FallsLogo

A Randomized Controlled Trial to Reduce the
Risk of Falls in Adults With ID


Aims
To reduce risk of recurrent falls in adults with ID who have a history of falls by improving musculoskeletal health (strength & balance) through a 6-month strength/balance or walking intervention.
Project Staff
Kelly Hsieh, PhD (Principal Investigator)
James Rimmer, PhD (Co-Principal Investigator)
Sumithra Murthy, MBBS, MPH
Steph Steiner, BS

Introduction
The purpose of this study is to reduce the occurrence of accidental falls in adults with intellectual disability (ID) by improving strength and balance through a randomized controlled trial involving a 6-month community-based strength and balance training or walking program, with a 1-year follow up.

Information about Current Project


Progress to Date
Publications
Training Materials
Previously research has shown that falls occur much more frequently in persons with ID, and the resultant injuries are often severe. Individuals with ID tend to have poorer dietary habits, poorer strength and balance, and reduced bone density, compared to the general population. There are currently no evidenced-based exercise programs to reduce the risk of falls in adults with ID. It is the purpose of the study to validate such a program.

Design
Eligibility of Participants
In order to be considered for UIC's falls study, each potential participant must meet all of the 4 criteria below:
  • Is 30-60 years of age
  • Has mild or moderate intellectual disability
  • Do not have severe visual impairment (i.e. legal blindness)
  • Be able to walk independently without assistive devices (i.e. wheelchair, walker, gait belts, or cane)
In addition, each potential participant needs to have clearance from their physician and a consent from their legal guardian (or provide consent if they are their own guardian) to participate in the study. Adults with ID who have an unregulated seizure disorder, are unable to follow exercise instructions (i.e. have uncontrolled behavior issues), and are currently enrolled in a significant strength and balance exercise program are excluded from the study.

Study Methods

Participants are randomly assigned to one of three groups:

Strength & Balance Group – In this group, there is a familiarization period in which UIC research staff teach the exercises to the participants. In addition, agency staff are trained on how to lead the strength and balance group, as they are the primary leader of this group. Participants engage in a combined strength and balance program delivered via an exercise DVD with agency/UIC staff supervision (3 days per week, 45 minutes per session). Each participant wears adjustable 5-pound ankle weights to create resistance and improve strength. UIC research staff frequently monitor to ensure the safety of the participants and proper implementation of the research protocol.
Participant Balancing
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Walking Group – Participants walk 5 days per week for 30 minutes each day. Each participant wears a pedometer to monitor the number of steps achieved during each walking session.

Control Group – Participants have no change to their daily routine.
All three groups are monitored for falls at the agency and at home for the entire length of the study. For this study, the definition of a fall is “An unexpected event in which the participants come to rest on the ground, floor, or lower level.”

Measures
The study uses the following measures:
  • Strength, Balance, and Cardiorespiratory Fitness Assessments are completed by UIC research staff;
  • Informant Survey is completed by a primary caregiver, family caregiver, or direct support staff and includes information on the adult with ID’s health and fitness status, nutrition habits, and demographics;
  • Falls Risk Assessment is completed by a caregiver and agency staff and includes a checklist to assess falls risk.
The data are collected at 3 time points: Baseline, 6-months, and 12- months.

Study Participant
Roybal Disability Pilot Study
The pilot study is a randomized control trial on fall prevention for older Hispanic adults with ID. It examines the cultural relevance of the intervention based on the current project. Participants undergo the same general research protocol as non-Hispanic participants except there are only two groups (strength & balance and control groups). Hispanic adults with ID are an underserved population, and are also at high risk for falls. To date, there is limited data examining the health profiles, risk factors for falls, and occurrence of falls for Hispanic adults with ID. This is the reason we are actively seeking Hispanic participants for our study.