Abstract
BackgroundPhysical inactivity and falls in older people are important public health problems. Health conditions that could be ameliorated with physical activity are particularly common in older people. One in three people aged 65 years and over fall at least once annually, often resulting in significant injuries and ongoing disability. These problems need to be urgently addressed as the population proportion of older people is rapidly rising. This trial aims to establish the impact of a combined physical activity and fall prevention intervention compared to an advice brochure on objectively measured physical activity participation and mobility-related goal attainment among people aged 60 +.Methods/designA randomised controlled trial involving 130 consenting community-dwelling older people will be conducted. Participants will be individually randomised to a control group (n = 65) and receive a fall prevention brochure, or to an intervention group (n = 65) and receive the brochure plus physical activity promotion and fall prevention intervention enhanced with health coaching and a pedometer.Primary outcomes will be objectively measured physical activity and mobility-related goal attainment, measured at both six and 12 months post randomisation. Secondary outcomes will include: falls, the proportion of people meeting the physical activity guidelines, quality of life, fear of falling, mood, and mobility limitation. Barriers and enablers to physical activity participation will be measured 6 months after randomisation.General linear models will be used to assess the effect of group allocation on the continuously-scored primary and secondary outcome measures, after adjusting for baseline scores. Between-group differences in goal attainment (primary outcome) will be analysed with ordinal regression. The number of falls per person-year will be analysed using negative binomial regression models to estimate the between-group difference in fall rates after one year (secondary outcome). Modified Poisson regression models will compare groups on dichotomous outcome measures. Analyses will be pre-planned, conducted while masked to group allocation and will use an intention-to-treat approach.DiscussionThis trial will address a key gap in evidence regarding physical activity and fall prevention for older people and will evaluate a program that could be directly implemented within Australian health services.Trial registrationACTRN12614000016639, 7/01/2014.
Highlights
Physical inactivity and falls in older people are important public health problems
This trial will address a key gap in evidence regarding physical activity and fall prevention for older people and will evaluate a program that could be directly implemented within Australian health services
Potential participants will be excluded from participation if they: are “house-bound”; have a cognitive impairment; have insufficient English language skills to fully participate in the program; have a progressive neurological disease (e.g., Parkinson’s disease); have a medical condition precluding exercise; already meet the Australian Physical Activity Guidelines for older adults [13] (operationalised as 150 minutes of moderate intensity physical activity per week, assessed using the Incidental and Planned Exercise Questionnaire (IPEQ [14])) and have had a falls risk assessment in the past year, since they may already be receiving the fall prevention intervention
Summary
This trial is highly significant given the dual importance of falls and inactivity for individuals and health care systems. Public health recommendations for older adults highlight the need to engage in a combination of aerobic, muscle strength, flexibility and balance activities. This trial is the first to offer an integrated strategy that can fulfil this goal. Population surveys of older adults indicate very low participation in fall prevention balance exercise [25] with the vast majority engaged in aerobic physical activity, such as walking, but this has not been demonstrated to prevent falls [26] This trial will address a key gap in the current evidence regarding physical activity and fall prevention for older people. All authors contributed to refinement of the study protocol and approved the final manuscript
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
