‘Real world’ effectiveness of the Falls Management Exercise (FaME) programme: an implementation study

Elizabeth Orton*, Sarah Audsley, Carol Coupland, John R.F. Gladman, Steve Iliffe, Natasher Lafond, Phillipa Logan, Tahir Masud, Dawn A. Skelton, Claire Timblin, Stephen Timmons, Derek Ward, Denise Kendrick

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

BackgroundFalls incidence increases with age alongside declines in muscle strength and balance. Clinical trials show that the Falls Management Exercise (FaME) programme, improves strength and balance, can reduce falls and improve physical functioning.
AimTo determine if the clinical-trial efficacy of FaME translates into effectiveness in non-research settings. 
Design and settingAn implementation study of FaME in ten local authorities across the East Midlands region of England.
MethodAnonymised outcome data collected by the FaME providers were compared at baseline, end of programme and six months follow-up using univariate and multivariate analyses.
ResultsA total of 361 adults enrolled in programmes. The mean age was 76.8, 73% were female and 143 (41%) completed ≥75% of classes. Overall confidence in balance, fear of falling, functional reach and timed-up-and-go (all p<0.001), and turn 180o (p=0.008) improved significantly at the end of FaME compared to baseline, but improvements were not maintained 6 months later. Falls risk (FRAT score) and total minutes of physical activity did not change significantly though minutes of strength and balance activity increased by 55% at the end of FaME and was maintained at 6 months. The falls incidence rate ratio (IRR) was non-significantly lower at the end of FaME (IRR 0.76, 95% Confidence Interval (CI) 0.48,1.21) and follow-up (IRR 0.82 95% CI 0.48,1.39) compared to baseline. 
ConclusionsThere is evidence of modest translation of FaME efficacy into effectiveness, but not all effects persist after completion. Strategies to aid programme adherence and exercise maintenance are important to maximise benefits.
Original languageEnglish
JournalAge and Ageing
Publication statusAccepted/In press - 26 Nov 2020

Keywords

  • exercise interventions
  • falls prevention
  • fidelity
  • implementation
  • evidence based practice
  • aged people
  • exercise promotion
  • primary health care
  • falls
  • physical activity

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