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Trial registered on ANZCTR
Registration number
ACTRN12610000634077
Ethics application status
Approved
Date submitted
30/07/2010
Date registered
2/08/2010
Date last updated
19/03/2021
Date data sharing statement initially provided
19/03/2021
Type of registration
Prospectively registered
Titles & IDs
Public title
Can the Alexander Technique improve balance and mobility in adults over 50 with visual impairments? A randomised controlled trial.
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Scientific title
Can the Alexander Technique improve balance and mobility in adults over 50 with visual impairments?: A randomised controlled trial.
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Secondary ID [1]
252351
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Nil
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Universal Trial Number (UTN)
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Trial acronym
VISIBILITY
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Vision Impairment in adults over 50 years
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Balance in adults over 50 years with vision impairment
257856
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Mobility in adults over 50 years with vision impairment
257857
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Falls Risk in adults over 50 years with vision impairment
257858
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Mood in adults over 50 years with vision impairment
257859
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Social Participation in adults over 50 years with vision impairment
257860
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Quality of Life in adults over 50 years with vision impairment
257861
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Condition category
Condition code
Eye
258020
258020
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0
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Diseases / disorders of the eye
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Injuries and Accidents
258021
258021
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0
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Other injuries and accidents
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Physical Medicine / Rehabilitation
258022
258022
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0
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Other physical medicine / rehabilitation
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Participants in the intervention group will be offered one weekly lessons in the Alexander Technique on 12 consecutive weeks. The lessons are ‘hands-on’ guided movement sessions aimed at improving proprioceptive acuity and postural control in everyday activity. Lessons typically last 30-40 minutes as timing varies depending on individual ability and wellbeing.
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Intervention code [1]
256909
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Treatment: Other
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Intervention code [2]
256910
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Rehabilitation
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Intervention code [3]
256911
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Prevention
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Comparator / control treatment
Participants in the control group will continue to receive usual care from Guide Dogs NSW/ACT during the 12 week intervention period of the study. Participants access services from Guide Dogs NSW/ACT on a needs driven basis, and are free to contact the organisation at any time for help with their orientation and mobility needs. Services include mobility training and hazard assessment on specific routes, public transport training and the use of canes, dogs and electronic aids.
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Control group
Active
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Outcomes
Primary outcome [1]
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Primary Outcome 1: Performance on the "5 Times Sit to Stand" test from the Short Physical Performance Battery
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Assessment method [1]
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Timepoint [1]
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at baseline and at 3 months after intervention commences
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Primary outcome [2]
258875
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Primary Outcome 2: Performance on the "Standing Balance" test from the Short Physical performance Battery
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Assessment method [2]
258875
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Timepoint [2]
258875
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at baseline and at 3 months after intervention commences
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Primary outcome [3]
258876
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Primary Outcome 3: Performance on the "Timed Walking" test from the Short Physical Performance Battery
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Assessment method [3]
258876
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Timepoint [3]
258876
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at baseline and at 3 months after intervention commences
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Secondary outcome [1]
265010
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Secondary Outcome 1: Fall rate with falls calendars
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Assessment method [1]
265010
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Timepoint [1]
265010
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Timepoint: monthly for 12 months from randomisation
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Secondary outcome [2]
265011
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Secondary Outcome 2: Fear of falling with Falls Efficacy Scale - International
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Assessment method [2]
265011
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Timepoint [2]
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Timepoint: at baseline and at 3 and 12 months after intervention commences
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Secondary outcome [3]
265012
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Secondary Outcome 3: Mood with the Geriatric Depression Scale and the Positive and Negative Affect Scale
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Assessment method [3]
265012
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Timepoint [3]
