BackgroundFalls and fall-related injuries are a serious public health issue. Exercise programs can effectively reduce fall risk in older people. The iStoppFalls project developed an Information and Communication Technology-based system to deliver an unsupervised exercise program in older people’s homes. The primary aims of the iStoppFalls randomized controlled trial were to assess the feasibility (exercise adherence, acceptability and safety) of the intervention program and its effectiveness on common fall risk factors.MethodsA total of 153 community-dwelling people aged 65+ years took part in this international, multicentre, randomized controlled trial. Intervention group participants conducted the exercise program for 16 weeks, with a recommended duration of 120 min/week for balance exergames and 60 min/week for strength exercises. All intervention and control participants received educational material including advice on a healthy lifestyle and fall prevention. Assessments included physical and cognitive tests, and questionnaires for health, fear of falling, number of falls, quality of life and psychosocial outcomes.ResultsThe median total exercise duration was 11.7 h (IQR = 22.0) over the 16-week intervention period. There were no adverse events. Physiological fall risk (Physiological Profile Assessment, PPA) reduced significantly more in the intervention group compared to the control group (F1,127 = 4.54, p = 0.035). There was a significant three-way interaction for fall risk assessed by the PPA between the high-adherence (>90 min/week; n = 18, 25.4 %), low-adherence (<90 min/week; n = 53, 74.6 %) and control group (F2,125 = 3.12, n = 75, p = 0.044). Post hoc analysis revealed a significantly larger effect in favour of the high-adherence group compared to the control group for fall risk (p = 0.031), postural sway (p = 0.046), stepping reaction time (p = 0.041), executive functioning (p = 0.044), and quality of life (p for trend = 0.052).ConclusionsThe iStoppFalls exercise program reduced physiological fall risk in the study sample. Additional subgroup analyses revealed that intervention participants with better adherence also improved in postural sway, stepping reaction, and executive function.Trial registrationAustralian New Zealand Clinical Trials Registry Trial ID: ACTRN12614000096651International Standard Randomised Controlled Trial Number: ISRCTN15932647

No abstract

Knowledge about the experiences of flow by older adults through the engagement of digital games is scarce. This article describes an important element of an international, multicenter, randomized, controlled trial which utilized three purpose-built exergames to facilitate physical activity and to assist with fall prevention of adults aged 65þ years in their homes. Measurement of flow was assessed through the distribution of the Activity Flow State Scale in participants assigned to the intervention group after completion of the trial. Results were analyzed across three areas: study centers, age-groups (50-69 years, 70-78 years, 79-84 years, and 85þ), and gender. A positive trend in results was shown by participants from Valencia and Cologne and by gender. Future work should consider qualitative data collection to complement the quantitative data and to provide an in-depth understanding of users' experiences with exergames.

No abstract

No abstract