Catastrophizing thoughts about falls can trip people up. We are now looking for programs that can help reduce concern about falling in older people.
Falls and fear of falling affect many older adults and can impose limitations upon daily activities. Over one third of community dwelling older adults fall each year with about 15% of falls being injurious. However, over two thirds of older adults express fear of falling during common daily activities, making it more common than falls itself. Fear of falling has been associated with needless restriction in physical and social activities with consequent negative impacts on lower quality of life.
Previous research has suggested that fear of falling can be reduced through cognitive behavioural therapy and balance exercise programs. We are collaborating with Black Dog Institute to investigate the effectiveness of an online cognitive behavioural program (myCompass) versus a health education program for 6 weeks at reducing concerns about falling in community-dwelling older people. The intervention consists of a fully-automated cognitive behavioural therapy program (myCompass) delivered through a tablet or computer in people’s homes with no therapist input, including evidence-based and interactive psychological modules that users can complete via the internet on a tablet or computer in their homes.
An engaging self-managed neuro-rehabilitation program using eHealth technologies to improve mobility and enhance independence in people with Parkinson’s disease:
Parkinson’s disease is a multi-systems neurodegenerative disease with the severity of clinical symptoms (including postural instability, gait dysfunction an falls). With the population aging, the number of people affected by Parkinson’s disease is expected to double every 25 years presenting an increasing burden on health service and society as a whole. Falls are a common and devastating event in individuals with Parkinson’s disease and often precipitated by excessive gait variability, postural instability and freezing of gait.
Visual, attentional, haptic and auditory stimuli have been used to improve gait dysfunction in people with Parkinson’s disease. The aim of this project is to develop and evaluate a self-managed program using mHealth technology to improve mobility in people suffering from Parkinson’s disease. Dr Matthew Brodie was awarded a Michael & Elizabeth Gilbert Scholarship in Parkinson’s Disease Research.
An engaging self-management program and scalable intervention using mobile technology to enhance healthy ageing and reduce fall risk in people with intermittent claudication: a randomised trial.
Cardiovascular disease is the leading cause of death and hospital admissions in Australia. Intermittent claudication is an intense cramping leg pain triggered by exercise and a common symptom of Peripheral Arterial Disease. It often causes functional decline, high health service use and loss of independence. Vascular interventions are often used to treat peripheral arterial disease, but are expensive and have limited durability. There is strong evidence that supervised exercise mitigates symptoms and reduces surgery rates. However, compliance and motivation with existing programs is poor (>40% dropout) due to beliefs that exercise-induced pain is harmful.
Supported by the UNSW Medicine Neuroscience, Mental Health and Addiction Theme and SPHERE Clinical Academic Group, we have developed a scalable self-management program for peripheral arterial disease delivered through mobile technology. Our program includes evidence-based standing balance exercises, pain management and interval walking components. It provides individually-tailored tools to empower older people suffering from intermittent claudication to lead more active lives, manage their pain and thereby improving their health outcomes long-term.