The primary aim of the COSMOS trial is to examine the effectiveness of the community-based health and physical activity counselling program in increasing life-space mobility and reducing the rate of falls in community-dwelling elderly people. Secondary aims of the study are to evaluate the effects of the counselling on fall-induced injuries, physical activity, physical ability and performance, quality of life, fracture risk, fear of falling, balance confidence, mood, cognition, and living-arrangements.
The trial is planned for four years. Health examinations and physical performance tests are carried out four times at the Health Kiosk of Ylöjärvi or at the Crevice Centre of Ylöjärvi: at baseline and one, two, and four years after the baseline measurements. Participants are at least 65 years old, live in Pirkanmaa district, and have at least minor mobility limitation. Our goal is to have 450 participants.
During the first health examination, the research nurse confirms the eligibility of the participants. In addition, height, weight, blood pressure, pulse, medical and geriatric conditions, and prescribed medications are confirmed. Physical performance tests are carried out to measure muscle strength, balance, agility, and walking speed. Interviews and questionnaires are used to collect information on life-space mobility, earlier falls and fall-induced injuries, balance confidence, fear of falling, fracture risk, quality of life, mood, cognition and living arrangements. All participants wear an activity meter for seven days after the baseline, one-year and two-year assessments.
Additionally, participants fill a physical activity diary during the first year and a fall diary for two years.
After the baseline assessments, participants are randomly allocated into a physical activity group (225 persons) or relaxation group (225 persons). There are five group specific individualized counselling sessions for all participants taking place at one week, and one, three, six, and 12 months after the baseline assessments. The participants in the physical activity group receive individualized health and physical activity counselling based on the Otago program. Those in the relaxation group receive structured relaxation exercises. All counselling sessions are face-to-face meetings at the Health Kiosk of Ylöjärvi or at the Cervice Centre of Ylöjärvi.
The aim of this study is to develop and test a new easily accessible health care concept to enable rapid screening and counselling, especially for those elderly people, who have a demanding situation in life.
Funding
Academy of Finland
Research group
Principal Investigator
Professor Riku Nikander, Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä and GeroCenter Foundation, Jyväskylä, Finland
Head Investigator
Postdoctoral Researcher Johanna Edgren, Gerontology Research Center, Faculty of Sport and Health Sciences
Senior Researchers (University of Jyväskylä)
Professor Taina Rantanen, Gerontology Research Center, Faculty of Sport and Health Sciences
Professor Urho Kujala, Faculty of Sport and Health Sciences
Senior Researcher Timo Törmäkangas, Gerontology Research Center, Faculty of Sport and Health Sciences
Dean, Professor Ari Heinonen, Faculty of Sport and Health Sciences
Professor Sarianna Sipilä, Gerontology Research Center, Faculty of Sport and Health Sciences
Professor Emeritus Lasse Kannas, Faculty of Sport and Health Sciences
Senior Researcher Timo Rantalainen, Faculty of Sport and Health Sciences
Collaborators
Professor Robin Daly, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia
Senior Researcher, Saija Karinkanta, UKK Institute for Health Promotion, Tampere, Finland
Chief Physician Pekka Kannus, UKK Institute for Health Promotion, Tampere, Finland
Research Director Harri Sievänen, UKK Institute for Health Promotion, Tampere, Finland
Project Specialist Outi Teittinen, Research and Development, School of Health and Social Studies, JAMK University of Applied Sciences, Jyväskylä, Finland
Other personnel
Research Physiotherapist Eerika Tiirikainen, MsC
Research Physiotherapist Paju Becker, MsC-student
Research Physiotherapist Elina Ahlstedt-Kivelä, physiotherapist
Research Nurse Tiina Raittila, nurse
Research Nurse Laura-Emilia Vainio, public health nurse
Publications
Edgren J, Karinkanta S, Rantanen T, Daly R, Kujala UM, Törmäkangas T, Sievänen H, Kannus P, Heinonen A, Sipilä S, Kannas L, Rantalainen T, Teittinen O, Nikander R. Counselling for physical activity, life-space mobility and falls prevention in old age (COSMOS): protocol of a randomised controlled trial. BMJ Open. 2019 Sep 24;9(9):e029682. doi: 10.1136/bmjopen-2019-029682.