The effectiveness of preventing falls among older people using trained volunteers in home based exercise programmes

Abstract

Falls, and injuries from falls are common among older people. As the population is ageing rapidly and life expectancy continues to increase, the consequences of falls among older people are of increasing concern, not only for the individuals but also for the national health system.

Older people are being encouraged to remain living independently in their own homes for as long as possible and health authorities are promoting strategies to enable this to happen. It is known that having falls is a factor in relocating to a care facility so efforts are being made to provide appropriate falls prevention interventions in the community.

The risk factors for falls are widely known, but there is a lack of evidence on which interventions are effective and efficient. Researchers at the University of Otago have developed and trialled a Home Exercise Programme of individually tailored strength and balance retraining exercises, which has been shown to significantly reduce falls among older people when the programme is delivered by physiotherapists and trained nurses.

This study looked at an intervention in Canterbury, New Zealand to determine if peer volunteers, who have been trained by a physiotherapist, are also effective in delivering the Otago programme. Data was gathered from 46 people who completed 6 months on the programme, after having been referred to the programme by their general practitioner. The data was analysed to determine if the subjects had improved in strength, balance and confidence and if they had reduced their number of falls.

Although the results were limited by having a small sample and by the lack of a control group, this analysis of the Stay on Your Feet Canterbury Home Exercise Programme suggests that trained volunteer instructors are effective in delivering the programme. The results indicate improvements in strength, balance and confidence following the intervention. The number of falls reported by the group during the six months intervention reduced by 34%, compared with the previous six months, and this was shown to be statistically significant for those subjects aged 80 years and over.

There is potential for the peer volunteer delivered programme to increase the capacity to extend the reach of the Home Exercise Programme to many more older people, so further research is encouraged to confirm the effectiveness of this method.