This research program on aging to create Living Lab Sag aims at maintaining older adult's
full individual and collective abilities in the Saguenay-Lac-Saint-Jean (SLSJ) region.
The need for innovation and creativity aims at optimizing independence, whether for
mobility, the ability to take charge of one's health, to remain at home, to have access
to services, and to prevent falls in a frail and aging population. Thus, this program
includes expert investigators in the areas of health, engineering and computer science,
aging, neuropsychology, geriatrics, and rehabilitation/prevention within a
multidisciplinary work approach for durable health for older adults in Saguenay. Living
Lab Sag will be implemented based on an enriched research program, approved by the CIUSSS
SLSJ (CER# 2019-008) and entitled: Development of a new clinical approach in
rehabilitation for the care of older adults with a neuro-musculo-skeletal disorder and a
risk of falling: Project in partnership between UQAC and the specialized geriatrics
services of the CIUSSS-SLSJ. Canada census reports clearly show the demographic aging of
the local population. It is predicted that people 65 years and older will comprise about
24% of the population in 2036, in Canada and Quebec. In parallel with this demographic
phenomenon, 50% of Canadians live with at least one chronic disability that is often
associated with advanced age, as well as with different neurological, orthopedic and
cardiopulmonary degenerative diseases. Some diseases affecting the neuro-musculo-skeletal
system will lead to physical disability and to a significant functional limitation in
terms of balance, mobility and walking and, consequently, to an increase in the risk of
falling. Falls have a significant financial effect on healthcare services. Every year, in
Quebec, approximately 1/3 of people aged 65 and over will fall and, sadly, some data
suggest that 424,000 people will die, worldwide, because of a fall. The present scenario
also shows the importance of developing strategies to reduce the weight of falls on the
healthcare system, such as the creation of Living Lab Sag where the older adults will be
at the heart of the situation. With team's experience in the area, one strategy among
others is the early identification of physical-functional factors leading to a fall,
despite the presence of other associated extrinsic factors that are also associated with
the fall (i.e., multifactor phenomenon). This identification can be realized through
neurophysiological measures from valid and reliable biological signals in rehabilitation,
that will help determine the neuromuscular responses associated to the level of physical
frailty of the individual and his/her fall risk. However, geriatric services in general
don't often have access to high-end screening tools that permit an early detection of
balance problems and fall risk. Within an innovative action plan, our research program,
in partnership with specialized geriatric services and researchers aims to determine the
efficiency of new evaluation and intervention methods for the health of the older adults.
Since 2019, this programm integrate new measures using various high-end equipment to
capture biological signals enabling to perform research with patients from Hospital and
patients from Parkinson Association and community local. The mission of this program is
to build a new paradigm for this site while being a reference to evaluate
balance/mobility and walking problems, better screen frail older adults who are at risk
of falling and direct then to personalized therapy. At this time, this work will develop
a longitudinal intervention study using OTAGO (PEO) exercise program. The name "OTAGO" is
not an acronym, as "Otago" is a region of New Zealand located southwest of the southern
island. PEO is defined by a reeducation program for strength and balance at home (or in a
rehabilitation center), that is personalized, and based on conclusive data. The PEO was
developed by a geriatrician (Dr. Campbell) and his team of physiotherapists in 1997,
after many years of research, to identify the risks of falling and the potential
interventions that could reduce these risks. The program exists worldwide but has never
been tested in Québec. Although there are different fall prevention programs, conclusive
data show the more frequent use of OTAGO because of its efficiency to reduce the risk of
death and the incidence rate of falls over a period of one year in an aging population.
This program also reduces falls by 25% according to conclusive data, which no other
program in Québec and in rural areas has demonstrated until now. Finally, this program
can be a cost-effective intervention for the healthcare system by reducing expenses
associated to falls in rural areas, and in particular for patients in La Baie Hospital.
Already used in Australia and the United States, we have yet to determine its effects in
the Saguenay area. The goal is to test and show its efficiency for the fist time in the
area by a random clinical trial in La Baie Hospital. This step will make it possible to
advance our research program on the effective intervention plan to reduce future public
healthcare expenses related to falls. The aim of this study will thus be to evaluate if
the PEO, when adapted to La Baie geriatric services, is superior to conventional therapy
to improve parameters of walking, balance, muscle activation, postural trunk control,
mobility, force, endurance and perception of symptoms related to pain, function, fall
risk and, consequently, quality of life (wellbeing), volume of medication and expenses
associated to fall. In other step, the purpose is also evaluate the effect of carrying
out the OTAGO exercises in an outdoor and nature modality during a feasibility study to
see the impact of nature on the functional abilities of older people with
neuromusculoskeletal disorders (ex. Parkinson disease).