efficacy of a less intensive maintenance programme for reducing the risk of falls over an extended period.

Year2015
JournalTrials (online)
Journal citation16 (120), pp. 1 - 15
ISSN1745-6215
Digital Object Identifier (DOI)https://doi.org/10.1186/s13063-015-0652-y
Scopus EID2-s2.0-84928159810
Open accessOpen access
Page range1 - 15
Research GroupInstitute for Health and Ageing
Publisher's version
Grant IDnhmrc/1046267
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Levinger, Itamar, Scott, David, Nicholson, Geoffrey, Stuart, Amanda, Duque, Gustavo, McCorquodale, Thomas, Herrmann, Markus, Ebeling, Peter and Sanders, Kerrie. (2014). Undercarboxylated osteocalcin, muscle strength and indices of bone health in older women. Bone. 64, pp. 8 - 12. https://doi.org/10.1016/j.bone.2014.03.008
The rapid assessment of disability - Informing the development of an instrument to measure the effectiveness of disability inclusive development through a qualitative study in Bangladesh
Huq, Nafisa L., Edmonds, Tanya, Baker, Sally, Busija, Ljoudmila, Devine, Alexandra, Fotis, Kathy, Marella, Manjula, Goujon, Nicolas and Keeffe, Jill. (2013). The rapid assessment of disability - Informing the development of an instrument to measure the effectiveness of disability inclusive development through a qualitative study in Bangladesh. Disability, CBR and Inclusive Development. 24(3), pp. 37 - 60. https://doi.org/10.5463/DCID.v24i3.174
Is high dose Vitamin D harmful?
Sanders, Kerrie, Nicholson, Geoffrey and Ebeling, Peter. (2013). Is high dose Vitamin D harmful? Calcified Tissue International. 92(2), pp. 191 - 206. https://doi.org/10.1007/s00223-012-9679-1
Vitamin D and health in adults in Australia and New Zealand : A position statement
Nowson, Caryl A., McGrath, John J., Ebeling, Peter R., Haikerwal, Anjali, Daly, Robin M., Sanders, Kerrie M., Seibel, Markus J. and Mason, Rebecca S.. (2012). Vitamin D and health in adults in Australia and New Zealand : A position statement. Medical Journal of Australia. 196(11), pp. 686-687. https://doi.org/10.5694/mja11.10301
Osteo-cise: Strong Bones for Life: Protocol for a community-based randomised controlled trial of a multi-modal exercise and osteoporosis education program for older adults at risk of falls and fractures
Gianoudis, Jenny, Bailey, Christine A., Sanders, Kerrie M., Nowson, Caryl A., Hill, Keith, Ebeling, Peter R. and Daly, Robin M.. (2012). Osteo-cise: Strong Bones for Life: Protocol for a community-based randomised controlled trial of a multi-modal exercise and osteoporosis education program for older adults at risk of falls and fractures. BMC Musculoskeletal Disorders. 13(78), pp. 1 - 16. https://doi.org/10.1186/1471-2474-13-78
Vitamin D with calcium reduces mortality: Patient level pooled analysis of 70,528 patients from eight major vitamin D trials
Rejnmark, Lars, Avenell, Alison, Masud, Tahir, Anderson, Frazer, Meyer, Haakon E., Sanders, Kerrie M., Salovaara, Kari, Cooper, Cyrus, Smith, Helen E., Jacobs, Elizabeth T., Torgerson, David, Jackson, Rebecca D., Manson, JoAnn E., Brixon, Kim, Mosekilde, Leif, Robbins, John A., Francis, Roger M. and Abrahamsen, Bo. (2012). Vitamin D with calcium reduces mortality: Patient level pooled analysis of 70,528 patients from eight major vitamin D trials. The Journal of Clinical Endocrinology and Metabolism. 97(8), pp. 2670 - 2681. https://doi.org/10.1210/jc.2011-3328
Fracture risk score and absolute risk of fracture
Henry, Margaret, Pasco, Julie, Merriman, Elizabeth, Zhang, Yu, Sanders, Kerrie, Kotowicz, Mark and Nicholson, Geoffrey. (2011). Fracture risk score and absolute risk of fracture. Radiology. 259(2), pp. 495 - 501. https://doi.org/10.1148/radiol.10101406
