A feasibility study to prevent falls in older people who are sight impaired: the VIP2UK randomised controlled trial.
Published evaluations of successful interventions to prevent falls in people with sight impairment (SI) are limited. The aim of this feasibility study is to optimise the design and investigation of home safety (HS) and home exercise (HE) programmes to prevent falls in older people with SI.



A community-based feasibility study in north-west England comprising a three-arm randomised controlled trial (RCT) allocated participants to (1) a control group receiving usual care and social visits, (2) an experimental group receiving the HS programme and (3) an experimental group receiving the HS + HE programme. Participants were community-dwelling, aged 65 years and older and sight impaired. Primary outcome data on falls were collected continuously over 6 months. Secondary outcomes on physical activity (self-report and instrumented) and adherence were collected at baseline and 3 and 6 months for HE and at 6 months for the HS programme. Costs for the HS and HS + HE groups were calculated from logs of time spent on home visits, telephone calls and travel. The research assistant and statistician were blinded to group allocation.



Altogether, 49 people were recruited over a 9-month period (randomised: 16 to control, 16 to HS, 17 to HS + HE). The interventions were implemented over 6 months by an occupational therapist at a cost per person (pounds sterling, 2011) of £249 (HS) and £674 (HS + HE). Eighty-eight percent (43/49) completed the trial and 6-month follow-up. At 6-month follow-up, 100 % reported partially or completely adhering to HS recommendations but evidence for adherence to HE was equivocal. Although self-reported physical activity increased, instrumented monitoring showed a decrease in walking activity. There were no statistically significant differences in falls between the groups; however, the study was not powered to detect a difference.



It is feasible and acceptable for an occupational therapist to deliver HS and HE falls prevention programmes to people with SI living independently in the community. Future studies could access Local Authority Registers of people with SI to improve recruitment rates. Further research is required to identify how to improve adherence to HE and to measure changes in physical activity before conducting a definitive RCT.



ISRCTN53433311 , registered on 8 May 2014.
University of Cardiff, Eastgate House, 35-43 Newport Road, Cardiff, CF24 0AB, UK. watermanh1@cardiff.ac.uk.
Heather
H
Waterman
University of Southampton, Southampton, UK.
Claire
C
Ballinger
Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK.
Caroline
C
Brundle
Glasgow Caledonian University, Glasgow, UK.
Sebastien
S
Chastin
University of Surrey, Surrey, UK.
Heather
H
Gage
Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK.|Manchester Academic Health Sciences Centre, Manchester, UK.
Robert
R
Harper
Manchester Academic Health Sciences Centre, Manchester, UK.|University of Manchester, Manchester, UK.
David
D
Henson
University of Loughborough, Loughborough, UK.
Bob
B
Laventure
Manchester Academic Health Sciences Centre, Manchester, UK.|Trafford General Hospital, Trafford, UK.
Lisa
L
McEvoy
Manchester Academic Health Sciences Centre, Manchester, UK.|University of Manchester, Manchester, UK.
Mark
M
Pilling
Manchester Academic Health Sciences Centre, Manchester, UK.|University of Manchester, Manchester, UK.
Nicky
N
Olleveant
Glasgow Caledonian University, Glasgow, UK.
Dawn A
DA
Skelton
Manchester Academic Health Sciences Centre, Manchester, UK.|University of Manchester, Manchester, UK.
Penelope
P
Stanford
Manchester Academic Health Sciences Centre, Manchester, UK.|University of Manchester, Manchester, UK.
Chris
C
Todd
D000058:Accidental Falls / Q000517:prevention & control*; D000368:Aged; D000369:Aged, 80 and over; D015444:Exercise; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D010342:Patient Acceptance of Health Care; D012449:Safety; D014786:Vision Disorders / Q000150:complications*
Exercise; Falls; Home safety; Older people; Sight loss; Visual impairment
Ophthalmic Epidemiol. 2001 Feb;8(1):1-11
11262678
Age Ageing. 2001 Jan;30(1):77-83
11322678
J Eval Clin Pract. 2004 May;10(2):307-12
15189396
J Am Geriatr Soc. 2005 Sep;53(9):1618-22
16137297
BMJ. 2005 Oct 8;331(7520):817
16183652
Age Ageing. 2005 Nov;34(6):614-9
16267188
Age Ageing. 2006 Jan;35(1):5-10
16364930
Health Educ Res. 2006 Aug;21(4):508-17
16467173
Age Ageing. 2006 Sep;35 Suppl 2:ii37-ii41
16926202
Inj Prev. 2006 Oct;12(5):296-301
17018669
Med Eng Phys. 2007 Oct;29(8):930-4
17134934
Pharm Stat. 2007 Apr-Jun;6(2):89-97
17230434
J Gerontol B Psychol Sci Soc Sci. 2007 Mar;62(2):P119-25
17379672
Age Ageing. 2008 Jan;37(1):45-50
18032400
J Aging Phys Act. 2008 Apr;16(2):201-14
18483442
J Aging Phys Act. 2008 Jul;16(3):292-315
18660552
Gait Posture. 2010 Jan;31(1):82-6
19854651
Eye (Lond). 2010 Sep;24(9):1437-46
20448666
BMC Med Res Methodol. 2010 Jul 16;10:67
20637084
J Trauma. 2011 Sep;71(3):748-53
21045738
J Aging Phys Act. 2011 Jul;19(3):189-200
21727300
BMC Med Res Methodol. 2012 Apr 17;12:50
22510239
Cochrane Database Syst Rev. 2012 Sep 12;(9):CD007146
22972103
Trials. 2013 Jul 01;14:192
23815878
Ethn Health. 2013;18(6):626-45
23834070
Clin Rehabil. 2015 Mar;29(3):244-60
25027444
Health Expect. 2015 Dec;18(6):2021-31
25736829
Eur J Ageing. 2011 Oct 20;8(4):271-279
28798656
Age Ageing. 1972 Nov;1(4):233-8
4669880
Stat Med. 1995 Sep 15;14(17):1933-40
8532986
Med Care. 1996 Mar;34(3):220-33
8628042