Comparison of Smartphone and Community-Based Delivery of the Otago Exercise Program for Fall Risk in Older Adults
Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age55+
SponsorBinghamton University
About this trial
The long-term goal of this project is to effectively bridge the research-clinic-community gap and to foster partnerships that support the implementation, utilization, and advocacy of evidence-based fall prevention programs in the older adult community. The Otago Exercise Program (OEP) is an evidence-based fall prevention program that has been shown to reduce falls and fall-related injuries among older adults. Traditionally, OEP is delivered in the home by a physical therapist and focuses on muscle strengthening and balance training. Despite its proven effectiveness, adherence and compliance rates have been low. The personnel and resource demands of program delivery, along with challenges in monitoring participant adherence, represent significant barriers to broader implementation. Alternative delivery systems using remote and community-based platforms may help address these limitations.
Specific Aim 1: To compare the effectiveness of two delivery modes of the Otago Exercise Program: a remotely delivered, home-based smartphone program and an in-person, community-based program.
Specific Aim 2: To examine the feasibility, acceptability, and usability of the Otago Exercise Program delivered through both smartphone-based and in-person formats.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Community-dwelling older adults 55 years of age or older
Communicate in English
Able to ambulate at least 10 meters with or without an assistive device.
Cognitively intact based on scoring 18/22 or greater on the Montreal Cognitive Assessment (MoCA)-Blind during a phone screening process
Disqualifiers
Lower limb amputation
Visual impairment uncorrectable with lenses
Uncontrolled hypertension, diabetes, neurological or musculoskeletal impairment
Persistent symptoms of dizziness or lightheadedness
Trial design
Design model
Parallel
Treatments tested in this trial
Smartphone-Based Intervention
BehavioralParticipants in the smartphone-based group will receive Otago Exercise Program instructions delivered through Improve, an investigator-developed application. This application, installed on each participant's iOS or Android smartphone, will allow participants to track their exercises and review workout instructions. Participants in the smartphone-based group will be contacted weekly by phone to ensure safety and adherence and to assist with troubleshooting any technology-related issues. All participants will be instructed to maintain their usual activity patterns and to refrain from initiating any new structured physical activity programs during the 8-week study period. Participants will be directed by Doctor of Physical Therapy students under the supervision of a licensed Physical Therapist, with weekly phone check-ins.
Group-Based Intervention
BehavioralParticipants in the in-person, community-based group will complete the individualized Otago Exercise Program in a group setting at the Johnson City Senior Center, under the guidance of Doctor of Physical Therapy students (4) and supervision of licensed Physical Therapists.
Treatment groups
36 Participants
are divided into 2 treatment groupsGroup A: Smartphone In-home DeliveryExperimental treatment 1 intervention
Group B: Group In-Person DeliveryActive comparator 1 intervention
Trial outcomes
Primary outcomes
1
Gait Velocity
Self-selected walking speed (m/s) over level surface
Time frame
Baseline (Day 0) and 1 week post-training (9 weeks later)Secondary outcomes
1
Injurious Falls
Self-reported falls that lead to injury requiring clinical evaluation
Time frame
Up to 1-year post intervention2
PPA-Short Form: Postural Sway
Sway Area (units: mm\^2) while standing quietly for 30 seconds
Time frame
Baseline (Day 0) and 1 week post-training (9 weeks later)3
PPA-Short Form: Finger Reaction Time
Simple reaction time (units: msec)
Time frame
Baseline (Day 0) and 1 week post-training (9 weeks later)4
PPA-Short Form: Knee Extensor Strength
Maximum isometric knee extensor force (kg)
Time frame
Baseline (Day 0) and 1 week post-training (9 weeks later)Other outcomes
1
Four square step test
Time to complete a clockwise and counterclockwise stepping into four quadrants
Time frame
Baseline (Day 0) and 1 week post-training (9 weeks later)2
Frailty
Physical Frailty Phenotype, reported on a scale of 0-5. A higher score indicates increased frailty.
Time frame
Baseline (Day 0) and 1 week post-training (9 weeks later)3
Self-reported Assessment: Enjoyment
Participant report of enjoyment, usability, and feasibility of the exercise program (1-5 scale), where higher scores indicate increased self-report.
Time frame
At study completion, or on average 1 week post-training4
SF-36
Short-form health survey to evaluate participant self-reported health quality of life.
Time frame
Baseline (Day 0) and 1 week post-training (9 weeks later)Sponsors and contacts
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Source ClinicalTrials.gov