The Footfall Programme: participant experiences of a lower limb, foot and ankle exercise intervention for falls prevention - an exploratory study

Abstract

Exercise-based interventions offer a multitude of health benefits to community-dwelling older adults, including reducing falls risk, falls rate and falls-induced injuries 1,2. Home-based exercise interventions, if adhered to, offer effects similar to group based programmes. But such interventions are only effective when meeting sufficient 'dosage', progression and individual tailoring requirements 2. Programme characteristics (e.g. convenience of setting; home-based vs group exercise) 3 and sociocultural aspects appear to be factors that influence uptake and completion of falls prevention exercise interventions 4. Franco et al 5 reported that both home-based exercise formats and avoidance of the need to travel to were rated as the highest value attributes of exercise programmes by mobility-impaired and older adults who had suffered falls. Given the barriers to exercise faced by older adults, home-based solutions offer advantages by Abstract Objectives: Despite growing evidence that foot and ankle exercise programmes are effective for falls prevention, little is known about older adults' views and preferences of programme components for long-term maintenance. The aims of this study were to explore the experiences and acceptability of Scottish and Portuguese older adults of undertaking a home-based foot, ankle and lower limb exercise intervention. Methods: Ten Scottish (mean age 76 years, 7 female) and fourteen Portuguese (mean age 66 years, 12 female) community-dwelling older adults undertook the programme for one week, followed by focus group discussions (2-6 people per group), guided by a semi-structured interview guide. Data was analysed using thematic analysis. Results: Seven themes were identified: Assessment, Group exercise taster, Home based exercise; Footfall programme kit, Midweek phone call, Reasons for participation and the Research Process. Programme components, support telephone calls and research procedures were generally well accepted by participants and they valued having a contribution to the design. They preferred a blended home and intermittent groupbased programme format for motivation and progression and recommended changes to some of the exercises and equipment to reduce barriers to participation. Some cultural differences emerged, including importance of the functional assessments for Portuguese participants, time issues and difficulty in completion of the exercise diary, reflecting lower literacy levels. Conclusions: Participants found the programme acceptable but preferred a blended home and occasional group-based programme for adherence and motivation. A strong educational component to improve health literacy and simple paperwork completion to avoid data loss in future studies with Portuguese older adults is important.

´Feet are second class citizens': exploring the perceptions of Scottish and Portuguese older adults about feet, falls and exercise‐ a qualitative study

“…This qualitative study using focus group discussions was part of a larger programme of research exploring older adults´ views on a tailored home‐based lower limb, ankle and feet exercise programme [16]. After participants took part in an introductory group session and a one‐week trial of the exercise programme; three focus groups were conducted in Scotland and three in Portugal.…”

“…After participants took part in an introductory group session and a one‐week trial of the exercise programme; three focus groups were conducted in Scotland and three in Portugal. Further information about the home‐based exercise programme, views of participants on undertaking the programme and the outcome measures proposed are reported elsewhere [16]. Focus groups were used as this approach offers high ecological validity, and is adequate for groups less experienced in research participation [17].…”