Older people's experiences of therapeutic exercise as part of a falls prevention service: survey findings from England, Wales and Northern Ireland

Age Ageing. 2014 May;43(3):369-74. doi: 10.1093/ageing/aft182. Epub 2013 Nov 28.

Abstract

Introduction: falling, and fear of falling, significantly affect older people and their lifestyle resulting in loss of confidence, restriction of activity and deteriorating quality of life. Multi-factorial assessment and active participation in an evidence-based exercise programme are key interventions to prevent and manage falls.

Objective: to examine older people's experiences of therapeutic exercise as part of a falls prevention service in NHS Trusts in England, Wales and Northern Ireland.

Methods: a cross-sectional survey targeted patients and staff members delivering exercise interventions for reducing falls. A multi-disciplinary group including patient and staff representatives developed a 20-item patient questionnaire and a 12-item staff questionnaire that were distributed to 94 NHS Trusts (113 participating sites within the NHS Trusts) in October 2011.

Results: response was 57% for the patient sample and 88% for the staff sample. The median (IQR) age of patients was 82 (77-86) years. 72% were women. Two-thirds reported attending group-based therapeutic exercise classes generally of short duration (80% <12 weeks) and low intensity (85% one class per week) at hospitals and community venues. Balance and strength exercises were prescribed; 68% reported using resistance equipment such as ankle weights and/or exercise band. Only 52% reported exercises were made more difficult as they improved. However, patient satisfaction levels were high (95% satisfied or very satisfied). Patients and staff reported limited availability of strength and balance follow-up classes.

Conclusion: despite high levels of patient satisfaction therapeutic exercise provision was limited and implementation of evidence-based exercise interventions by healthcare providers is incomplete and varies widely. Patients and staff wanted greater availability of long-term exercise services for falls prevention.

Keywords: exercise; falls; falls prevention; older people; patient involvement; survey.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Accidental Falls* / prevention & control
  • Accidental Falls* / statistics & numerical data
  • Activities of Daily Living / psychology
  • Aged
  • Aged, 80 and over
  • Aging* / physiology
  • Aging* / psychology
  • Cross-Sectional Studies
  • Efficiency, Organizational
  • England
  • Evidence-Based Practice / methods
  • Exercise / physiology
  • Exercise Therapy* / methods
  • Exercise Therapy* / psychology
  • Female
  • Humans
  • Life Style
  • Male
  • Northern Ireland
  • Postural Balance
  • Quality of Life*
  • Self Efficacy
  • Surveys and Questionnaires
  • Treatment Outcome
  • Wales