Effects of an Exercise Program to Reduce Falls in Older People Living in Long-Term Care: A Randomized Controlled Trial

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aut.relation.endpage208.e6
aut.relation.issue2
aut.relation.journalJournal of the American Medical Directors Association
aut.relation.startpage201
aut.relation.volume25
dc.contributor.authorTaylor, LM
dc.contributor.authorParsons, J
dc.contributor.authorMoyes, SA
dc.contributor.authorBinns, E
dc.contributor.authorCavadino, A
dc.contributor.authorTaylor, D
dc.contributor.authorLord, S
dc.contributor.authorDel Din, S
dc.contributor.authorKlenk, J
dc.contributor.authorRochester, L
dc.contributor.authorKerse, N
dc.date.accessioned2024-02-07T02:21:50Z
dc.date.available2024-02-07T02:21:50Z
dc.date.issued2023-11-29
dc.description.abstractObjectives: To investigate the effect of an exercise program on falls in intermediate and high-level long-term care (LTC) residents and to determine whether adherence, physical capacity, and cognition modified outcomes. Design: Randomized controlled trial. Setting and Participants: Residents (n = 520, aged 84 ± 8 years) from 25 LTC facilities in New Zealand. Methods: Individually randomized to Staying UpRight, a physical therapist–led, balance and strength group exercise program delivered for 1 hour, twice weekly over 12 months. The control arm was dose-matched and used seated activities with no resistance. Falls were collected using routinely collected incident reports. Results: Baseline fall rates were 4.1 and 3.3 falls per person-year (ppy) for intervention and control groups. Fall rates over the trial period were 4.1 and 4.3 falls ppy respectively [P = .89, incidence rate ratio (IRR) 0.98, 95% CI 0.76, 1.27]. Over the 12-month trial period, 74% fell, with 63% of intervention and 61% of the control group falling more than once. Risk of falls (P = .56, hazard ratio 1.08, 95% CI 0.85, 1.36) and repeat falling or fallers sustaining an injury at trial completion were similar between groups. Fall rates per 100 hours walked did not differ between groups (P = .42, IRR 1.15, 95% CI 0.81, 1.63). Program delivery was suspended several times because of COVID-19, reducing average attendance to 26 hours over 12 months. Subgroup analyses of falls outcomes for those with the highest attendance (≥50% of classes), better physical capacity (Short Physical Performance Battery scores ≥8/12), or cognition (Montreal Cognitive Assessment scores ≥ 18/30) showed no significant impact of the program. Conclusions/Implications: In intermediate and high-level care residents, the Staying UpRight program did not reduce fall rates or risk compared with a control activity, independent of age, sex, or care level. Inadequate exercise dose because of COVID-19–related interruptions to intervention delivery likely contributed to the null result.
dc.identifier.citationJournal of the American Medical Directors Association, ISSN: 1525-8610 (Print); 1538-9375 (Online), Elsevier BV, 25(2), 201-208.e6. doi: 10.1016/j.jamda.2023.10.022
dc.identifier.doi10.1016/j.jamda.2023.10.022
dc.identifier.issn1525-8610
dc.identifier.issn1538-9375
dc.identifier.urihttp://hdl.handle.net/10292/17187
dc.languageeng
dc.publisherElsevier BV
dc.relation.urihttps://www.sciencedirect.com/science/article/pii/S152586102300909X
dc.rights2023 The Authors. Published by Elsevier Inc. on behalf of AMDA e The Society for Post-Acute and Long-Term Care Medicine. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
dc.rights.accessrightsOpenAccess
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.subjectFalls
dc.subjectcognitive impairment
dc.subjectexercise
dc.subjectfrailty
dc.subjectnursing homes
dc.subjectolder adults
dc.subject4203 Health Services and Systems
dc.subject4206 Public Health
dc.subject42 Health Sciences
dc.subjectRehabilitation
dc.subjectBehavioral and Social Science
dc.subjectPrevention
dc.subjectClinical Trials and Supportive Activities
dc.subjectClinical Research
dc.subject3.1 Primary prevention interventions to modify behaviours or promote wellbeing
dc.subject3 Prevention of disease and conditions, and promotion of well-being
dc.subjectInjuries and accidents
dc.subject1103 Clinical Sciences
dc.subject1110 Nursing
dc.subject1117 Public Health and Health Services
dc.subjectGeriatrics
dc.subject4203 Health services and systems
dc.subject4205 Nursing
dc.subject4206 Public health
dc.titleEffects of an Exercise Program to Reduce Falls in Older People Living in Long-Term Care: A Randomized Controlled Trial
dc.typeJournal Article
pubs.elements-id532059
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