Technological-based platform for risk assessment, detection and prevention of falls among home-dwelling elderly: a study protocol. (Preprint)

Abstract

BACKGROUND
According to the United Nations it is estimated that by 2050 the number of people aged 80 and over will triple. The increased longevity is often accompanied by structural and functional changes occurring throughout the lifespan. These changes are often aggravated by chronic comorbidities, adopted behaviours and lifestyles and environmental exposures, among others. Some of the related outcomes are muscle strength, balance control and mobility impairments, which are strongly associated with the occurrence of falls in this population. Despite primary care health professionals still undervalue the importance of knowledge on fall prevention among the elderly population, several evidence-based (single or multifaceted) fall prevention programmes have demonstrated a significant reduction in the risk of falls and fall-related injuries in the elderly within community settings, such as the Otago Exercise Programme (OEP). Recent evidence has strived to integrate technologies into physical exercise programmes that have shown a positive effect in adherence and overcoming barriers to exercise, as well as improvements in physical functioning.

OBJECTIVE
To assess the impact of the Otago's physical exercise programme on the functionality of home-dwelling elderly, using a common technological platform. Namely, the impact on muscle strength, balance, mobility, risk of falling, the perception of fear of falling and the perception of the elderly regarding the ease of use of technology.

METHODS
A quasi-experimental study (before and after a single group) comprising male and female participants, aged 65 years or over, living at home in the district of Porto, will be conducted. Participants will be recruited through the network COLABORAR, with a minimum of 30 participants, following the study inclusion and exclusion criteria. All participants will sign informed consent The data collection instrument consists of socio-demographic/clinical variables (self-reported), functional evaluation variables and environmental risk variables. The functional variables of the study are the strength and muscle resistance of the lower limbs, assessed through the 30 Seconds Chair Stand Test (CST), and the mobility evaluated by the Timed-Up and Go Test (TUGT). These functional tests, together with the 4 Stage Balance Test (SBT) will allow evaluating the risk of fall, which will also be assessed with the application of Fall Risk Screening, available in the FallSensing Clinical App. The functional capacity, through the Lawton & Brody tool, the fear of falling, through the Falls Efficacy Scale - International (FES-I), the usability of the technology with the System Usability Scale (SUS) will also be evaluated. The Home Fall Prevention Checklist (HFPC) for older adults was selected to identify environmental risk factors. Two other technological solutions will be used - FallSensing Home App and Kallisto wearable device, which will allow the detection and prevention of falls. The intervention is characterized by the OEP with a common technological platform, conducted over 8 weeks and a frequency of 3 times a week. Throughout these weeks, the participants will be followed-up in person or by telephone contact by the rehabilitation nurse. Considering the COVID-19 outbreak, all guidelines from the National Health Service (NHS) will be followed. The project was funded by InnoStars, in collaboration with the Local EIT Health RIS Hub of the University of Porto.

RESULTS
This study was approved 10/09/2020 by the Ethics Committee of ESEP The recruitment process will start in October. The study results are expected to be published by the end of December.

CONCLUSIONS
The findings of this study protocol will contribute to the design and development of future robust studies for technological tests in a clinical context

CLINICALTRIAL
ISRCTN15895163 , https://doi.org/10.1186/ISRCTN15895163