Implementing an evidence-based exercise program to reduce falls in community-dwelling older adults

Each year, 30 percent of seniors have at least one fall — half of whom fall more than once. In fact, nine out of 10 hip fractures result from falls.

Fortunately, falls are preventable. There is strong evidence that the Otago Exercise Program, which consists of strength and balance training delivered by a physiotherapist, can reduce falls in this population. Seniors who are at risk of a fall are the prime population to benefit from the Otago program, but as little as 25 percent of people who start the program continue with it over time.

The research team recently demonstrated that exercise coaching with the use of a consumer wearable, such as a Fitbit, was feasible and could help older adults with chronic disease to stay active. A key element was to empower the person to develop realistic exercise goals.

In this project, the team will test two methods of delivering the Otago program, which includes a new coaching approach by a physiotherapist and the use of a Fitbit to provide feedback (versus the traditional delivery, which is the current standard).

The team will measure success by the degree to which the program is delivered as intended, and the degree to which it is followed by seniors at 12, 18 and 24 months. The number of falls, risk of falling, and participation in walking activities between the two groups will also be assessed over time. In addition, the team will assess whether the coaching approach is a cost-effective option for delivering the Otago program.

Given the serious consequences, fall prevention is a high priority in BC. To this end, the team has brought together a team of national leaders in fall prevention and implementation science, as well as health system partners and a prominent national patient group to address this important issue.