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

Co-leads:

Executive sponsor:

  • Barb Lawrie
    VCH

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.

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

Co-leads:

Executive sponsor:

  • Megan Oakey
    PHSA

Each year, 30% of seniors fall at least once, and half of those fall more than once. In fact, nine out of ten 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, can reduce falls in this population. Seniors who have had a fall recently are the group most likely to benefit from the Otago program, but only 28% of people who start the program end up continuing with it over time.

It has recently been shown that exercise coaching with the use of consumer wearables, such as a Fitbit, is feasible and can help older people with chronic disease to stay active.

In this project, exercise coaching will be adapted for seniors who have had a recent fall, and then two visual feedback approaches will be tested for implementing the Otago Exercise Program within two BC health authorities – Fraser Health and Provincial Health Services Authority. The success of these approaches will be measured by the degree to which the coaching is delivered as intended by a provider, and the degree to which the exercise program is followed by seniors at 6 and 12 months.

Given the serious consequences, falls prevention is a high priority in BC. To this end, this team includes national leaders in falls prevention and implementation science, as well as health system partners and a prominent national patient group.

Improving resistance training in people with rheumatoid arthritis: A foundational behaviour change science approach

Resistance training has been shown to improve myriad health indicators, including quality of life, in people with rheumatoid arthritis (RA). However, resistance training participation rates among people with RA are remarkably low (1-14%), even in those with well-controlled disease. Anecdotally, unique barriers exist that prevent those with RA from participating in resistance training, including fear, health care provider knowledge, and functional limitation.

Resistance training-specific promotional efforts are sorely needed; however, understanding and research into changing resistance training behaviours is only in its early beginnings. The barriers to participating have yet to be scientifically explored and the state of behaviour change theory testing in resistance training behaviour is almost non-existent.

Dr. Ma’s will conduct a four-phase study to better understand the barriers and facilitators to resistance training, select promising behaviour change theories, and develop knowledge tools proposing resistance training interventions. The overarching aim is to launch the field of resistance training behaviour change, aid the uptake of guidelines, and improve health outcomes for patients with RA.