Effects of three home-based exercise programmes regarding falls, quality of life and exercise-adherence in older adults at risk of falling: protocol for a randomized controlled trial

BACKGROUND Fall prevention interventions with home-based exercise programmes are effective to reduce the number and the rate of falls, by reducing risk factors. They improve balance, strength, function, physical activity, but it is known that older adults' exercise adherence declines over time. However, it is unclear which delivery-modalities of the home-based exercise programmes show the best adherence and the largest effect. We created a new home-based exercise programme, the Test-and-Exercise (T&E) programme, based on the concepts of self-efficacy and empowerment. Patients learn to build their own exercise programme with a mobile application, a brochure and cards, as well as with eight coaching sessions by physiotherapists. The main objective of this study is to compare the T&E programme with the Otago Exercise Programme and the recommendation-booklet and exercise-cards of Helsana regarding incidence of falls. Other outcomes are severity of falls, functional capacities, quality of life and exercise-adherence. METHODS The design of this study is a Swiss multicentre assessor blind randomized controlled trial. A block-randomization, stratified in groups for age and risk of fall categories, will be used to allocate the participants to three groups. The targeted study sample consists of 405 older adults, ≥ 65 years of age, living in the community and evaluated as at "risk of falling". Experimental group will receive the T&E programme (N = 162). Second group will receive the Otago programme (N = 162) and the third group will receive the Helsana programme (N = 81). All interventions last six months. Blinded assessors will assess participants three times: at baseline before the start of the intervention, after six months of intervention and a final assessment after twelve months (six months of follow up). DISCUSSION Although home-based exercises programmes show positive effects in fall prevention in elderly persons, existing programmes do often not include patients in the decision-making process about exercise selection. In our programme the physiotherapist and the older adult work together to select the exercises; this collaboration helps to increase health literacy, pleasure of exercising, and empowers patients to be more autonomy. TRIAL REGISTRATION ClinicalTrials.gov: NCT02926105 , First Posted: October 6, 2016, Last Update: November 11, 2016: Enrolment of the first participant

Effects of three home-based exercise programmes regarding falls, quality of life and exercise-adherence in older adults at risk of falling: protocol for a randomized controlled trial

Abstract Background Fall prevention interventions with home-based exercise programmes are effective to reduce the number and the rate of falls, by reducing risk factors. They improve balance, strength, function, physical activity, but it is known that older adults’ exercise adherence declines over time. However, it is unclear which delivery-modalities of the home-based exercise programmes show the best adherence and the largest effect. We created a new home-based exercise programme, the Test-and-Exercise (T&E) programme, based on the concepts of self-efficacy and empowerment. Patients learn to build their own exercise programme with a mobile application, a brochure and cards, as well as with eight coaching sessions by physiotherapists. The main objective of this study is to compare the T&E programme with the Otago Exercise Programme and the recommendation-booklet and exercise-cards of Helsana regarding incidence of falls. Other outcomes are severity of falls, functional capacities, quality of life and exercise-adherence. Methods The design of this study is a Swiss multicentre assessor blind randomized controlled trial. A block-randomization, stratified in groups for age and risk of fall categories, will be used to allocate the participants to three groups. The targeted study sample consists of 405 older adults, ≥ 65 years of age, living in the community and evaluated as at “risk of falling”. Experimental group will receive the T&E programme (N = 162). Second group will receive the Otago programme (N = 162) and the third group will receive the Helsana programme (N = 81). All interventions last six months. Blinded assessors will assess participants three times: at baseline before the start of the intervention, after six months of intervention and a final assessment after twelve months (six months of follow up). Discussion Although home-based exercises programmes show positive effects in fall prevention in elderly persons, existing programmes do often not include patients in the decision-making process about exercise selection. In our programme the physiotherapist and the older adult work together to select the exercises; this collaboration helps to increase health literacy, pleasure of exercising, and empowers patients to be more autonomy. Trial registration ClinicalTrials.gov: NCT02926105, First Posted: October 6, 2016, Last Update: November 11, 2016: Enrolment of the first participant

(Re)framing resistance and (re)forging solidarity : negotiating the politics of space, race, and gender in Maria Magdalena Campos-Pons’ Habla La Madre

This study provides one of the first examinations of Habla La Madre, a 2014 performance by Afro-Cuban artist Maria Magdalena Campos-Pons launched in the Guggenheim Museum. The performance stems from practices that resulted in the marginalization and exclusion of artists of color from hegemonic cultural institutions such as the Guggenheim. Habla La Madre concerns itself with the politics of identity in its desire to function as a tool for (re)building African Diasporic solidarity. The project looks at historical, cultural, religious, and mythological texts in order to investigate Habla La Madre as a manifestation of Campos-Pons’ hybridized “exilic,” “female,” “African,” and “Cuban” identities. (Re)Framing Resistance and (Re)Forging Solidarity: Negotiating the Politics of Space, Race, and Gender in Maria Magdalena Campos-Pons’ Habla La Madre situates the performance in a history of public performative acts of resistance enacted by enslaved Africans, Afro-Cubans, and African American communities which is a primary goal of this study. The project pays close attention to Habla La Madre as it intersects with the politics of space. A critical objective of this study is to understand the sociopolitical implications of Campos-Pons’ acts of spatial transformation and spatial appropriation around and within the museum. The project also looks at Campos-Pons’ introduction of Santería into the Guggenheim as an attempt at its institutionalization. A history of African and African Diasporic altar production structures an investigation into Campos-Pons’ construction of an altar within the Guggenheim. As a performance that challenges discriminatory practices of art institutions, Habla La Madre situates itself within the genre of institutional critique. The project highlights its consistencies, deviations, and contributions to the field. This research also draws upon conversations with the artist to determine the extent to which her peers have influenced the production and goals of Habla La Madre. Most prior research on Campos-Pons focuses on her practice as mourning; however, this project focuses on the cultural diffusion and celebration the performance brings about.Art Histor