Lighting and perceptual cues: Effects on gait measures of older adults at high and low risk for falls

Figueiro, Mariana G.; Plitnick, Barbara; Rea, Mary S.; Gras, Laura Z.; Rea, Mark S.

doi:10.1186/1471-2318-11-49

Cited by 46 publications

(40 citation statements)

References 26 publications

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“…Sight and visibility are important for good perception; therefore, it is important to provide light that will support the perceptual system. At night, light levels should be dim and allow for safe navigation, especially in bedrooms and bathrooms [81,[83][84][85]. It is also important to encourage older people to increase their exposure to light-dark patterns as part of their wellness program.…”

Section: Future Perspectivementioning

confidence: 99%

Light, Sleep and Circadian Rhythms in Older Adults With Alzheimer’s Disease and Related Dementias

Figueiro

2017

Neurodegener. Dis. Manag.

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Alzheimer's disease and related dementias (ADRD) can cause sleep and behavioral problems that are problematic for ADRD patients and their family caregivers. Light therapy has shown promise as a nonpharmacological treatment, and preliminary studies demonstrate that timed light exposure can consolidate and improve nighttime sleep efficiency, increase daytime wakefulness and reduce evening agitation without the adverse effects of pharmacological solutions. Compliance with light treatment and the accurate measurement of light exposures during treatment, however, have presented barriers for the adoption of light therapy for ADRD. Recent research showing that the circadian system is maximally sensitive to short-wavelength light opens the way for the potential application of lower, more-targeted light intensities to maximize compliance and individualize light dose/timing in therapeutic settings.

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Section: Future Perspectivementioning

confidence: 99%

Light, Sleep and Circadian Rhythms in Older Adults With Alzheimer’s Disease and Related Dementias

Figueiro

2017

Neurodegener. Dis. Manag.

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“…A series of completed investigations have examined the effects of various forms of indoor night lighting for older people [45–47]. These studies found that at comparable low illumination levels, indoor lighting systems that enhanced horizontal and vertical (H/V) spatial elements were associated with the highest levels of performance on standardised tests of gait and balance.…”

Section: Introductionmentioning

confidence: 99%

Feasibility of a stepped wedge cluster RCT and concurrent observational sub-study to evaluate the effects of modified ward night lighting on inpatient fall rates and sleep quality: a protocol for a pilot trial

Chari

Smith

Mudge

et al. 2016

Pilot Feasibility Stud

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BackgroundFalls among hospitalised patients impose a considerable burden on health systems globally and prevention is a priority. Some patient-level interventions have been effective in reducing falls, but others have not. An alternative and promising approach to reducing inpatient falls is through the modification of the hospital physical environment and the night lighting of hospital wards is a leading candidate for investigation. In this pilot trial, we will determine the feasibility of conducting a main trial to evaluate the effects of modified night lighting on inpatient ward level fall rates. We will test also the feasibility of collecting novel forms of patient level data through a concurrent observational sub-study.Methods/designA stepped wedge, cluster randomised controlled trial will be conducted in six inpatient wards over 14 months in a metropolitan teaching hospital in Brisbane (Australia). The intervention will consist of supplementary night lighting installed across all patient rooms within study wards. The planned placement of luminaires, configurations and spectral characteristics are based on prior published research and pre-trial testing and modification. We will collect data on rates of falls on study wards (falls per 1000 patient days), the proportion of patients who fall once or more, and average length of stay. We will recruit two patients per ward per month to a concurrent observational sub-study aimed at understanding potential impacts on a range of patient sleep and mobility behaviour. The effect on the environment will be monitored with sensors to detect variation in light levels and night-time room activity. We will also collect data on possible patient-level confounders including demographics, pre-admission sleep quality, reported vision, hearing impairment and functional status.DiscussionThis pragmatic pilot trial will assess the feasibility of conducting a main trial to investigate the effects of modified night lighting on inpatient fall rates using several new methods previously untested in the context of environmental modifications and patient safety. Pilot data collected through both parts of the trial will be utilised to inform sample size calculations, trial design and final data collection methods for a subsequent main trial.Trial registrationAustralian New Zealand Clinical Trials Register (ANZCTR): ACTRN12614000615684 (cluster RCT) and ACTRN12614000616673 (observational sub-study).Date Registered: 10 June 2014 (both studies).Protocol version: 1.2 (Dated: 01 June 2014)Anticipated completion: September 2015Role of Trial Sponsor: The named sponsor for this investigator-initiated trial was the Director of the Royal Brisbane and Women’s Hospital (RBWH) Safety and Quality Unit (Therese Lee, Phone: +61 7 3646 8111). The principal investigators, SC and MA, are employed by the RBWH Safety and Quality Unit. The trial sponsor has no involvement in any aspects of study design, conduct or decision to submit the report for publication. AM and MD are employed by other departments in the sam...

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“…Lighting affects elderly individuals' ability to acquire visual information while moving in the environment. Age-related changes in vision may result in severely impaired balance control, leading to an increased risk of trip-related falls which more commonly occur among older adults 14) .…”

Section: Introductionmentioning

confidence: 99%

“…Low vision is correlated with poor performance in crossing obstacles 13) . Even small reductions in visibility affect the balance of the elderly 14) . Older adults with disordered gait show more variable and less steady gait while walking under dim lighting conditions 15) .…”

Section: Introductionmentioning

confidence: 99%

Effects of Illumination on Toe Clearance and Gait Parameters of Older Adults when Stepping over an Obstacle: a Pilot Study

Cho

Ryu

et al. 2013

J Phys Ther Sci

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Abstract.[Purpose] The purpose of this study was to investigate how older adults adjust gait patterns when stepping over a ground-based obstacle under two different lighting conditions. [Subjects] A total of 10 communitydwelling healthy older adults (mean age, 67.9 ± 2.12 years; age range, 65-72 years) were enrolled in this study.[Methods] All participants stood quietly in a self-selected foot position on the floor. Each participant was then instructed to step over a 10 cm high wooden obstacle under two illumination conditions (1 and 200 lx) at a selfselected pace with the right leg in response to the verbal cue "GO", and continued walking with the left leg on a 5 m pathway. Toe clearances and step parameters were measured using an eight-camera motion analysis system.[Results] Under the low lighting condition, toe clearance of the trailing leg was significantly lower than under the normal lighting condition. However, no significant differences were observed in toe clearance of the lead leg, step velocity, stride length, step length, cadence, or swing/stance duration between the normal and low lighting conditions.[Conclusion] Older adults reduce toe clearance of the trailing leg under low lighting conditions while stepping over an obstacle, which places them at greater risk of falling.

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Lighting and perceptual cues: Effects on gait measures of older adults at high and low risk for falls

Cited by 46 publications

References 26 publications

Light, Sleep and Circadian Rhythms in Older Adults With Alzheimer’s Disease and Related Dementias

Light, Sleep and Circadian Rhythms in Older Adults With Alzheimer’s Disease and Related Dementias

Feasibility of a stepped wedge cluster RCT and concurrent observational sub-study to evaluate the effects of modified ward night lighting on inpatient fall rates and sleep quality: a protocol for a pilot trial

Effects of Illumination on Toe Clearance and Gait Parameters of Older Adults when Stepping over an Obstacle: a Pilot Study

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