Feasibility and acceptability of the HOLObalance telerehabilitation system compared with standard care for older adults at risk of falls: the HOLOBalance assessor blinded pilot randomised controlled study.

IF 6 2区 医学 Q1 GERIATRICS & GERONTOLOGY Age and ageing Pub Date : 2024-10-01 DOI:10.1093/ageing/afae214
Marousa Pavlou, Carol Ann Flavell, Fariba Mostajeran Gourtani, Christos Nikitas, Dimitris Kikidis, Athanasios Bibas, Dimitris Gatsios, Vassilis Tsakanikas, Dimitrios I Fotiadis, Dimitrios Koutsouris, Frank Steinicke, Isabelle Daniela Walz, Christoph Maurer, Sofia Papadopoulou, Michalis Tsoukatos, Athanasios Pardalis, Doris-Eva Bamiou
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Abstract

Background: Falls have high socioeconomic costs. Information and communication technologies may support provision and monitoring of multisensory (MSR) physiotherapy programmes. The HOLOBalance platform used augmented reality holograms to provide patient-centred, individualised MSR.

Objectives: To determine the platform's safety, acceptability and feasibility, investigate functional gait and dynamic balance benefits and provide data for a definitive trial.

Design and setting: Single-blinded pilot randomised controlled feasibility study. Interventions were conducted at clinical sites or participants' homes in three European countries.

Participants: Community-dwelling older adults (median age 73 years; 64.2% female) at risk of falls were enrolled (May 2020-August 2021).

Methods: Participants were randomised to an 8-week clinic or home-based telerehabilitation MSR or OTAGO (control group) programme. Compliance, satisfaction, and adverse events determined feasibility. Clinical outcomes, assessed (blinded) within one-week prior to and post-intervention, included functional gait assessment (FGA), Mini BESTest and cognitive function.

Results: Randomisation to completion rate was 76.15% with 109 participants recruited (n = 289 screened). Drop-out rate was similar between groups. Adverse events were reported (n = 3) in the control group. Sixty-nine percent would recommend the HOLOBalance intervention. Findings were similar for the home and clinic-based arms of each intervention; data was combined for analysis. FGA (95%CI [1.63, 4.19]) and Mini-BESTest (95%CI [1.46, 3.93]) showed greater improvement in the HOLOBalance group with a clinically meaningful change of 4/30 noted for the FGA.

Conclusions: HOLObalance was feasible to implement and acceptable to older adults at risk of falls, with FGA and Mini-BEST improvements exceeding those for the OTAGO programme. A definitive trial is warranted.

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与针对有跌倒风险的老年人的标准护理相比,HOLObalance 远程康复系统的可行性和可接受性:HOLOBalance 评估师盲法随机对照试验研究。
背景:跌倒的社会经济成本很高。信息和通信技术可支持多感官(MSR)物理治疗方案的提供和监测。HOLOBalance 平台利用增强现实全息图提供以患者为中心的个性化 MSR:确定该平台的安全性、可接受性和可行性,调查功能性步态和动态平衡的益处,并为最终试验提供数据:单盲试验性随机对照可行性研究。干预在三个欧洲国家的临床机构或参与者家中进行:有跌倒风险的社区老年人(中位数年龄为 73 岁;64.2% 为女性)被纳入研究(2020 年 5 月至 2021 年 8 月):参与者被随机分配到为期 8 周的诊所或家庭远程康复 MSR 或 OTAGO(对照组)项目中。依从性、满意度和不良事件决定了该计划的可行性。干预前后一周内的临床结果评估(盲法)包括功能步态评估(FGA)、Mini BESTest和认知功能:随机完成率为 76.15%,共招募了 109 名参与者(n = 289 名筛选者)。各组的退出率相似。对照组有不良事件报告(n = 3)。69%的人愿意推荐 HOLOBalance 干预疗法。家庭干预组和诊所干预组的结果相似;数据合并进行分析。FGA(95%CI [1.63,4.19])和Mini-BESTest(95%CI [1.46,3.93])显示,HOLOBalance组的改善幅度更大,其中FGA的临床意义变化为4/30:结论:HOLObalance 的实施是可行的,有跌倒风险的老年人也能接受,FGA 和 Mini-BEST 的改善程度超过了 OTAGO 计划。有必要进行最终试验。
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来源期刊
Age and ageing
Age and ageing 医学-老年医学
CiteScore
9.20
自引率
6.00%
发文量
796
审稿时长
4-8 weeks
期刊介绍: Age and Ageing is an international journal publishing refereed original articles and commissioned reviews on geriatric medicine and gerontology. Its range includes research on ageing and clinical, epidemiological, and psychological aspects of later life.
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