Comprehensive Fall Prevention and Detection in MS

多发性硬化症的全面跌倒预防和检测

• 批准号: 9391619
• 负责人: Michelle Hannah Cameron
• 金额: --
• 依托单位: PORTLAND VA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-12-01 至 2019-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9391619
• 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; young adult

 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。MS患者经常跌倒。这些福尔斯跌倒导致受伤，并与丧失信心和独立性、社会孤立、活动减少、更多福尔斯跌倒风险增加、使用更多医疗保健服务和生活质量下降相关。鉴于MS患者中福尔斯的高患病率、严重后果和显著影响，降低该人群中福尔斯风险的干预措施至关重要。此外，管理福尔斯的重大挑战之一是具有用于检测和计数福尔斯并确定福尔斯的情况的准确、高效和用户友好的方法，该方法不依赖于患者回忆和报告。 研究表明，团体运动和教育计划可能有助于预防MS患者的福尔斯跌倒，但没有一项在随机对照试验中进行评估。综合性跌倒预防计划结合锻炼和教育可预防老年人的福尔斯。这项拟议中的研究将在一项随机对照试验中评估一项名为“免于福尔斯”（FFF）的综合性团体跌倒预防计划的影响，该计划包括锻炼和教育，最近已经开发了设备，以使用具有陀螺仪和加速度计的身体佩戴传感器来自动检测福尔斯，并且使用安装在家中的接入点来定位这些福尔斯，GPS接收器在户外。这项研究，受试者可能会经常跌倒，提供了理想的 优化这项技术的机会。 本研究的目的是评估一个全面的跌倒预防计划和一个全面的自动跌倒检测系统的人与MS。本研究的目的是，在MS的人：首先，评估，在一个随机对照试验，影响的FFF计划对福尔斯和跌倒相关的伤害;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，确定是否使用自动跌倒检测系统 加速度计、陀螺仪和射频收发器可以准确地检测、计算和捕捉福尔斯的位置。 我们将在VA波特兰医疗保健系统进行一项两组随机试验，以比较FFF计划与标准护理对照条件的有效性。FFF包括每周8次2小时的课程，1小时的教育和1小时的锻炼。控制条件将包括为参与者提供预防跌倒的教育手册，并告知他们的提供者他们经常跌倒。主要结局将是在项目期间和项目后6个月前瞻性计数的福尔斯和跌倒相关损伤，以及在项目开始和结束时以及项目后3个月和6个月患者报告的平衡信心、社会满意度和参与度以及生活质量的结局。两种干预分配中的一部分受试者还将使用MobileRF监测系统，该系统包括一个腕戴式传感器，该传感器包含陀螺仪、加速度计、射频和GPS发射器以及安装在家中的接入点，以自动检测、计数和定位家庭内外的福尔斯。 我们预计，与随机分配至标准治疗条件的受试者相比，随机分配至FFF项目的受试者的福尔斯和跌倒相关损伤的减少程度更大，平衡信心、社会满意度和参与度以及生活质量的改善程度更大。此外，与自我报告相比，MobileRF系统将准确检测、计数和定位福尔斯，并且将更可靠、更即时。拟议的工作将明确确定FFF计划是否可以防止MS患者的福尔斯跌倒，并将验证MobileRF跌倒检测系统，同时也是验证其他有福尔斯风险的退伍军人的全面跌倒预防和检测计划的第一步。