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Randomized Controlled Trial
. 2024 Oct 1;53(10):afae214.
doi: 10.1093/ageing/afae214.

Feasibility and acceptability of the HOLObalance telerehabilitation system compared with standard care for older adults at risk of falls: the HOLOBalance assessor blinded pilot randomised controlled study

Marousa Pavlou  1   2   3 , Carol Ann Flavell  1 , Fariba Mostajeran Gourtani  4 , Christos Nikitas  5 , Dimitris Kikidis  5 , Athanasios Bibas  5 , Dimitris Gatsios  6 , Vassilis Tsakanikas  6 , Dimitrios I Fotiadis  6   7 , Dimitrios Koutsouris  8 , Frank Steinicke  4 , Isabelle Daniela Walz  9   10 , Christoph Maurer  9 , Sofia Papadopoulou  5 , Michalis Tsoukatos  5 , Athanasios Pardalis  6 , Doris-Eva Bamiou  2   3
Affiliations
Randomized Controlled Trial

Feasibility and acceptability of the HOLObalance telerehabilitation system compared with standard care for older adults at risk of falls: the HOLOBalance assessor blinded pilot randomised controlled study

Marousa Pavlou et al. Age Ageing. .

Abstract

Background: Falls have high socioeconomic costs. Information and communication technologies may support provision and monitoring of multisensory (MSR) physiotherapy programmes. The HOLOBalance platform used augmented reality holograms to provide patient-centred, individualised MSR.

Objectives: To determine the platform's safety, acceptability and feasibility, investigate functional gait and dynamic balance benefits and provide data for a definitive trial.

Design and setting: Single-blinded pilot randomised controlled feasibility study. Interventions were conducted at clinical sites or participants' homes in three European countries.

Participants: Community-dwelling older adults (median age 73 years; 64.2% female) at risk of falls were enrolled (May 2020-August 2021).

Methods: Participants were randomised to an 8-week clinic or home-based telerehabilitation MSR or OTAGO (control group) programme. Compliance, satisfaction, and adverse events determined feasibility. Clinical outcomes, assessed (blinded) within one-week prior to and post-intervention, included functional gait assessment (FGA), Mini BESTest and cognitive function.

Results: Randomisation to completion rate was 76.15% with 109 participants recruited (n = 289 screened). Drop-out rate was similar between groups. Adverse events were reported (n = 3) in the control group. Sixty-nine percent would recommend the HOLOBalance intervention. Findings were similar for the home and clinic-based arms of each intervention; data was combined for analysis. FGA (95%CI [1.63, 4.19]) and Mini-BESTest (95%CI [1.46, 3.93]) showed greater improvement in the HOLOBalance group with a clinically meaningful change of 4/30 noted for the FGA.

Conclusions: HOLObalance was feasible to implement and acceptable to older adults at risk of falls, with FGA and Mini-BEST improvements exceeding those for the OTAGO programme. A definitive trial is warranted.

Keywords: augmented reality; balance rehabilitation; falls risk; older adults; older people.

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Conflict of interest statement

None declared.

Figures

Figure 1
Figure 1
Image of HOLOBalance electronic dashboard (1A), sample of movement and performance data (B), example of in-clinic HOLOBalance training (C) and holographic virtual physiotherapist demonstrating MSR exercises (D).
Figure 2
Figure 2
CONSORT diagram to demonstrate participant flow through the HOLOBalance study (modified from CONSORT 2010) [25].
See this image and copyright information in PMC

References

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