Projects

The ReacStep study is investigating the short-term effects of two balance training programs (i.e. reactive balance training and conventional balance training) on balance recovery from slips and trips in older adults. These programs are designed from evidence-based research and offer a challenging and unique experience to improving balance.

The ReacStep team are calling on volunteers who:

• are aged 65 and over living independently in the Sydney metropolitan community
• can walk 500m comfortably with mobility aids or rest
• have not been advised by a medical practitioner not to exercise
• have no neurological conditions (e.g. Parkinson’s Disease, multiple sclerosis, Alzheimer’s, dementia, etc.)
• have no history or lower limb, pelvic or vertebral fracture(s) and/or lower limb joint replacement(s) in the past 6 months
• have no other existing conditions that may prevent them from exercising (e.g. injury, pain, fatigue, etc.)

Eligible volunteers will be subjected to a health and safety screening before they are enrolled and randomly allocated into one of the two groups. Both groups will undertake a 3-week training program with an exercise physiologist, at NeuRA (i.e. in Randwick) as well as a balance recovery assessment at the 4-week time point.

Reactive balance training involves intentionally stepping on a sliding tile, stepping over obstacles, trigger-release recovery as well as strength training. Participants will be wearing a full-body safety harness to ensure safety.

Conventional balance training involves keeping balance in varying foot positions (i.e. feet together, in tandem or on one leg) whilst performing secondary tasks such as throwing a ball, card sorting, solving a maze or playing computer games.

For more detailed information, read the Participant Information Statement and watch the video below. To get involved or to register your interest, click HERE.

For all other queries, please contact the ReacStep Team on 02 9399 1002 or reacstep-study@neura.edu.au. HC210350

Older people with cognitive impairment/dementia have a higher prevalence of hip fracture and poorer outcomes after hip fracture when compared to cognitively normal older people. A recent Cochrane review has reported low to very low-quality evidence in relation to the effectiveness of models of care including enhanced rehabilitation strategies for people with cognitive impairment/dementia and that none of the interventions were specifically designed for people with cognitive impairment/dementia. There was some suggestion that enhanced care and rehabilitation may reduce delirium and an orthogeriatric model of care may reduce length of stay. This Cochrane review suggested that research should seek to determine the strategies needed to improve outcomes in people with cognitive impairment/dementia who sustain a hip fracture.

In the Australian and New Zealand Hip Fracture Registry (ANZHFR) annual report there is significant hospital variation in the proportion of patients with cognitive impairment who are offered rehabilitation after a hip fracture. The aim of this study is to use NSW Linked data to examine outcomes (e.g. mortality, admission to residential aged care, readmissions) in people with dementia who do and don’t receive rehabilitation after a hip fracture.

Older people with cognitive impairment/dementia have a higher prevalence of hip fracture and poorer outcomes after hip fracture when compared to cognitively normal older people. A recent Cochrane review has reported low to very low-quality evidence in relation to the effectiveness of models of care including enhanced rehabilitation strategies for people with cognitive impairment/dementia and that none of the interventions were specifically designed for people with cognitive impairment/dementia. There was some suggestion that enhanced care and rehabilitation may reduce delirium and an orthogeriatric model of care may reduce length of stay. This Cochrane review suggested that research should seek to determine the strategies needed to improve outcomes in people with cognitive impairment/dementia who sustain a hip fracture.

The Australian and New Zealand Hip Fracture Registry (ANZHFR) is a clinical audit of hip fracture care. The data collected is used for benchmarking against the national quality indicators for hip fracture and to understand clinical variation between hospitals and states. Describing clinical variation in care provides a strong impetus to improve care. The ANZHFR has presented minimal data comparing people with and without cognitive impairment/dementia (e.g. access to rehabilitation). Understanding clinical variation in care provided to people with and without cognitive impairment/dementia may assist in designing effective intervention strategies for this group of high risk patients. This study will therefore compare care provision and performance against national quality care indicators in people with and without cognitive impairment/dementia who have sustained a hip fracture.

Physiotherapists commonly provide care to people living with dementia. However, in Australia, undergraduate training in aged care, including dementia, is not considered core training and there are no competency assessments. We will conduct an international modified e-Delphi to develop consensus-based core competencies for entry-level physiotherapists who care for people with dementia.

Falls are common in older people with dementia and there is still a lack of effective fall prevention interventions in this population. Understanding what factors contribute to falls in this group will allow for interventions to be designed to target these factors. We have conducted a comprehensive search of 5 databases and are undertaking a systematic review and meta-analysis of published literature prospectively examining risk factors for falls in community-dwelling older people with mild cognitive impairment (MCI), cognitive impairment and dementia. The review will have a particular focus on physical and neuropsychological factors that are potentially amenable to treatment.