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Comprehensive Fall Prevention and Detection in MS

多发性硬化症的全面跌倒预防和检测

基本信息

批准号：
10174744
负责人：
Michelle Hannah Cameron
金额：
--
依托单位：
PORTLAND VA MEDICAL CENTER
依托单位国家：
美国
项目类别：
财政年份：
2015
资助国家：
美国
起止时间：
2015-12-01 至 2021-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10174744
关键词：
Accelerometer Address Affect American Awareness Calendar Caring Communities Data Databases Detection Devices Education Elderly Equilibrium Exercise Fall prevention Frequencies Goals Healthcare Systems High Prevalence Home environment Hour Injury Intervention Knowledge Location Methods Monitor Motor Multiple Sclerosis Pamphlets Paper Participant Patient Outcomes Assessments Patient Self-Report Patients Population Prevention program Prevention strategy Provider Quality of life Randomized Randomized Controlled Trials Recurrence Reporting Research Research Personnel Resources Risk Risk Reduction Sensory Services Social isolation Study Subject System Technology Time Veterans Work Wrist cohort compare effectiveness cost design fall risk falls follow-up health care service improved injured nervous system disorder primary outcome programs prospective public health relevance radio frequency randomized trial satisfaction sensor social social engagement standard of care trial design user-friendly wearable sensor technology young adult

项目摘要

DESCRIPTION (provided by applicant): Multiple sclerosis (MS) is the most common disabling neurological disease of young adults. People with MS fall frequently. These falls result in injuries and are associated with loss of confidence and independence, social isolation, curtailment of activities, increased risk for more falls, use of more healthcare services, and poorer quality of life. Given the high prevalence, serious consequences, and significant impact of falls in people with MS, interventions that reduce the risk of falls in this population are essential. In addition, one of the significant challenges in managing falls is having an accurate, efficient and user-friendly method for detecting and counting falls and determining the circumstances of falls that does not rely on patient recall and reporting. Studies suggest that group exercise and education programs may help prevent falls in people with MS but none have been evaluated in a randomized controlled trial. Comprehensive fall prevention programs with exercise and education prevent falls in older adults. The proposed study will evaluate, in a randomized controlled trial, the impact of a comprehensive group fall-prevention program called Free From Falls (FFF) that includes both exercise and education, on falls and their consequences in people with MS. Devices have recently been developed to automatically detect falls using body worn sensors with gyroscopes and accelerometers and to localize these falls with access points installed in the home and GPS transceivers outdoors. This study, where subjects are likely to fall frequently, provides the ideal opportunity for optimizing this technology. The goals of this research are to evaluate a comprehensive fall prevention program and a comprehensive automated fall detection system in people with MS. The objectives of this research are, in people with MS: First, to assess, in a randomized controlled trial, the impact of the FFF program on falls and fall-related injuries; second, to assess the impact of the FFF program on confidence, social satisfaction and participation, and quality of life; third, to determine if an automated fall detection system using accelerometers, gyroscopes and radio-frequency transceivers, accurately detects, counts and captures the location of falls. We will conduct a two group randomized trial at VA Portland Health Care System to compare the effectiveness of the FFF program to a stand of care control condition. FFF consists of 8 weekly 2-hour sessions with 1 hour of education and 1 hour of exercise. The control condition will consist of providing participants with a fall prevention educational brochure and informing their provider that they are falling frequently. The primary outcome will be prospectively counted falls and fall-related injuries during and for 6 months following the program and patient reported outcomes of balance confidence, social satisfaction and participation and quality of life at the beginning and end of the program and 3 and 6 months following the program. A subset of subjects in both intervention allocations will also use the MobileRF monitoring system, which includes a wrist worn sensor containing gyroscopes, accelerometers, a radio-frequency and a GPS transmitter and access points installed in the home, to automatically detect, count and localize falls in and outside the home. We expect to find a greater reduction in falls and fall related injuries and greater improvements in balance confidence, social satisfaction and participation, and quality of life in subjects randomized to th FFF program than in subjects randomized to the standard of care condition. In addition, the MobileRF system will accurately detect, count and localize falls compared with self report and will be more reliable and more immediate. The proposed work will definitively determine if the FFF program prevents falls in people with MS and will validate the MobileRF fall detection system while also being a first step in validating a comprehensive fall prevention and detection program for other Veterans at risk for falls.

描述(由申请人提供)：多发性硬化症(MS)是年轻人最常见的致残性神经系统疾病。多发性硬化症患者经常摔倒。这些跌倒会导致受伤，并与丧失信心和独立性、社会孤立、活动减少、更多跌倒的风险增加、使用更多医疗服务以及较差的生活质量有关。鉴于MS患者跌倒的高患病率、严重后果和显著影响，降低该人群跌倒风险的干预措施至关重要。此外，管理跌倒的一个重大挑战是拥有一种准确、高效和用户友好的方法来检测和计数跌倒，并确定跌倒的情况，而不依赖于患者的回忆和报告。研究表明，集体锻炼和教育计划可能有助于预防多发性硬化症患者跌倒，但没有一项在随机对照试验中进行评估。全面的预防跌倒计划与运动和教育相结合，可以防止老年人跌倒。这项拟议的研究将在一项随机对照试验中评估一项名为自由跌倒(Free From Falls，简称FFF)的综合性集体跌倒预防计划对MS患者跌倒的影响及其后果最近开发出的设备可以使用带有陀螺仪和加速计的身体穿戴传感器自动检测跌倒，并通过安装在家里的接入点和室外的GPS收发器来定位这些跌倒。这项研究提供了理想的答案，因为受试者很可能经常摔倒优化这项技术的机会。这项研究的目标是评估综合预防跌倒计划和综合自动跌倒检测系统在多发性硬化症患者中的应用。本研究的目标是：第一，在随机对照试验中，评估FFF计划对跌倒和与跌倒相关的伤害的影响；第二，评估FFF计划对信心、社会满意度和参与度以及生活质量的影响；第三，确定自动跌倒检测系统是否使用加速计、陀螺仪和射频收发机可以准确地检测、计数和捕捉跌落的位置。我们将在弗吉尼亚州波特兰卫生保健系统进行一项两组随机试验，以比较FFF计划和看护控制条件的有效性。FFF包括每周8次，每次2小时，1小时的教育和1小时的锻炼。控制条件将包括向参与者提供预防跌倒的教育手册，并通知他们的提供者他们经常摔倒。主要结果将是在计划开始和结束时以及计划结束后3个月和6个月期间和之后6个月，患者报告的平衡信心、社会满意度、参与度和生活质量方面的结果，前瞻性地计算摔倒和与摔倒相关的伤害。两个干预分配中的一部分受试者还将使用MobileRF监测系统，该系统包括一个手腕佩戴的传感器，其中包含陀螺仪、加速计、射频和安装在家里的GPS发射器和接入点，以自动检测、计数和定位家中内外的跌倒。我们预计，与随机接受标准护理条件的受试者相比，随机参加FFF计划的受试者在跌倒和跌倒相关伤害方面的减少程度更大，平衡信心、社会满意度和参与度以及生活质量得到更大改善。此外，与自我报告相比，MobileRF系统将准确地检测、计数和定位跌倒，将更加可靠和即时。这项拟议的工作将最终确定FFF计划是否能防止MS患者跌倒，并将验证MobileRF跌倒检测系统，同时也是验证针对其他有跌倒风险的退伍军人的全面跌倒预防和检测计划的第一步。