The effectiveness of the Healthworks Staying Steady community-based falls prevention exercise programme to improve physical function in older adults: a 6-year service evaluation

James, Emily; Oman, Paul; Ali, Michael; Court, Paul; Goodall, Stuart; Nichols, Simon J; O'doherty, Alasdair F

Abstract

Background: Falls prevention exercise programmes are evidence-based and recommended for improving physical function in older adults. However, few service evaluations exist to assess the effectiveness of community-delivered interventions in practice. Methods: We conducted a six-year, retrospective evaluation of the community-delivered Staying Steady programme (Healthworks, United Kingdom). Staying Steady is a 27-week, tailored strength and balance programme delivered in a group setting (1-h, once/week) and at home (30-40 min, 2-3 times/week). Participants were referred by healthcare professionals, or self-referred, due to a history or risk of falling. Routinely collected outcome measures (30-s chair stand, Timed Up and Go, four-stage balance test, and patient reported outcomes; including 'fear of falling' and 'ability to manage health') were analysed. Factors associated with programme completion were reported. The intervention effect on physical function was analysed in subgroups: participants used arms to chair-stand or a walking-aid at both ('aided'), neither ('unaided'), or one assessment timepoint ('aided at baseline only' or 'aided at follow-up only'). Results: There were 1,426 referrals; 835 (67.3%) participants enrolled on to the Staying Steady programme, 406 (32.7%) declined, 185 (13.0%) were inappropriately referred and excluded from analysis. After enrolling, 451 (54.0%) participants completed, and 384 (46.0%) dropped out. Chair stand performance improved in participants who were unaided (n = 264; median 2.0 [1.0, 4.0] repetitions; P < 0.001), or aided at baseline, follow-up or both (n = 170, P < 0.05). Timed Up and Go performance improved in the unaided (n = 387; median ˗3.1 [˗5.4, ˗1.4] s, P < 0.001), and aided at baseline only (n = 32; median ˗4.9 [˗10.8, ˗3.4] s, P < 0.001) groups. Four-stage balance performance improved (n = 295; median 1.0 [0.0, 1.0] points, P < 0.001). After programme completion, participants self-reported an improved ability to manage their health and daily activities, improved confidence, and a reduced fear of falling. Presence of chronic obstructive pulmonary disease, fear of falling, prescribed nutritional support, disability and social deprivation influenced non-completion of Staying Steady.

Citation

James, E., Oman, P., Ali, M., Court, P., Goodall, S., Nichols, S. J., & O'doherty, A. F. (2022). The effectiveness of the Healthworks Staying Steady community-based falls prevention exercise programme to improve physical function in older adults: a 6-year service evaluation. BMC Public Health, 22(1), Article 1457. https://doi.org/10.1186/s12889-022-13832-3

• Journal Article Type: Article
• Acceptance Date: Jul 19, 2022
• Online Publication Date: Aug 1, 2022
• Publication Date: 2022-12
• Deposit Date: Oct 21, 2024
• Publicly Available Date: Oct 21, 2024
• Journal: BMC Public Health
• Electronic ISSN: 1471-2458
• Publisher: BMC
• Peer Reviewed: Peer Reviewed
• Volume: 22
• Issue: 1
• Article Number: 1457
• DOI: https://doi.org/10.1186/s12889-022-13832-3
• Keywords: Healthcare, Health inequality, Service evaluation, Falls, Exercise, Strength, Balance