Older people's experiences of therapeutic exercise as part of a falls prevention service: survey findings from England, Wales and Northern Ireland

Buttery, Amanda K.; Husk, Janet; Lowe, Derek; Treml, Jonathan; Vasilakis, N; Riglin, Jackie

doi:10.1093/ageing/aft182

Cited by 6 publications

(1 citation statement)

References 6 publications

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“…64 In the UK, two main programmes of exercise are offered as part of falls prevention services: the Otago home exercise programme 49,65 and the FaME group exercise programme delivered by PSIs. 59 A Royal College of Physicians report 66 showed that 54% of falls exercise services in the UK have trained PSIs delivering the FaME programme. FaME exercise classes are balance-specific, individually tailored and include backward chaining, functional floor exercises and targeted training for dynamic balance, strength, endurance, flexibility, functional skills, gait and 'righting' or 'correcting' skills to avoid a fall.…”

Section: Chapter 2 Stakeholder Involvement In the Adaptation Of The Fmentioning

confidence: 99%

Visually Impaired OLder people’s Exercise programme for falls prevenTion (VIOLET): a feasibility study

et al. 2019

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Background The visually impaired have a higher risk of falling and are likely to avoid activity. Objectives To adapt the existing Falls Management Exercise (FaME) programme, which is delivered in the community, for visually impaired older people (VIOP) and to investigate the feasibility of conducting a definitive randomised controlled trial of this adapted intervention. Design Phase I – consultation with stakeholders to adapt the existing programme. Two focus groups were conducted, each with 10 VIOP across the study sites. Phase II – two-centre randomised pilot trial and economic evaluation of the adapted programme for VIOP versus usual care. Phases III and IV – qualitative interviews with VIOP and Postural Stability Instructors regarding their views and experiences of the research process, undertaking the intervention and its acceptability. Intervention This was adapted from the group-based FaME programme. A 1-hour exercise programme ran weekly over 12 weeks at the study sites (Newcastle upon Tyne and Glasgow) and was delivered by third-sector organisations. Participants were advised to also exercise at home for 2 hours per week. Those randomised to the usual activities group received no intervention. Outcome measures These were completed at baseline, week 12 and week 24. The primary potential outcome measure used was the Short Form Falls Efficacy Scale – International. Secondary outcome assessment measures were activity avoidance, current activity, balance/falls risk, physical activity, loneliness, anxiety and depression, work and social adjustment, quality of life and economic costs. Participants’ compliance was assessed by reviewing attendance records and self-reported compliance with the home exercises. Instructors’ compliance with the course content (fidelity) was assessed by a researcher attending a sample of exercise sessions. Adverse events were collected in a weekly telephone call for all participants in both the intervention and control arm. Findings An adapted exercise programme was devised with stakeholders. In the pilot trial, 82 participants drawn from community-living VIOP were screened, 68 met the inclusion criteria and 64 were randomised, with 33 allocated to the intervention and 31 to the usual activities arm. A total of 94% of participants provided data at week 12 and 92% at week 24. Adherence to the study was high. The intervention was found to be both safe and acceptable to participants, with 76% attending nine or more classes. Median time for home exercise was 50 minutes per week. There was little or no evidence that fear of falling, exercise, attitudinal or quality-of-life outcomes differed between trial arms at follow-up. Thematic analysis of the interviews with VIOP participants identified facilitators of and barriers to exercise, including perceived relevance to health, well-being and lifestyle, social interaction, self-perception and practical assistance. Instructors identified issues regarding level of challenge and assistance from a second person. Limitations The small sample size and low falls risk of the study sample are study limitations. Conclusion Although adaptation, recruitment and delivery were successful, the findings (particularly from qualitative research with instructors and participants) indicated that VIOP with low to moderate falls risk could be integrated into mainstream programmes with some adaptations. A future definitive trial should consider graduated exercises appropriate to ability and falls risk within mainstream provision. Other outcome measures may additionally be considered. Trial registration Current Controlled Trials ISRCTN16949845. Funding This project was funded by the NIHR Public Health Research programme and will be published in full in Public Health Research; Vol. 7, No. 4. See the NIHR Journals Library website for further project information.

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Section: Chapter 2 Stakeholder Involvement In the Adaptation Of The Fmentioning

confidence: 99%

Visually Impaired OLder people’s Exercise programme for falls prevenTion (VIOLET): a feasibility study

et al. 2019

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Exercise for Falls Prevention: Decision-making among Australian-born and Italian-born Older People

Liamputtong

Lam

2017

Activities, Adaptation & Aging

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Factors influencing older adult community fall prevention exercise implementation: a scoping review

Sibley,

Tittlemier,

Olarinde

et al. 2024

Age and Ageing

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Background Exercise that challenges balance is the most effective fall prevention intervention in community-dwelling older adults. Identifying factors influencing implementation of community fall prevention exercise programs is a critical step in developing strategies to support program delivery. Objective To identify implementation facilitators, barriers, and details reported in peer-reviewed publications on community fall prevention exercise for older adults. Design Scoping review. Methods We searched multiple databases up to July 2023 for English-language publications that reported facilitators and/or barriers to implementing an evidence-based fall prevention exercise program in adults aged 50+ years living independently. At least two reviewers independently identified publications and extracted article, implementation, and exercise program characteristics and coded barriers and facilitators using the Consolidated Framework for Implementation Research (CFIR). Results We included 22 publications between 2001 and July 2023 that reported factors influencing implementation of 10 exercise programs. 293 factors were reported: 183 facilitators, 91 barriers, 6 described as both a facilitator and barrier, and 13 unspecified factors. Factors represented 33 CFIR constructs across all five CFIR domains: implementation inner setting (n = 95 factors); innovation (exercise program) characteristics (n = 84); individuals involved (n = 54); implementation process (n = 40) and outer setting (n = 20). Eight publications reported implementation strategies used; 6 reported using a conceptual framework; and 13 reported implementation outcomes. Conclusion The high number of factors reflects the complexity of fall prevention exercise implementation. The low reporting of implementation strategies, frameworks and outcomes highlight the ongoing need for work to implement and sustain community fall prevention exercise programs.

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Older people's experiences of therapeutic exercise as part of a falls prevention service: survey findings from England, Wales and Northern Ireland

Cited by 6 publications

References 6 publications

Visually Impaired OLder people’s Exercise programme for falls prevenTion (VIOLET): a feasibility study

Visually Impaired OLder people’s Exercise programme for falls prevenTion (VIOLET): a feasibility study

Exercise for Falls Prevention: Decision-making among Australian-born and Italian-born Older People

Factors influencing older adult community fall prevention exercise implementation: a scoping review

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