Effect of cognitive-only and cognitive-motor training on preventing falls in community-dwelling older people: protocol for the smart±step randomised controlled trial
Catherine Sherrington,
Barbara Toson,
Jessica Turner,
Jacqueline Close,
Daina L Sturnieks,
Jasmine Menant,
Michael Valenzuela,
Kim Delbaere,
Robert D Herbert,
Amit Lampit,
Kathryn Broadhouse,
Daniel Schoene,
Stephen R Lord,
Daina Sturnieks,
Stephen Lord,
Rob Herbert,
Cameron Hicks,
Mayna Ratanapongleka,
Natassia Smith,
Carly Chaplin,
Bethany Halmy,
Angeliki Stivactas,
Ashley Woodbury,
Dinaz Parekh,
Matthew Hand,
Isabella Hoi Kei leung,
Polly Barr,
Jennifer Davis
Affiliations
Catherine Sherrington
6 Institute for Musculoskeletal Health, School of Public Health, The University of Sydney and Sydney Local Health District, Sydney, New South Wales, Australia
Barbara Toson
Flinders Centre for Epidemiology and Biostatistics, Flinders University, Adelaide, South Australia, Australia
Jessica Turner
1 Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Randwick, New South Wales, Australia
Jacqueline Close
Neuroscience Research Australia, Randwick, New South Wales, Australia
Daina L Sturnieks
2 School of Medical Sciences, University of New South Wales, Sydney, New South Wales, Australia
Jasmine Menant
1 Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Randwick, New South Wales, Australia
Michael Valenzuela
4 Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
Kim Delbaere
UNSW Ageing Futures Institute, University of New South Wales, Sydney, New South Wales, Australia
Robert D Herbert
2 School of Medical Sciences, University of New South Wales, Sydney, New South Wales, Australia
Amit Lampit
Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Melbourne, Victoria, Australia
Kathryn Broadhouse
7 Sunshine Coast Mind and Neuroscience Thompson Institute, University of the Sunshine Coast, Birtinya, Queensland, Australia
Daniel Schoene
Institute of Medical Physics, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
Stephen R Lord
3 School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
Daina Sturnieks
Stephen Lord
2Neuroscience Research Australia
Rob Herbert
2NeuRA, Margarete Ainsworth Building Barker Street Randwick NSW 2031, Australia
Cameron Hicks
Mayna Ratanapongleka
Natassia Smith
Carly Chaplin
Bethany Halmy
Angeliki Stivactas
Ashley Woodbury
Dinaz Parekh
Neuroscience Research Australia, Randwick, New South Wales, Australia
Background Physical and cognitive impairments are important risk factors for falls in older people. However, no studies have been adequately powered to examine whether cognitive or cognitive-motor training can prevent falls in older people. This is despite good evidence of improvements in fall-related cognitive and physical functions following both intervention types. This manuscript describes the study protocol for a three-arm randomised controlled trial to evaluate the effectiveness of home-based cognitive and cognitive-motor training interventions, compared to a minimal-intervention control group, in preventing falls in older people. This trial was prospectively registered with the Australia New Zealand Clinical Trial Registry, number ACTRN12616001325493.Methods and analysis Community-dwelling adults aged 65 years and over, residing in Sydney Australia, will be recruited. Participants (n=750) will be randomly allocated to (1) cognitive-only training, (2) cognitive-motor training or (3) control groups. Both training interventions involve the use of the smart±step home-based computerised game playing system for a recommended 120 min/week for 12 months. Cognitive training group participants will use a desktop electronic touch pad to play games with the smart±step system while seated and using both hands. The cognitive-motor training group participants will use a wireless electronic floor step mat that requires accurate stepping using both legs for playing the same smart±step games, hence incorporating balance exercises. All groups will receive an education booklet on fall prevention. The primary outcome will be rate of falls, reported by monthly diaries during the 12-month duration of the study and analysis will be by intention-to-treat. Secondary outcomes include the proportion of fallers, physical and cognitive performance in 300 participants, and brain structure and function in 105 participants who will undertake MRI scans at baseline and 6 months. Cost-effectiveness will be determined using intervention and health service costs.Ethics and dissemination Ethical approval was obtained from UNSW Ethics Committee in September 2015 (ref number HC15203). Outcomes will be disseminated through publication in peer-reviewed journals and presentations at international conferences.Trial registration number ACTRN12616001325493
