Feasibility of a Multicomponent Digital Fall Prevention Exercise Intervention for At-Risk Older Adults

Background: Falls are a leading cause of disability, institutionalization and mortality for older adults. More effective strategies to prevent falls are essential and may help at-risk older adults continue to live independently. While exercise programs with in-person supervision reduce fall risk, there are numerous barriers associated with older adults' participation in such programs. Digitally delivered exercise interventions utilizing wearable technology may be an alternative fall prevention strategy for many vulnerable older adults.

Objectives: To evaluate the feasibility of a scalable, multicomponent, remotely delivered, digital fall prevention exercise intervention for community-dwelling older adults with elevated fall risk.

Design: This single arm intervention trial enrolled older adults who reported ≥ 2 falls, or ≥ 1 injurious fall in the past year, or fear of falling.

Study setting and participants: Community-dwelling adults aged ≥ 65 years were recruited from the greater Boston region, MA, USA.

Intervention: The 12-week multicomponent intervention was delivered via tablet and wearable sensors and consisted of a program of progressive moderate-intensity strength, power and balance training, adaptive aerobic walking exercise, regular coaching calls and digital motivational messaging.

Measurements: Intervention adherence and measures of intervention feasibility, acceptability, and appropriateness were evaluated. Intervention effects on measures of fall risk, physical and cognitive performance, and other measures of well-being were also examined.

Results: Twenty-three participants enrolled in the study and 20 completed the intervention (mean age: 76.3±5.5 yrs; BMI: 26.9±4.6 kg/m2; short physical performance battery score: 8.8±2.2; 70% female). Overall adherence rates were 84.4±14.6% with no serious adverse events. Significant reductions in fear of falling and improvements in cognition and technology readiness were elicited (p≤0.04).

Conclusion: This study has demonstrated the feasibility of a multicomponent digital fall prevention exercise intervention for at-risk older adults. Additional studies are warranted to establish the efficacy of this highly scalable fall prevention strategy.