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Trial registered on ANZCTR
Registration number
ACTRN12624000563561
Ethics application status
Approved
Date submitted
20/04/2024
Date registered
3/05/2024
Date last updated
28/07/2024
Date data sharing statement initially provided
3/05/2024
Type of registration
Prospectively registered
Titles & IDs
Public title
Efficacy of a VR-based Balance Training Program on Exercise Adherence, Balance, and Mobility of Older Adults: A Randomized Controlled Trial
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Scientific title
Efficacy of a VR-based Balance Training Program on Exercise Adherence, Balance, and Mobility of Older Adults: A Randomized Controlled Trial
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Secondary ID [1]
312006
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None
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Falls
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Impaired balance
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Mobility difficulty
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Condition category
Condition code
Physical Medicine / Rehabilitation
330304
330304
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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
The intervention is a virtual reality-based balance exercise (VR-BEx) program designed for healthy older adults. VR-BEx contains 5 exergames that are designed to address different fall risk factors such as balance, reaction time, and lower body strength. The exergames will be projected on an LED TV position 3 meters in front of the participant. The exercise tasks featured in the exergames include tandem stance, single leg stance, lateral weight-transfer, reaction stepping, and squat. The exercise task will be performed 10 times at each trial and the exergame will be played twice. Each exergame will be played for 5 minutes interspersed with a 2 minute rest interval. The difficulty setting of each exergame will be adjusted to ensure that the exercise task is performed at a moderate difficulty level (i.e. 4 - 6 of the 10-point Perceived Difficulty Rating scale). The intervention will be implemented for 30 - 40 minutes three times a week for 6 months at the Selwyn Village (i.e., aged care facility) and Exercise Science Building of the University of Auckland. A research assistant will supervise the intervention in-person for the first 3 months to help the participant familiarize with the system and how to change the game settings (e.g., difficulty level). The participant will perform the balance exergame program unsupervised in the remainder of the study. VR-BEx will automatically record the scores and relevant data (e.g., date, exercise duration) each time the participant uses the exergame system.
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Intervention code [1]
328461
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Prevention
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Comparator / control treatment
Participants in the control group will be prescribed with an individualized fall prevention exercise program by a physiotherapist or clinical exercise physiologist that consists of balance and strengthening exercises. The individualized exercise prescription will be based on the baseline functional tests (e.g., Short Physical Performance Battery) to determine which risk factor (e.g., balance, lower extremity strength) needs to be addressed. Examples of balance exercises are 10 - 30 seconds tandem stance while 5 - 10 sit to stands is an example of a strengthening exercise. A research assistant will teach the exercises to the study participant during the first week and the participant will be given an exercise log book to help them monitor their performance.The exercise program will be unsupervised but the participant will be encouraged to perform the exercises for 30-40 minutes, three times a week for 6 months.
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Control group
Active
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Outcomes
Primary outcome [1]
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Exercise Adherence
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Assessment method [1]
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Total number of exercise sessions during the study period which will be recorded through VR-BEx system (i.e., intervention group) and exercise log book (i.e., control group)
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Timepoint [1]
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Weekly during the 6 month study period
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Primary outcome [2]
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Falls
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Assessment method [2]
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Total number of fall events during the study period through a monthly self-report and as reported by care managers of the facility. A study-specific questionnaire will be completed by the study participant and care manager at the end of every month.
