Older adults' preferences for, adherence to and experiences of two self-management falls prevention home exercise programmes: A comparison between a digital programme and a paper booklet

Abstract

Background: Fall prevention exercise programmes are known to be effective, but access to these programmes is not always possible. The use of eHealth solutions might be a way forward to increase access and reach a wider population. In this feasibility study the aim was to explore the choice of programme, adherence, and self-reported experiences comparing two exercise programmes – a digital programme and a paper booklet.Methods: A participant preference trial of two self-managed fall prevention exercise interventions. Community-dwelling adults aged 70 years and older exercised independently for four months after one introduction meeting. Baseline information was collected at study start, including a short introduction of the exercise programme, a short physical assessment, and completion of questionnaires. During the four months intervention period, participants self-reported their performed exercises in an exercise diary. At a final meeting, questionnaires about their experiences, and post-assessments, were completed. For adherence analyses data from diaries were used and four subgroups for different levels of participation were compared. Exercise maintenance was followed up with a survey 12 months after study start.Results: Sixty-seven participants, with mean age 77±4 years were included, 72% were women. Forty-three percent chose the digital programme. Attrition rate was 17% in the digital programme group and 37% in the paper booklet group (p=.078). In both groups 50-59% reported exercise at least 75% of the intervention period. The only significant difference for adherence was in the subgroup that completed ≥75% of exercise duration, the digital programme users exercised more minutes per week (p=.001). Participants in both groups were content with their programme but digital programme users reported a significantly higher (p=.026) degree of being content, and feeling supported by the programme (p=.044). At 12 months follow-up 67% of participants using the digital programme continued to exercise regularly compared with 35% for the paper booklet (p=.036).Conclusions: Exercise interventions based on either a digital programme or a paper booklet can be used as a self-managed, independent fall prevention programme. There is a similar adherence in both programmes during a 4-month intervention, but the digital programme seems to facilitate long-term maintenance in regular exercise.Trial registration: ClinTrial: NCT02916849

Recruitment strategies and reach of a digital fall-prevention intervention for community-dwelling older adults

“…31 Additional strategies are therefore needed to attract older adults who are less prone to using digital technology for health purposes. In a previous study, we found that a proportion of people did not wish to use digital technology and instead used paper-based resources, 32 but it is likely that more regular prompting to support behaviour change and regularity of use may be necessary as compliance to the exercise prescription was better when prompted by the digital technology. 32 Although eHealth literacy is negatively associated with age, 28 and older adults are more often represented among non-users of the Internet, 18 this group is rapidly decreasing, and older adults are becoming more accustomed to using smartphones and tablets.…”

A Big Data Infrastructure in Support of Healthy and Independent Living: A Real Case Application

“…The OTAGO exercise program (OEP) it is a well described falls program, flexible in its implementation, which can be either home or community based. It consists of warm up and cool down phase, strengthening balance and gait exercises as the main pillars of the program, and can be performed either on a group or in personal [63][64][65]. It is a well-documented and structured tool, disseminated widely to the physiotherapy community as it offers a significant reduction of morbidity and mortality and falls for the participants in a one-year prevalence time [66].…”

Effectiveness of a self-managed digital exercise programme to prevent falls in older community-dwelling adults: study protocol for the Safe Step randomised controlled trial

“…22 The majority of the participants exercised at least during 75% of the intervention weeks and one-third of the participants completed more than 75% of recommended exercise time. 29 To investigate the effectiveness of a self-managed digital exercise programme, this randomised (1:1) controlled trial (RCT) aims to compare the Safe Step application in combination with monthly educational videos with a control group that only receives the educational videos.…”