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1.
Sleep Med ; 100: 448-453, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-2245454

ABSTRACT

OBJECTIVES: Falls in older people can lead to serious injury and significant societal health and financial burden. Obstructive sleep apnoea (OSA) is associated with impaired gait/balance and may increase fall risk, yet few studies examined whether treating OSA reduces fall risk. This study examined the effect of continuous positive airway pressure (CPAP) on fall risk markers in people over 65yrs diagnosed with OSA. DESIGN: Single arm intervention study. SETTING: University and tertiary care CPAP clinic. PARTICIPANTS: Individuals over 65 years diagnosed with OSA and recommended CPAP. INTERVENTION: 3-6 months CPAP therapy. MEASUREMENTS: 28 participants had a physiological profile assessment (PPA) at baseline and following 3-6 months of CPAP. The PPA examines visual contrast sensitivity, lower limb proprioception, knee extension strength, reaction time and postural sway to generate a fall risk score (FRS). t-tests were used to determine difference between pre- and post-treatment FRS. Regression was used to examine the associations between CPAP use and daytime sleepiness with FRS. RESULTS: CPAP significantly reduced the FRS ([Mean ± SD] 0.59 ± 1.0 vs 0.04 ± 1.1, p = 0.016), contrast sensitivity and lower limb proprioception (P < 0.05). Increased CPAP use was associated with improvement in FRS in unadjusted analysis (ß = -0.213, 95%CI -0.371 to -0.056, p = 0.01). Reduction in Epworth sleepiness score was associated with a reduction in FRS in unadjusted (p = 0.023) and adjusted analysis (adjusted for AHI p = 0.027 or O2Nadir p = 0.015). CONCLUSIONS: CPAP may reduce fall risk in people over 65yrs, possibly related to better CPAP adherence and reduced daytime sleepiness. Future controlled trials and mechanistic studies are needed to elucidate how CPAP may reduce fall risk.


Subject(s)
Disorders of Excessive Somnolence , Plastic Surgery Procedures , Sleep Apnea, Obstructive , Humans , Aged , Continuous Positive Airway Pressure , Sleep Apnea, Obstructive/therapy , Risk Factors
2.
Injury Prevention ; 28(Suppl 2):A89, 2022.
Article in English | ProQuest Central | ID: covidwho-2137915

ABSTRACT

BackgroundYoga may reduce fall risk in older age. The Successful AGEing (SAGE) yoga trial investigates the effect of yoga on falls among community-dweller people aged 60+. We conducted a process evaluation to gauge participants’ impressions of the supervised 40-week yoga program delivered face-to-face and/or online (due to COVID-19).MethodsParticipants completed a survey assessing: a) perceived program benefit for physical health, wellbeing, and balance/risk of falls, b) satisfaction with program features;c) physical ability to participate in the program. They self-rated these aspects using a 0 to 10 scale, where higher scores indicated more benefit, greater satisfaction/ability. We also measured the proportion of participants who would recommend the program and continue participation in yoga.ResultsWe included 179 participants (mean age of 68 (SD 5);80% female). The mean rating of program benefit was 9/10 (SD 1.8) for physical health and 8/10 (SD 2.0) for wellbeing and balance/risk of fall. Overall, participants expressed greater satisfaction associated with program content (mean 9/10 [SD 1.4]) and yoga instructors (9/10 [SD 1.2]). Participants viewed the yoga program as enjoyable but challenging and reported that yoga instructors were supportive, professional and tailored poses to individual needs. Participants rated their physical ability to participate in the program as excellent (9/10 [SD 1.7]). The majority (n=157, 94%) would recommend the program and intended to continue practising yoga after trial completion (n=100;58%).ConclusionOverall, the SAGE yoga was well-received, perceived to benefit health, wellbeing and balance/falls risk and would be recommended to others.

3.
BMJ Open ; 11(7): e048395, 2021 07 26.
Article in English | MEDLINE | ID: covidwho-1327672

ABSTRACT

INTRODUCTION: One in three people aged 65 years and over fall each year. The health, economic and personal impact of falls will grow substantially in the coming years due to population ageing. Developing and implementing cost-effective strategies to prevent falls and mobility problems among older people is therefore an urgent public health challenge. StandingTall is a low-cost, unsupervised, home-based balance exercise programme delivered through a computer or tablet. StandingTall has a simple user-interface that incorporates physical and behavioural elements designed to promote compliance. A large randomised controlled trial in 503 community-dwelling older people has shown that StandingTall is safe, has high adherence rates and is effective in improving balance and reducing falls. The current project targets a major need for older people and will address the final steps needed to scale this innovative technology for widespread use by older people across Australia and internationally. METHODS AND ANALYSIS: This project will endeavour to recruit 300 participants across three sites in Australia and 100 participants in the UK. The aim of the study is to evaluate the implementation of StandingTall into the community and health service settings in Australia and the UK. The nested process evaluation will use both quantitative and qualitative methods to explore uptake and acceptability of the StandingTall programme and associated resources. The primary outcome is participant adherence to the StandingTall programme over 6 months. ETHICS AND DISSEMINATION: Ethical approval has been obtained from the South East Sydney Local Health District Human Research Ethics Committee (HREC reference 18/288) in Australia and the North West- Greater Manchester South Research Ethics Committee (IRAS ID: 268954) in the UK. Dissemination will be via publications, conferences, newsletter articles, social media, talks to clinicians and consumers and meetings with health departments/managers. TRIAL REGISTRATION NUMBER: ACTRN12619001329156.


Subject(s)
Exercise Therapy , Independent Living , Aged , Australia , Cost-Benefit Analysis , Humans , Randomized Controlled Trials as Topic
4.
Front Neurol ; 11: 604299, 2020.
Article in English | MEDLINE | ID: covidwho-961646

ABSTRACT

Governments around the globe have introduced quarantine, lockdown, and mandatory isolation to slow the transmission of COVID-19. These public health and policy measures aim to protect the public and vulnerable people. This perspective paper argues that the impacts of lockdown (such as social disconnection, reduced exercise, and fewer physiotherapy treatments) may be amplified for people with neurological conditions with subsequent increases in frailty. The paper outlines why this may occur, and explores how adverse impacts for these vulnerable populations may be minimized through strategies such as telehealth, exercise programs, and health policies.

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