Changes in hip fracture rates in southeastern Australia spanning the period 1994-2007
Pasco, Julie, Brennan, Sharon, Henry, Margaret, Nicholson, Geoffrey, Sanders, Kerrie, Zhang, Yu and Kotowicz, Mark. (2011). Changes in hip fracture rates in southeastern Australia spanning the period 1994-2007. Journal of Bone and Mineral Research. 26(7), pp. 1648 - 1654. https://doi.org/10.1002/jbmr.393
Independent and combined effects of calcium-vitamin D3 and exercise on bone structure and strength in older men: An 18-month factorial design randomized controlled trial
Kukuljan, Sonja, Nowson, Caryl, Sanders, Kerrie, Nicholson, Geoffrey, Seibel, Markus, Salmon, Jo and Daly, Robin. (2011). Independent and combined effects of calcium-vitamin D3 and exercise on bone structure and strength in older men: An 18-month factorial design randomized controlled trial. The Journal of Clinical Endocrinology and Metabolism. 96(4), pp. 955 - 963. https://doi.org/10.1210/jc.2010-2284
Inflammatory cytokine responses to progressive resistance training and supplementation with fortified milk in men aged 50+ years: An 18-month randomized controlled trial
Peake, Jonathan, Kukuljan, Sonja, Nowson, Caryl, Sanders, Kerrie and Daly, Robin. (2011). Inflammatory cytokine responses to progressive resistance training and supplementation with fortified milk in men aged 50+ years: An 18-month randomized controlled trial. European Journal of Applied Physiology. 111(12), pp. 3079 - 3088. https://doi.org/10.1007/s00421-011-1942-z
Paracetamol (acetaminophen) use, fracture and bone mineral density
Williams, Lana, Pasco, Julie, Henry, Margaret, Sanders, Kerrie, Nicholson, Geoffrey, Kotowicz, Mark and Berk, Michael. (2011). Paracetamol (acetaminophen) use, fracture and bone mineral density. Bone. 48(6), pp. 1277 - 1281. https://doi.org/10.1016/j.bone.2011.03.435
Annual high-dose vitamin D3 and mental well-being: Randomised controlled trial
Sanders, Kerrie, Stuart, Amanda, Williamson, Elizabeth, Jacka, Felice, Dodd, Seetal, Nicholson, Geoff and Berk, Michael. (2011). Annual high-dose vitamin D3 and mental well-being: Randomised controlled trial. British Journal of Psychiatry. 198(5), pp. 357 - 364. https://doi.org/10.1192/bjp.bp.110.087544
Annual feedback is an effective tool for a sustained increase in calcium intake among older women
Sanders, Kerrie, Stuart, Amanda L., Kotowicz, Mark and Nicholson, Geoff. (2010). Annual feedback is an effective tool for a sustained increase in calcium intake among older women. Nutrients. 2(9), pp. 1018 - 1025. https://doi.org/10.3390/nu2091018
Annual high-dose oral vitamin D and falls and fractures in older women: A randomized controlled trial
Sanders, Kerrie, Stuart, Amanda L., Williamson, Elizabeth J., Simpson, Julie A., Kotowicz, Mark, Young, Doris and Nicholson, Geoff. (2010). Annual high-dose oral vitamin D and falls and fractures in older women: A randomized controlled trial. JAMA: Journal of the American Medical Association. 303(18), pp. 1815 - 1822. https://doi.org/10.1001/jama.2010.594
The use of clinical risk factors enhances the performance of BMD in the prediction of hip and osteoporotic fractures in men and women
Kanis, John, Oden, Anders, Johnell, O., Johansson, Helena, Laet, C. De, Brown, Jacques P., Burckhardt, Peter, Cooper, Cyrus, Christiansen, Claus, Cummings, Steven R., Eisman, John A., Fujiwara, S., Glüer, C. C., Goltzman, David, Hans, Didier, Krieg, Marc Antoine, Lacroix, Andrea Z., McCloskey, Eugene, Mellström, Dan, ... Yoshimura, N.. (2007). The use of clinical risk factors enhances the performance of BMD in the prediction of hip and osteoporotic fractures in men and women. Osteoporosis International. 18(8), pp. 1033 - 1046. https://doi.org/10.1007/s00198-007-0343-y