Reducing falls in the elderly: beyond the laboratory to the community

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DESCRIPTION (provided by applicant): ABSTRACT The long-term objective of our work is to reduce the premature death and disability due to fall-related injuries to older adults. The proposed randomized prospective study will determine the effectiveness of a novel exercise-based fall-prevention intervention. To date, our work with the exercise-based intervention has demonstrated its efficacy for reducing laboratory-induced trip-related falls by older women. The basis of the fall-prevention intervention is task-specific training focused on improving performance of compensatory stepping responses (CSR). The intervention specifically improves CSR necessary to avoid falling following postural disturbances that serve as a biomechanical surrogate for a trip. The proposed randomized 12-month prospective study will be conducted over a period of three years. One specific aim will be addressed and one primary hypothesis will be tested. Older women who do not participate in the CSR intervention will be compared to those of older women who complete the 2 week-4 session CSR intervention. The specific aim is to quantify the influence of a CSR intervention on the incidence of all-cause falls during the 12 months following completion of the intervention. We hypothesize that women who participate in the CSR intervention will have significantly fewer all-cause falls. Secondary hypotheses include expectations that compared to the control group, the women who complete the CSR training will have a significantly longer period of time to the first fall and significantly fewer fall-related injuries that require medical attention. PUBLIC HEALTH RELEVANCE: PROJECT NARRATIVE Support of the hypotheses will provide compelling evidence that task-specific CSR training can contribute meaningfully, and in a time- and cost- efficient manner, to fall prevention interventions for older adults. Support of the hypotheses will support the larger-scale adoption of CSR training programs, extension of these methods to additional types of falls, such as slips and laterally-directed falls, and application of CSR training to other populations having high fall-risk such as those with some type of neuromuscular and musculoskeletal conditions that give rise to physical impairments and disabilities.