Understanding current fall prevention program design in community-based exercise programs for older adults in Canada
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Date
2019-12
Authors
Touchette, Alexie
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Abstract
Background: Falls – events by which an individual inadvertently comes to rest on the ground, floor, or lower level – present a major public health concern as they have potential to cause serious injury, admission to long-term care, and even death. Research has shown that training balance through exercise is effective at reducing falls in community-dwelling older adults. Specifically, evidence-based fall prevention exercise recommendations include at least three hours of high challenge balance exercise per week, on an ongoing basis. Community exercise programs are a potential delivery mode for implementing effective fall prevention exercises, however, little is known regarding current practice and whether they include effective fall prevention exercise recommendations.
Objective: To describe characteristics of fall prevention and balance training community exercise programs for adults aged 50 years and older in Canada and determine whether the programs include the evidence-based exercise recommendations. To determine instructor and program characteristics associated with the inclusion of evidence-based recommendations.
Methods: Instructors of fall prevention community exercise programs completed an electronic self-report questionnaire following a modified Dillman recruitment strategy. Questions explored program design, exercise content, target population, and demographic information. Exercises were coded for balance challenge using a previous coding scheme based on existing recommendations. Analysis followed stated objectives using descriptive statistics and multiple logistic regression.
Results: 140 completed eligible responses were analyzed. One program (0.7%) included all recommendations for effective fall prevention exercise. 59 programs (42%) were offered on an ongoing basis, 1 program (0.7%) conducted at least three hours of balance exercises a week, and 133 programs (95%) prescribed mostly moderate or high challenge balance exercises. Based on descriptive statistics of programs including the recommendations, exploratory multiple logistic regression was conducted to determine instructor and/program characteristics associated with program duration. Instructor educational background in a related field and the prescription of home exercises were significantly associated with program duration.
Conclusions: Most programs included at least one recommendation for effective fall prevention exercise, with only one program included all three. Future studies should focus on barriers and facilitators influencing design and delivery of community fall prevention exercise programs.
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Keywords
Fall prevention, Older adults, Evidence-based recommendations, Community exercise programs