June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
PrevenTing Falls in a high-risk, low vision population through specialist ORientation and Mobility services: the PlaTFORM randomised trial
Author Affiliations & Notes
  • Lisa Keay
    School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
    The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
  • Lisa Dillon
    School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
    The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
  • Kelly Prentice
    Guide Dogs NSW/ACT, North Sydney, New South Wales, Australia
    School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
  • Kirsten Jakobsen
    The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
  • Kris Rogers
    The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
    School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
  • Jodi Martin
    Guide Dogs NSW/ACT, North Sydney, New South Wales, Australia
  • Rebecca Ivers
    School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
    The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
  • Anne Tiedemann
    Institute for Musculoskeletal Health, The University of Sydney School of Public Health, Sydney, New South Wales, Australia
  • Cathie Sherrington
    Institute for Musculoskeletal Health, The University of Sydney School of Public Health, Sydney, New South Wales, Australia
  • Pradeep Y Ramulu
    Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, United States
  • Peter J McCluskey
    Save Sight Institute, The University of Sydney Save Sight Institute, Sydney, New South Wales, Australia
  • Stephen Jan
    The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
  • Ashleigh Chandra
    School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
    The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
  • Sheela Kumaran
    School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
  • Xiaoqiu (Julia) Liu
    The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
  • Lindy Clemson
    School of Health Science, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia
  • Footnotes
    Commercial Relationships   Lisa Keay None; Lisa Dillon None; Kelly Prentice None; Kirsten Jakobsen None; Kris Rogers None; Jodi Martin None; Rebecca Ivers None; Anne Tiedemann None; Cathie Sherrington None; Pradeep Ramulu None; Peter McCluskey None; Stephen Jan None; Ashleigh Chandra None; Sheela Kumaran None; Xiaoqiu (Julia) Liu None; Lindy Clemson None
  • Footnotes
    Support  Australian National Health and Medical Research Council (NHMRC project grant APP1108176) and supported by Guide Dogs NSW/ACT.
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 1827. doi:
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      Lisa Keay, Lisa Dillon, Kelly Prentice, Kirsten Jakobsen, Kris Rogers, Jodi Martin, Rebecca Ivers, Anne Tiedemann, Cathie Sherrington, Pradeep Y Ramulu, Peter J McCluskey, Stephen Jan, Ashleigh Chandra, Sheela Kumaran, Xiaoqiu (Julia) Liu, Lindy Clemson; PrevenTing Falls in a high-risk, low vision population through specialist ORientation and Mobility services: the PlaTFORM randomised trial. Invest. Ophthalmol. Vis. Sci. 2022;63(7):1827.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To evaluate the Lifestyle-integrated Functional Exercise fall prevention programme for older people with low vision or blindness (v-LiFE).

Methods : A single-blinded randomised controlled trial evaluated the v-LiFE program compared to usual care. Primary outcomes were the activity normalised fall rate over 12 months, measured using prospective falls calendars and function and participation (Late Life Function and Disability Instrument, Function sub-scale LLFI, Rasch scored). Activity was estimated using a wrist worn accelerometer over 1-week periods at baseline, 3 months and 12 months. Multiple imputation was used when accelerometer data were missing, based on self-reported physical activity. The rate ratio (RR) for falls were modelled using a negative binomial regression, mean differences were calculated with 95% Confidence Intervals (CI) for continuous measures, all analyses were on an intention to treat basis with pre-planned sub-groups (high physical activity, peripheral field loss and multiple fallers). The Short Physical Performance Battery (SPPB) was used to investigate if the v-LiFE program led to improvements in strength and balance

Results : 588 participants were randomised and 532 (90%) completed the trial. Mean age was 74 years, 346 (59%) were female, median visual acuity was 1.0 logMAR, (inter-quartile range 0.4-1.9) and 497 (85%) used a mobility aid. The annual falls rate was 2.1±3.5 and similar in the intervention and control groups (RR 0.89, 95% confidence interval, CI 0.69-1.13). The LLFI score was also similar (-0.02 95% CI -0.06-0.03). There was no difference in the rate of falls requiring medical care (RR 1.04 (0.79,1.36). There were no differences in the sub-groups for the primary outcomes. The SPPB total score was similar between groups (0.13 95% CI -0.24-0.51). Cadence in the 4m walk was better in the intervention group (0.20, 95% CI 0.06-0.34 steps/metre), but the timed sit-to-stand, 4m walk time and standing balance scores were not different.

Conclusions : Though strength and balance training has been shown to prevent falls in older people, this trial involving older people with low vision did not demonstrate any benefit. It is possible that a higher dose program and/or a different approach to implementation will be required to reduce falls and improve function in older people with low vision.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

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