The Falls Prevention Study

Scientific Study Title:

The Falls Prevention Study: Implementing an Evidence-Based Exercise Program to Reduce Falls in Community-Dwelling Older Adults

Principal Investigator:

Linda Li PT, PhD; Professor, University of British Columbia; Senior Research Scientist, Arthritis Research Canada

Start Date:

August 2021

End Date:

September 2024

Why do this research?

Falls are a major health care problem for older adults and health care systems as they account for 50 per cent of injury-related hospital admissions, 40 per cent of nursing home admissions, and a 10 per cent increase in home care services. This is why preventing falls is important.

There is strong evidence that the Otago Exercise Program, which consists of strength and balance training delivered by a physical therapist, can reduce falls in older adults 65+, but only 25 per cent of people who start, continue with the program over time.

Our team thinks this trend can, and should, be changed. We want to help more people continue with the Otago Exercise Program over time to receive maximal benefits. We aim to test if a strategy that includes the use of new technology and specific counselling techniques can help more people to continue with the Otago Exercise Program over time.

What will be done?

We will test two methods to prepare and support physical therapists to deliver the Otago Exercise Program. Method One will include the standard Otago Exercise Program training. Method Two will include the same training and practice to set specific and tangible goals to motivate patients with a Brief Action Planning expert.

We are recruiting 40 physical therapists and 200 older adults who have recently had a fall. The physical therapists will be randomly assigned to receive one of the two training/practice methods. They will then deliver the Otago Exercise Program to five eligible older adult patients. A proportion of the sessions will be voice recorded for researchers to analyze how the exercise program is delivered.

Physical therapists who are assigned to Method Two will be offered the goal-setting training after they finish delivering the program to their five patients.

This Otago Exercise Program Includes:
• 5 home visits from the physical therapists to teach a standardized exercise program in their homes
• Three telephone calls to revise patients’ exercise plan

Older Adult Participants Will be Asked to Do the Following:
• Five in-person appointments at the Falls Prevention Clinic (at the beginning of the study, and at six, 12, 18, and 24 months). The appointments will include:
• Testing your risk of falls and completing a short questionnaire
• Getting fitted to use a step counter called Fitbit (for seven days)
• Telephone calls quarterly with a project staff member to complete a short questionnaire about your use of health services (at the beginning of the study, and at three, six, nine and 12 months)

You may be eligible if you are:

A Physical Therapist
• Are a registered physical therapist in British Columbia
• Have never received training in Motivational Interviewing or Brief Action Planning
• Are willing to be audio-recorded during the home visits and follow-up phone calls with the older adult participants
• Are willing to be randomized to one of the training groups

An Older Adult
• Are age 65 years or above
• Had a fall, corroborated by an informant, in the previous 6 months
• Are able to walk three metres with or without an assistive device
• Have a Mini-Mental State Examination score > 24/30
• Understand, speak, and read English
• Have access to a smart phone and internet
• Are willing to have their treatment sessions audio-recorded
• Are able to provide written informed consent

Funding Agency:

This study is funded by the Michael Smith Foundation for Health Research

Co-Investigators:

Dr. Teresa Liu-Ambrose, University of British Columbia
Dr. Jennifer Davis, University of British Columbia Okanagan
Megan Oakey, BC Injury Research and Prevention Unit
Cheryl Koehn, Arthritis Consumer Experts
Dr. Jasmin Ma, University of British Columbia
Dr. Chris Shaw, Simon Fraser University
Dr. Hui Xie, Simon Fraser University
Dr. Larry Dian, University of British Columbia
Dr. Lynne Feehan, University of British Columbia
Dr. Deborah Jehu, Augusta University

Technology Partner:

Tactica Interactive