An unintentional fall is an event that results in a person inadvertently coming to rest on the ground or at a lower level from causes other than sustaining a violent blow, loss of consciousness or sudden onset of paralysis as may occur during a stroke or epileptic seizure. (1) A long lie is defined as an inability to get up from a fallen position, usually on the floor or ground, for more than an hour. It is associated with complications such as rhabdomyolysis, fear of falling, pneumonia, pressure sores and dehydration. (2) Long lie is a marker of weakness, illness and isolation, and is associated with higher mortality rates. (3) Only 50% of fallers are able to get up from the ground or floor after a fall. (4)

Background Falls and fall-related injuries in older adults are a leading cause of disability and death. Evidence has shown the benefits of exercises in improving functional outcomes and reducing fall rates among community-dwelling older adults. However, there is lack of effective community-based single exercise intervention for a broad population of older adults who are at high risk for falls. We aim to evaluate the effectiveness of Steady Feet (SF), a 6-month tailored community fall prevention exercise programme for improving functional outcomes. SF classes are facilitated by community fitness instructors and an exercise video. The main outcome is between-group changes in short physical performance battery (SPPB) scores. Secondary outcomes include balance confidence, fear of falling, quality of life, fall rates, and cost effectiveness. Methods We present the design of a 6-month randomised controlled trial of 260 older adults (≥ 60 years old). Individuals will be randomised in a 1:1 allocation ratio to the SF group or usual care group. Participants will be assessed at baseline, 3-month, and 6-month. Data on socio-demographics, co-morbidities, balance confidence, fear of falling, quality of life, physical activity level, rate of perceived exertion, fall(s) history, healthcare utilisation and cost, and satisfaction levels will be collected. Participants will also undergo functional assessments such as SPPB. Moreover, providers’ satisfaction and feedback will be obtained at 3-month. Discussion An effective community fall prevention programme may lead to improved functional outcomes and reduced fall rates. Findings will also help inform the implementation and scaling of SF nation-wide. Trial registration Clinicaltrials.gov registration: NCT04801316. Registered on 15th March 2021.