Evaluation of a Technology-Based Multifactorial Intervention for Improving Fall Risk: A Cluster-Randomized Controlled Trial

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Abstract
Purpose: In the rapidly growing older adult demographic, falls are a critical issue as the leading cause of injury. Multifactorial interventions have been shown to improve fall risk, including physical function and fear of falling. This study evaluates the effect of the Physio-fEedback and Exercise pRogram (PEER), an 8-week multifactorial technology-based fall risk intervention. Methods : The longitudinal study included 387 community-dwelling, low-income older adults and was conducted at 4 timepoints at T1 (baseline), T2 (2 months), T3 (4 months), and T4 (6 months). The Timed Up and Go Test, 30-second chair stand test, and BTrackS Score were used as measures of physical function (dynamic balance, lower limb endurance, and static balance, respectively). The PEER intervention consisted of an 8-week technology-based physio-feedback, cognitive reframing, and group-based and at-home exercises (NCT05778604). Results: The PEER intervention mitigated time-related declines in dynamic balance post-intervention ( p <0.001) and subsequent follow-up ( p =0.005). Lower limb endurance and static balance did not show significant improvements. Conclusion: The intervention group showed sustained improvement of dynamic balance, indicating effectiveness of PEER after conclusion of the intervention. However, the lack of significant differences in the other fall risk metrics may be indicative of insufficient duration and/or intensity of the intervention. This study demonstrates both potential for the PEER technology-based mind-body fall prevention for improving dynamic balance and gaps in targeting measures of fall risk. Trial Registration: The trial was registered at ClinicalTrials.gov on March 21, 2023 (NCT05778604).

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