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Timepoint [2]
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Monthly during the 6 month study period
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Primary outcome [3]
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Balance
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Assessment method [3]
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Limits of stability (center of mass displacement) using position data recorded by camera or depth sensor
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Timepoint [3]
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Baseline, 3rd month, and 6th month post-commencement of the intervention by the participant
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Secondary outcome [1]
434302
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Mobility
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Assessment method [1]
434302
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Short Physical Performance Battery
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Timepoint [1]
434302
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Baseline, 3rd month, and 6th month post-commencement of the intervention by the participant
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Secondary outcome [2]
434303
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Fear of falling
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Assessment method [2]
434303
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Falls Efficacy Scale - International
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Timepoint [2]
434303
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Baseline, 3rd month, and 6th month post-commencement of the intervention by the participant
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Secondary outcome [3]
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Quality of life
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Assessment method [3]
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Quality of Life (SF-36)
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Timepoint [3]
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Baseline, 3rd month, and 6th month post-commencement of the intervention by the participant
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Secondary outcome [4]
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Acceptability of intervention
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Assessment method [4]
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Technology Acceptance Model Questionnaire
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Timepoint [4]
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Baseline, 3rd month, and 6th month post-commencement of the intervention by the participant
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Eligibility
Key inclusion criteria
Apparently healthy older adults living in the community and aged care facilities that can walk unaided and make informed decisions independently
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Minimum age
60
Years
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Maximum age
80
Years
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Sex
Both males and females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
Older adults who had a fall event in the past 6 months or with moderate to severe cognitive impairment or with moderate to severe auditory or visual impairment or with uncontrolled hypertension or with vestibular dysfunction.
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Study design
Purpose of the study
Prevention
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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)
Concealed allocation using computer-generated random numbers
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomization using a computer program
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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
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
A logistic regression model will be used to analyze the number of participants who had fall events during the study period. A two-way analysis of variance (i.e., group x time) will be employed to determine if significant differences exist in the quantitative outcome measures (e.g., limits of stability).
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
1/07/2024
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Actual
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Date of last participant enrolment
Anticipated
30/09/2024
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Actual
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Date of last data collection
Anticipated
31/03/2025
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Actual
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Sample size
Target
56
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Accrual to date
0
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Final
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Recruitment outside Australia
Country [1]
26266
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New Zealand
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State/province [1]
26266
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Auckland
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Funding & Sponsors
Funding source category [1]
316351
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Charities/Societies/Foundations
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Name [1]
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Selwyn Foundation
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Address [1]
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Country [1]
316351
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New Zealand
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Primary sponsor type
University
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Name
University of Auckland
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Address
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Country
New Zealand
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Secondary sponsor category [1]
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None
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Name [1]
318537
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Address [1]
318537
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Country [1]
318537
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
315162
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Central Health and Disability Ethics Committee
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Ethics committee address [1]
315162
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https://ethics.health.govt.nz/about/central-health-and-disability-ethics-committee/
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Ethics committee country [1]
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New Zealand
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Date submitted for ethics approval [1]
315162
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13/05/2024
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Approval date [1]
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05/07/2024
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Ethics approval number [1]
315162
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2024-FULL-20321
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Summary
Brief summary
A meta-analysis by Sherrington and colleagues (2017) provided strong evidence that exercise and balance training reduced fall events. Unfortunately, supervised exercise training programs are not viable in the long run due to limited resources and high cost. A possible solution to address low adherence and unaddressed fall-risk factors is to provide a multi-component rehabilitation program that utilizes gamified exercise tasks (i.e., exergames) through virtual reality. Our group developed a VR-based balance training program that had been deemed acceptable and tolerable by a small sample of older adults. The proposed clinical trial aims to compare the exercise adherence, balance, and mobility of older adults enrolled in a balance exergame program (i.e., intervention group) and traditional balance training program (i.e., control group). The intervention group is expected to report greater exercise adherence, balance outcome measures, and mobility outcome measures than the control group.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Yanxin Zhang
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Address
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Department of Exercise Sciences, University of Auckland, Building 907, End of Suiter Street, Newmarket, Auckland
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Country
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New Zealand
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Phone
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+6493737599
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Peter Fermin Dajime
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Address
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Department of Exercise Sciences, University of Auckland, Building 907, End of Suiter Street, Newmarket, Auckland
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Country
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New Zealand
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Phone
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+64 272372999
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Peter Fermin Dajime
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Address
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Department of Exercise Sciences, University of Auckland, Building 907, End of Suiter Street, Newmarket, Auckland
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Country
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New Zealand
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Phone
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+64 272372999
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Fax
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Email
133868
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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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.
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