Article

OBJECTIVE: To investigate the feasibility and comparative effect of supplementing
a modified OTAGO falls rehabilitation programme with multisensory balance
exercises and informed sample size calculation for a definitive trial. DESIGN:
Single-blinded randomized controlled trial with pre/postcomparisons using a
per-protocol analysis. SETTING: Secondary care-based falls clinic, London, UK.
SUBJECTS: Community-dwelling older people (n = 21) experiencing >/=2 non-syncopal
falls during previous 12 months. INTERVENTION: Modified OTAGO exercise classes
supplemented with supervised home-based rehabilitation consisting of multisensory
balance or stretching exercises. Group classes and home sessions each occurred
twice-weekly for eight weeks. MEASUREMENTS: A computerised randomization was used
for group allocation. A rater, blinded to intervention, performed the assessment
including the Functional Gait Assessment (primary outcome), Physiological Profile
Assessment, and questionnaires relating to symptoms, balance confidence, and
psychological state (secondary outcomes). RESULTS: Significant within-group
improvements were noted for the Functional Gait (p < 0.01, r = -0.63) and
Physiological Profile Assessments (p < 0.05, r = -0.63) in the OTAGO+multisensory
rehabilitation group only and for balance confidence scores in the
OTAGO+stretching group (p < 0.01, r = -0.63). Between-group differences were
noted for the Functional Gait (p < 0.01, r = -0.71) and Physiological Profile (p
< 0.05, r = -0.54) assessments with the OTAGO+multisensory group showing
significantly greater improvement. The drop-out rate was similar for both groups
(~30%). No serious adverse events were reported. CONCLUSIONS: Supplementing the
OTAGO programme with multisensory balance exercises is feasible in older people
who fall and may have a beneficial effect on falls risk as measured using the
Functional Gait and Short-form Physiological Profile Assessments. An adequately
powered randomized controlled trial would require 36 participants to detect an effect size of 1.35 on the Functional Gait Assessment.
CI - (c) The Author(s) 2014.
- Chute

Langue : ANGLAIS