265012
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Timepoint: at baseline and at 3 and 12 months after intervention commences
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Secondary outcome [4]
265013
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Secondary Outcome 4: Quality of Life with the European Quality of Life-5 Dimensions (EQ-5D)
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Assessment method [4]
265013
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Timepoint [4]
265013
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Timepoint: at baseline and at 3 and 12 months after intervention commences
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Secondary outcome [5]
265014
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Secondary Outcome 5: Functional Vision with the Perceived Visual Ability Scale and the Impact of Vision Impairment Scale
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Assessment method [5]
265014
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Timepoint [5]
265014
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Timepoint: at baseline and at 3 and 12 months after intervention commences
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Secondary outcome [6]
265015
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Secondary Outcome 6: Community Participation with the Keele Assessment of Participation
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Assessment method [6]
265015
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Timepoint [6]
265015
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Timepoint: at baseline and at 3 and 12 months after intervention commences
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Secondary outcome [7]
265016
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Secondary Outcome 7: Activity levels using Actigraphy
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Assessment method [7]
265016
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Timepoint [7]
265016
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Timepoint: prior to randomisation and 12 months after intervention commences
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Secondary outcome [8]
265017
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Secondary Outcome 8: Gait analysis using GAITrite pressure sensitive mat
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Assessment method [8]
265017
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Timepoint [8]
265017
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Timepoint: subgroup prior to randomisation and 12 months after intervention commences
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Secondary outcome [9]
295538
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Performance on the "5 Times Sit to Stand" test from the Short Physical Performance Battery at 12 months
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Assessment method [9]
295538
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Timepoint [9]
295538
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12 months after intervention commences
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Secondary outcome [10]
295539
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Performance on the "Standing Balance" test from the Short Physical performance Battery at 12 months
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Assessment method [10]
295539
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Timepoint [10]
295539
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12 months after intervention commences
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Secondary outcome [11]
295540
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Performance on the "Timed Walking" test from the Short Physical Performance Battery at 12 months
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Assessment method [11]
295540
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Timepoint [11]
295540
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12 months after intervention commences
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Eligibility
Key inclusion criteria
To be eligible, participants will:
1. have a vision impairment such that they require services from Guide Dogs NSW/ACT for assistance with independent mobility
2. be resident in Greater Metropolitan Sydney, NSW, Australia
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Minimum age
50
Years
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Maximum age
90
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1. Clinically diagnosed Dementia, or a Short Portable Mental Status Questionnaire score of less than 8
2. Inability to understand conversational English
3. People with severely restricted mobility, those in wheelchairs, or confined to stationary chairs or beds.
4. Those with planned cataract surgery in the following 12 months
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
120 participants will be recruited into the study in 4 blocks. After informed consent is gained baseline data collection will be carried out by Orientation & Mobility (O&M) Instructors from Guide Dogs NSW/ACT, trained as research assistants by the study team. These research assistants will be involved in later assessments and will remain masked to treatment allocation.
Participants will be sequentially allocated a study ID number by the study coordinator at Guide Dogs NSW/ACT as they are recruited. The study coordinator will be unaware of the allocation schedule, which will be held by the research team at the George Institute. The study coordinator will communicate the ID number, minus any personal details, to the research team at the George Institute, who will refer to a randomisation list to determine allocation.
The Alexander instructor will not be masked to intervention group allocation as the intervention is a physical modality delivered in the participant’s home. However, this individual will not be involved in outcome assessments.
As an additional precaution to reduce the possibility of unmasking of participants to the research assistants, any participants requiring regular services from Guide Dogs NSW/ACT (usual care) will be assigned to O&M instructors other than those involved in the research project. This means that the research assistants will only interact with the participants at data collection points.
The data assessment forms given to the study team will only have the participants initials, date of birth and study ID number , so that those entering the data from the assessment forms will be blinded to allocation status.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
The sequence will be generated using on-line software to randomly allocate the intervention balanced for each block of participants.
