Clinical Research Directory

Exercise and Fall Prevention for Fracture Reduction

According to the current guideline of the German Osteology Association (DVO), pharmacological treatment is a cornerstone of osteoporosis-related fracture prevention, effectively increasing bone mineral density and reducing fracture risk. However, particularly in older adults, falls represent a major independent fracture risk factor. Pharmacological treatment has limited effects on fall-related factors such as muscle strength, balance, mobility, and fall incidence. Physical exercise, either alone or combined with pharmacological treatment, can address these risk factors and improve fracture prevention. However, specialized osteoporosis exercise programs are not widely available, often face high demand, and require qualified instructors and suitable facilities. Older adults, particularly those with mobility limitations, face additional barriers to participation. Many prefer flexible home-based exercise, whereas fixed schedules and organizational requirements of group programs may compromise adherence and effectiveness. Currently available home-based osteoporosis exercise programs do not consistently follow the guideline "Physical Exercise for Fracture Prevention", which targets specific fracture risk determinants according to individual risk profiles. Moreover, these programs lack scientific evaluation. To address these limitations, our research group developed a home-based exercise program based on our S3 guideline "Physical Exercise for Fracture Prevention". The program differentiates between fracture risk profiles and enables accessible, flexible, and location-independent exercise. The present study will evaluate the effectiveness of this program in women with reduced bone strength and increased fall risk, a particularly relevant combination of osteoporotic fracture risk factors. Outcomes include surrogate measures of bone strength, fall risk, and mobility under real-world conditions. Research Question Is a guideline-based, fracture risk-adapted home exercise program effective in improving fracture risk determinants in women with reduced bone strength and increased fall risk when performed independently at home under real-world conditions?

ALERT-ED: Awareness and Linkage to Resources for At-Risk Emergency Department Patients

Falls are the leading reason for injury-related emergency department (ED) visits in older adults with high rates of ED revisits for falls. Evidence-based fall prevention programs can reduce falls by 30%, but older adults commonly describe limited awareness of resources. Currently, all UCHealth ED patients receive fall risk screening on ED arrival, but patients are rarely made aware of their screening results or referred to resources. To address this gap, our team developed ALERT-ED, an intervention where study patients receive automated notification of fall risk screening results and referral via Livi to evidence-based fall prevention programs near their homes. If ALERT-ED is successful, we will demonstrate that UCHealth can improve patient health via pragmatic, automated notification of screening results and referral to resources. Although we designed ALERT-ED to intervene on fall risk in EDs, the intervention could be used for other health concerns central to UCHealth's mission including for patients seeking care for transplants, cancer, brain health, or orthopedic concerns.

Fall Prevention in Mild Cognitive Impairment

Falls represent the leading cause of hospitalization, nursing home admissions, disability and mortality for older adults with annual healthcare costs over $50 billion. Older Veterans with cognitive impairment are at an increased risk of falls and injurious fall. The purpose of this study is to test the effects of 6 weeks of a virtual tele-neurorehabilitation intervention on fall prevention, functional mobility, strength, cognition and performance of activities of daily living. Participants will be one of 28 participants in the VA Maryland Health Care System. Participation in the study is voluntary and the research will be conducted at the VA Maryland Health Care System. The entire study will take approximately 2 years to complete. Subject's participation in the study will last 3 months.