Falls and broken bones are a common health problem faced by older adults. Worldwide, one third of adults aged over 65 years old, and half of adults aged over 80 years, fall each year. One in five falls in older adults result in hospitalisation and one in twenty cause broken bones. Each year, 300,000 older adults break a bone following a fall which costs the UK £4.4billion in healthcare costs. Broken hip bones are the most serious outcome of a fall. One in twenty older adults will die and one in five need care assisted living following a hip fracture.
Muscles and bones become weaker after 50 years of age which increases an older adults' risk of falling and breaking a bone. Falls prevention programmes that include muscle strength and balance exercise improves physical function and helps to prevent falls and broken bones in older adults. However, many older adults stop doing exercise and become less physically active after falls prevention programmes end. Gains in balance and muscle strength are lost and falls risk increase if people don't keep exercising. More people are reaching older ages and becoming less active. Therefore, this problem will worsen unless healthcare practices become better at preventing falls and broken bones in older adults.
The research ambition is to create a peer supported home exercise programme that encourages older adults to keep exercising after falls prevention programmes end. This will help to prevent future falls and broken bones which will allow more older adults to continue living independently. The home exercise programme will benefit older adults everyday lives by helping them to maintain good physical health and improve their ability to perform daily tasks without the fear of falling.
Older people at risk of falls, clinicians, and public members will be invited to form a community of practice group. The group will work with the research team to create the home exercise programme. We will target the research to help older adults with the greatest health needs. Older adults living in deprived neighbourhoods have the greatest risk of falling and dying following a broken bone. The home exercise programme will be researched in older adults attending falls prevention programmes in the most deprived regions of England. This will help us to explore whether the programme could encourage the continuation of exercise in older adults who need it most.
Community dwelling older adults
Enrolled on a Healthworks FaME programme in the Northeast region of England.
Able to provide informed written consent.
Unable to independently walk 5 metres with or without a walking aid.
Advised by a medic not to undertake exercise.
Has a medical, cognitive, or physical condition that prevents safe engagement with digital technology or unsupervised exercise.
Single group
Keep Exercising and Stay Steady
BehavioralEight KESS sessions will be delivered via a motivational interview approach, in face to face group sessions, delivered by postural stability instructors at the participants usual class venue. Guest speakers will deliver specialist education. Participants will receive text message reminders and telephone follow up for non attendance. Three KESS sessions will take place before programmes end with education and various behaviour change strategies being delivered to help participants develop an intention of continuing exercising/ being active when programmes end. Five sessions will take place over a 6 months duration when programmes end with behavior change strategies and education being delivered that aims to bridge the gap between behavioral intentions and actions to encourage the long-term continuation of good physical activity habits and continued social interactions.
Health Intervention Acceptability Questionnaire
KESS intervention acceptability feedback will be collected via Health Intervention Acceptability Questionnaire. The questionnaire contains 14 questions and statements and asks respondents to rate their responses using a 1 to 5 sliding scale (i.e. 1= completely unacceptable - 5 = completely acceptable).
Physical Activity Scale for the Elderly questionnaire (PASE)
Intervention adherence will be ascertained via weekly PASE scores measuring physical activity and strength and balance exercise. The PASE questionnaire asks respondents to provide information on the amount of physical activity they have performed for leisure, household chores and work / occupational tasks in the past 7 days.
Recruitment rates (phase 2)
Recruitment rates will be recorded as the number of participants invited and the percentage consenting to enter the feasibility study.
Retention rates (phase 2)
Retention rates will be calculated as the percentage of class participants providing follow up data post intervention.
Adverse event data (Phase 2)
Adverse event data will be collected by the research team monthly (via email and telephone) and assessed by the Principal Investigator and Clinical Leads for causality to determine if events are related to the interventions receipt.
Semi-structured interviews regarding KESS Acceptability
Intervention acceptability will be qualitatively examined via semi-structured interviews with up to n=20 participants. Interview Schedules will be informed by the Theoretical Framework of Acceptability and Seniors Technology Acceptance Model.
Click on the lead sponsor to view all of their trials.
Northumbria University
Lead sponsor
Orthopaedic Research UK
Collaborator
HealthWorks Newcastle Upon Tyne
Collaborator
KOKU Health CIC
Collaborator
The University of Manchester
Collaborator
Glasgow Caledonian University
Collaborator