This is an online service available at http://www.randomization.com
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people assessing the outcomes
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Intervention assignment
Parallel
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Other design features
Nil
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/09/2010
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Actual
30/08/2010
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Date of last participant enrolment
Anticipated
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Actual
15/09/2011
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Date of last data collection
Anticipated
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Actual
30/11/2012
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Sample size
Target
120
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Accrual to date
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Final
120
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment postcode(s) [1]
3064
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2046
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Recruitment postcode(s) [2]
3065
0
2035
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Recruitment postcode(s) [3]
3066
0
2039
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Recruitment postcode(s) [4]
3067
0
2037
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Recruitment postcode(s) [5]
3068
0
2020
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Recruitment postcode(s) [6]
3069
0
2192
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Recruitment postcode(s) [7]
3070
0
2063
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Recruitment postcode(s) [8]
3071
0
2074
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Recruitment postcode(s) [9]
3072
0
2030
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Recruitment postcode(s) [10]
3073
0
2200
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Recruitment postcode(s) [11]
3074
0
2032
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Recruitment postcode(s) [12]
3075
0
2071
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Recruitment postcode(s) [13]
3076
0
2136
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Recruitment postcode(s) [14]
3077
0
2196
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Recruitment postcode(s) [15]
3078
0
2219
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Recruitment postcode(s) [16]
3079
0
2099
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Recruitment postcode(s) [17]
3080
0
2027
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Recruitment postcode(s) [18]
3081
0
2010
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Recruitment postcode(s) [19]
3082
0
2047
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Recruitment postcode(s) [20]
3083
0
2197
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Recruitment postcode(s) [21]
3084
0
2011
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Recruitment postcode(s) [22]
3085
0
2194
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Recruitment postcode(s) [23]
3086
0
2212
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Recruitment postcode(s) [24]
3087
0
2088
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Recruitment postcode(s) [25]
3088
0
2066
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Recruitment postcode(s) [26]
3089
0
2095
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Recruitment postcode(s) [27]
3090
0
2221
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Recruitment postcode(s) [28]
3091
0
2220
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Recruitment postcode(s) [29]
3092
0
2134
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Recruitment postcode(s) [30]
3093
0
2228
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Recruitment postcode(s) [31]
3094
0
2137
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Recruitment postcode(s) [32]
3095
0
2199
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Recruitment postcode(s) [33]
3096
0
2042
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Recruitment postcode(s) [34]
3097
0
2121
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Recruitment postcode(s) [35]
3098
0
2060
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Recruitment postcode(s) [36]
3099
0
2204
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Recruitment postcode(s) [37]
3100
0
2033
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Recruitment postcode(s) [38]
3101
0
2111
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Recruitment postcode(s) [39]
3102
0
2135
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Recruitment postcode(s) [40]
3103
0
2211
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Recruitment postcode(s) [41]
3104
0
2076
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Recruitment postcode(s) [42]
3105
0
2061
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Recruitment postcode(s) [43]
3106
0
2207
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Recruitment postcode(s) [44]
3107
0
2195
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Recruitment postcode(s) [45]
3108
0
2065
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Recruitment postcode(s) [46]
3109
0
2031
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Recruitment postcode(s) [47]
3110
0
2057
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Recruitment postcode(s) [48]
3111
0
2087
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Recruitment postcode(s) [49]
3112
0
2093
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Recruitment postcode(s) [50]
3113
0
2229
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Recruitment postcode(s) [51]
3114
0
2114
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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Australian Postgraduate Award
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Address [1]
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Department of Education, Employment and Workplace Relations
16 - 18 Mort St
Canberra ACT 2600
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Country [1]
257364
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Australia
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Funding source category [2]
257365
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Charities/Societies/Foundations
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Name [2]
257365
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Guide Dogs NSW/ACT (substantial 'in-kind' suport)
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Address [2]
257365
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2-4 Thomas Street
Chatswood NSW 2067
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Country [2]
257365
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Australia
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Funding source category [3]
257366
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Charities/Societies/Foundations
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Name [3]
257366
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FM Alexander Trust
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Address [3]
257366
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The Society of Teachers of the Alexander Technique (STAT)
First Floor, Linton House
39-51 Highgate Road
London NW5 1RS
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Country [3]
257366
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United Kingdom
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Funding source category [4]
284502
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Charities/Societies/Foundations
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Name [4]
284502
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Australian Society of Teachers of the Alexander Technique
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Address [4]
284502
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PO Box 405
Beechworth
Victoria 3747
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Country [4]
284502
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Australia
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Primary sponsor type
University
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Name
The George Institue for Global Health, University of Sydney
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Address
Level 7
341 George St
Sydney NSW 2000
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Country
Australia
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Secondary sponsor category [1]
256606
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University
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Name [1]
256606
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Neuroscience Research Australia, University of NSW
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Address [1]
256606
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Hospital Rd
Randwick NSW 2031
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Country [1]
256606
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Australia
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Other collaborator category [1]
251409
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Charities/Societies/Foundations
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Name [1]
251409
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Guide Dogs NSW/ACT
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Address [1]
251409
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2-4 Thomas Street, Chatswood NSW 2067
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Country [1]
251409
0
Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
259386
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University of Sydney Human Research Ethics Committee
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Ethics committee address [1]
259386
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Level 6, Jane Foss Russell Building - G02 City Road - Darlington Campus The University of Sydney NSW 2006
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Ethics committee country [1]
259386
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Australia
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Date submitted for ethics approval [1]
259386
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Approval date [1]
259386
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23/07/2010
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Ethics approval number [1]
259386
0
12985
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Summary
Brief summary
Vision impairment is a growing public health problem in an ageing population, is an independent risk factor for falls, and compounds the effects of other risk factors by reducing mobility and physical fitness. This randomised controlled trial will investigate the effect of the Alexander Technique on balance and mobility in adults over 50 with vision impairments. 120 people over 50 years of age with vision impairments will participate in the trial. Participants will be independently mobile, with conversational English and no marked cognitive impairment. The intervention group will receive 12 home based lessons in the Alexander Technique on a weekly basis, and the control group will receive usual care. Outcome measures will be collected by assessors masked to group allocation at baseline, and at 3 and 12 months post randomisation. The primary outcome measure will be physical ability using the Short Physical Performance Battery. Secondary outcome measures will be mobility measured with actigraphy and falls measured with 12 monthly calendars. A smaller sub-study will investigate changes in gait patterns. Mood, quality of life, fall-related self-efficacy and functional vision will be measured with a series of validated questionnaires. If proven effective, the Alexander Technique will provide an additional modality to improve mobility and reduce falls risk in vulnerable adults with vision impairment.
