RESUMEN
BACKGROUND: Studies have shown that functional strength and balance exercises can reduce the risk of falling in older people if they are done on a regular basis. However, the repetitive nature of these exercises; combined with the inherent lack of feedback of progress may discourage seniors from exercising in the home, thereby rendering such an intervention ineffective. This study hypothesizes that the use of visual feedback and multimodal games will be more effective in encouraging adherence to home rehabilitation than standard care; thereby promoting independence and improving the quality of life in older adults at risk of falling. METHODS: A parallel-group pilot randomized controlled trial with 3 groups of participants will be conducted in the home for 12 weeks. Participants will include older adults who have been identified as at risk of falling (n = 48), over the age of 65, living in the community, and suitable for a home exercise intervention. The primary outcome is adherence to exercise. Secondary outcomes include: variability in stride length, stride time and double support time (DST); walking speed; Timed up and go test (TUG); Falls Efficacy Scale International (FES-I); CONFbal scale; Romberg's test; and quality of life measures (SF-12 and EuroQol EQ-5D). Qualitative assessments on personal experiences with rehabilitation tools will be done before and after the trial. DISCUSSION: This study will investigate the use of visual feedback and engaging multimodal activities to address the problem of non-compliance to home exercises for falls rehabilitation. One of the unique qualities of this study is the adaptation of special participatory design methods through which the end users (fallers) will be involved in the design of the proposed rehabilitation tools at various stages of the design process. TRIAL REGISTRATION: ISRCTN79967470.
Asunto(s)
Accidentes por Caídas/prevención & control , Terapia por Ejercicio , Retroalimentación Sensorial , Servicios de Atención de Salud a Domicilio , Proyectos de Investigación , Percepción Visual , Factores de Edad , Anciano , Protocolos Clínicos , Marcha , Conocimientos, Actitudes y Práctica en Salud , Humanos , Motivación , Fuerza Muscular , Folletos , Cooperación del Paciente , Educación del Paciente como Asunto , Proyectos Piloto , Equilibrio Postural , Calidad de Vida , Encuestas y Cuestionarios , Factores de Tiempo , Resultado del Tratamiento , Reino Unido , Juegos de Video , CaminataRESUMEN
This article describes the ongoing process of engaging with users in the development and evaluation of prototype visualisation software, which aims to assist in the understanding and improvement of appropriate movements during rehabilitation. The value of the process is illustrated in the article with a discussion of the key findings of pre-pilot focus groups with stroke survivors and therapists. The article describes how the design of the visualisation software is being adapted to meet the emerging understanding of the needs of patients and professionals, and of the rehabilitation process.