Keeping adults physically active after falls management exercise programmes end

Purpose Physical inactivity contributes to disability and falls in older adults. The ProAct 65 + trial showed that falls prevention exercise (FaME) programmes significantly improve physical activity, physical function and reduced falling rates. However, improvements in balance, strength and physical function reduce, and falls rates increase, if physical activity is not maintained. The ProAct 65 + trial found that 12 months after the FaME programme ended only those who maintained their physical activity continued to have a lower falls rate. This research aimed to design, implement and investigate the feasibility and acceptability of an intervention to maintain physical activity in older adults exiting routinely provided FaME programmes.

Methods The Keeping Adults Physically Active (KAPA) intervention comprised of six group sessions of motivational interviewing, delivered monthly by a trained and mentor-supported Postural Stability Instructor (PSI) after the FaME programme ceased. The KAPA intervention included participant manuals, illustrated exercise books, physical activity diaries and pedometers. A feasibility study was conducted in 8 FaME classes (4 intervention and 4 usual care groups). The study design was a two-arm, cluster randomised, multi-site feasibility study comparing the KAPA intervention with usual care. A sample of 10 PSIs and 50 community-dwelling adults aged 65 years old or older were recruited. Quantitive (i.e. recruitment, retention and attendance rates and self-reported physical activity) and qualitative (i.e. semi-structured interviews) research methods were used to examine the feasibility and acceptability of the KAPA intervention.

Results Fifty of the sixty-seven participants (74.6 %) invited into the study agreed to take part. Forty-five participants (92.3 %) provided outcome data at the 6-month time point. Attendance rates at the KAPA sessions were 94.2 % of the total available sessions. PSIs found the KAPA intervention feasible to deliver. The KAPA participants expressed positive views about the venues and PSIs and talked about gaining enjoyment from group interactions. Most discussed the written tasks to be the least enjoyable element of the KAPA intervention. Intervention participants discussed having increased their walking and home-based exercise activities in response to the peer-support, illustrated home exercise booklet, physical activity diaries and pedometers. The proportion of participants reporting at least 150 minutes of moderate to vigorous physical activity (MVPA) per week rose from 56.3 % to 62.5 % in the intervention arm and from 41.4 % to 52.0 % in the usual care arm (OR 1.25, 95 % CI 0.26 to 5.88, p = 0.78). The study was not adequately powered to detect significant between-group differences in MVPA.

Conclusion(s) The KAPA intervention was feasible for PSIs to deliver and acceptable to participants. Participants reported the illustrated home exercise booklet, peer support and the physical activity monitoring tools encouraged them to keep active. A full-scale trial is needed to assess whether physical activity can be significantly maintained in response to the KAPA intervention.

Implications This feasibility study has shown the KAPA intervention is feasible to deliver at the end of routinely provided FaME programmes and is acceptable to participants. The impact of the KAPA intervention on physical activity and other outcomes needs assessing in a full-scale trial.

Funding acknowledgements This abstract presents independent research funded by the University of Nottingham and the National Institute for Health Research School of Primary Care Research (NIHR-SPCR). The views expressed are those of the author(s) and not necessarily those of the NIHR, NHS or the Department of Health.