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Trial website
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Trial related presentations / publications
CONFERENCE PRESENTATIONS The 11th International Conference on Low Vision Melbourne, Australia. 31st March – 3rd April 2014. “Improving physical functioning to reduce physical falls risk in older adults with visual impairments - Can the Alexander Technique help?” Michael Gleeson, Cathie Sherrington, Serigne Lo, Lisa Keay AER International: Orientation & Mobility Conference New Orleans, Louisiana, USA, December 2013 “Visual Impairment, Balance and Mobility: Improving Balance and Mobility in People over 50 Years of Age with Visual Impairments: Can the Alexander Technique Help?” Michael Gleeson, Cathie Sherrington, Serigne Lo, Lisa Keay 12th National Emerging Researchers in Ageing Conference Sydney, Australia. 25th & 26th November 2013 “Vision Impairment Balance and Mobility” Michael Gleeson, Cathie Sherrington, Lisa Keay 14th International Mobility Conference: IMC14 Palmerston North, New Zealand. 13th – 17th February 2012 “Vision Impairment Balance and Mobility: A protocol for a randomised controlled trial” Michael Gleeson, Cathie Sherrington, Lisa Keay 4th Australasian Orientation and Mobility Conference Sydney, Australia. 24th -26th November 2010 “Vision and Postural Orientation” PUBLICATIONS Can the Alexander Technique improve balance and mobility in older adults with visual impairments? A randomized controlled trial (accepted 2014). Gleeson, M.G., Sherrington, C., Lo, S. & Keay, L. Clinical Rehabilitation Exercise and physical training can improve physical functioning in older adults with visual impairments but their effect on falls is unclear: A systematic review and meta-analysis (accepted 2014). Gleeson, M.G., Sherrington, C. & Keay, L. The Journal of Physiotherapy Improving balance and mobility in people over 50 years of age with vision impairments: can the Alexander Technique help? A study protocol for the VISIBILITY randomised controlled trial (2014). Gleeson, M., Sherrington, C., Borkowski, E. & Keay, L. 2014 Injury Prevention, 20(1) e3.
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Public notes
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Contacts
Principal investigator
Name
31453
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Mr Michael Gleeson
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Address
31453
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The George Institute for Global Health
Level 13, 321 Kent St
Sydney 2000 NSW
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Country
31453
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Australia
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Phone
31453
0
+61 2 9657 0435
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Fax
31453
0
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Email
31453
0
[email protected]
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Contact person for public queries
Name
14700
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Michael Gleeson
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Address
14700
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The George Institute for Global Health
Level 13, 321 Kent St
Sydney 2000 NSW
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Country
14700
0
Australia
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Phone
14700
0
+61 2 9657 0435
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Fax
14700
0
+61 2 9657 0301
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Email
14700
0
[email protected]
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Contact person for scientific queries
Name
5628
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Michael Gleeson
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Address
5628
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The George Institute for Global Health
Level 13, 321 Kent St
Sydney 2000 NSW
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Country
5628
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Australia
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Phone
5628
0
+61 2 9657 0435
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Fax
5628
0
+61 2 9657 0301
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Email
5628
0
[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
Download to PDF