About this trial
This study aims to evaluate the feasibility of a high-intensity functional exercise program with simultaneous cognitive challenge (HIFE+cog) among older people at risk of falls. The evaluation design and intervention development will be assessed with the following specific aims:
1. To investigate the acceptability and safety of the HIFE+cog program in older people at risk of falls, and the methods used in the study by evaluating recruitment, compliance with the intervention, severity of adverse events reported, and participant experiences. 2. To measure key outcome variables, including completion rates, missing data, estimates, variances, and 95% confidence intervals for between-group differences.
The study is designed as a randomized controlled pilot trial. Eligible participants will be randomized to either the intervention group (HIFE+cog) or the active control group (HIFE) to partake in individually tailored exercise, supervised and progressed by a physiotherapist, two times per week for 3 months.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
aged 75 years or older
moderate risk of falling (feeling unsteady or afraid of falling, or having fallen in the past year, with a self-selected gait speed ≤0,8 m/s or TUG >15 s without walking aid)
can walk independently indoors, without a walking aid
can walk 500m independently outdoors, with or without a walking aid
Disqualifiers
a high fall risk (≥2 falls in the past year, serious injury e.g. hip fracture from a fall in the past year requiring medical care, or inability to get up from the floor after a fall)
Mini-Mental State Examination (MMSE) score <24 or dementia diagnosis
a medical condition that may affect participation in high-intensity gait, balance, and leg strength exercise, or other movement-related conditions affecting exercise or tests (e.g., pain, dizziness, visual or hearing impairment)
Trial design
Parallel
Treatments tested in this trial
HIFE+cog
Other interventionEach session will consist of individually tailored exercises performed at weight- bearing positions and covering lower leg strengthening exercises, as well as static- and dynamic balance exercises. Simultaneous cognitive exercises are added to static and dynamic balance exercises. Relative exercise intensity is encouraged to be moderate to high, and progressively adjusted by for example altering load or difficulty of the exercise. Session duration is 1 hour, including warm-up.
HIFE
Other interventionEach session will consist of individually tailored exercises performed at weight- bearing positions and covering lower leg strengthening exercises, as well as static- and dynamic balance exercises. Relative exercises intensity is encouraged to be moderate to high, and progressively adjusted by for example altering load or difficulty of the exercise. Session duration is 1 hour, including warm-up.
Treatment groups
Trial outcomes
Primary outcomes
Recruitment
Rate of recruited participants, and sources for recruitment
Adherence
Number of exercise sessions attended
Exercise intervention content and delivery
Number of exercises, sets, repetitions, and intensity achieved measured using a standardized exercise diary completed by supervisors after each session
Retention
Number of participants that completed follow-ups
Secondary outcomes
Fear of falling
The Falls Self-Efficacy Scale (FES-I)
Psychological wellbeing
The Philadelphia Geriatric Center Morale Scale (PGCMS)
Physical activity
The International Physical Activity Questionnaire-Elderly (IPAQ-E)
Depressive disorders
The Geriatric Depression Scale (GDS-15)
Sponsors and contacts
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Umeå University
Lead sponsor
Region Västerbotten
Collaborator