The Footfall Programme: participant experiences of a lower limb, foot and ankle exercise intervention for falls prevention - an exploratory study

Objectives: Despite growing evidence that foot and ankle exercise programmes are effective for falls prevention, little
is known about older adults’ views and preferences of programme components for long-term maintenance. The aims
of this study were to explore the experiences and acceptability of Scottish and Portuguese older adults of undertaking
a home-based foot, ankle and lower limb exercise intervention. Methods: Ten Scottish (mean age 76 years, 7 female)
and fourteen Portuguese (mean age 66 years, 12 female) community-dwelling older adults undertook the programme
for one week, followed by focus group discussions (2-6 people per group), guided by a semi-structured interview
guide. Data was analysed using thematic analysis. Results: Seven themes were identified: Assessment, Group exercise
taster, Home based exercise; Footfall programme kit, Midweek phone call, Reasons for participation and the Research
Process. Programme components, support telephone calls and research procedures were generally well accepted by
participants and they valued having a contribution to the design. They preferred a blended home and intermittent groupbased
programme format for motivation and progression and recommended changes to some of the exercises and
equipment to reduce barriers to participation. Some cultural differences emerged, including importance of the functional
assessments for Portuguese participants, time issues and difficulty in completion of the exercise diary, reflecting lower
literacy levels. Conclusions: Participants found the programme acceptable but preferred a blended home and occasional
group-based programme for adherence and motivation. A strong educational component to improve health literacy and
simple paperwork completion to avoid data loss in future studies with Portuguese older adults is important.