Removing environmental barriers to independent living: A feasibility randomised controlled trial targeting people ageing with long-term physical disabilities.

INTRODUCTION

People ageing with long-term physical disabilities face unique challenges to maintaining independence. We developed a novel, evidence-based intervention - Removing Environmental Barriers to Independent Living - to support participation and reduce falls.

METHODS

To examine Removing environmental barriers to independent living's feasibility and estimate its magnitude of efficacy, we conducted a single-blinded randomised controlled trial. Fifty participants who were aged 45-65 years with a physical disability for at least 5 years were randomised to intervention (n = 24) or control (n = 26). Activity performance, environmental barriers to performance, community participation, environmental fall hazards and fall prevention behaviours were assessed at baseline and at 6-month follow-up. Dose, adherence, fidelity and cost were examined. Linear mixed-effects models for repeated measures were used to assess the effects of time, group and group by time interaction on the continuous outcomes.

RESULTS

Removing environmental barriers to independent living had high fidelity and adherence and a low implementation cost. There were trends for greater improvements in activity limitations and activity performance among intervention versus control participants.

CONCLUSION

Removing environmental barriers to independent living is a feasible intervention with high fidelity and adherence. Findings trended towards greater improvements in activity performance for intervention participants. Results could inform future planning for a larger pragmatic trial.