'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; Philippa Logan; Tahir Masud; Dawn A Skelton; Clare Timblin; Stephen Timmons; Derek Ward; Denise Kendrick

doi:10.1093/ageing/afaa288

'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, Philippa Logan, Tahir Masud, Dawn A Skelton, Clare Timblin, Stephen Timmons, Derek Ward, Denise Kendrick

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

3 Citations (Scopus)

Abstract

BACKGROUND: Falls incidence increases with age alongside declines in strength and balance. Clinical trials show that the Falls Management Exercise (FaME) programme improves strength and balance, which can reduce falls and improve physical functioning.

OBJECTIVE: To determine if the clinical trial efficacy of FaME translates into effectiveness in non-research settings.

DESIGN AND SETTING: An implementation study of FaME in 10 local authorities across the East Midlands region of England.

SUBJECTS: Adults aged 65 and over enrolled on a FaME programme.

METHOD: Anonymised outcome data collected by the FaME providers were compared at baseline, end of programme and 6 months follow-up using univariate and multivariate analyses.

RESULTS: For 348 adults enrolled in programmes and analysed, 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 180° (P = 0.008) improved significantly at programme completion versus 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 programme completion and was maintained at 6 months. The falls incidence rate ratio (IRR) was non-significantly lower at programme completion (IRR 0.76, 95% Confidence Interval (CI) 0.48,1.21) and follow-up (IRR 0.82 95% CI 0.48,1.39) versus baseline.

CONCLUSIONS: There is modest translation of FaME efficacy into effectiveness, but not all effects persist after completion. Strategies to aid adherence and exercise maintenance are important to maximise benefits.

Original language	English
Pages (from-to)	1290-1297
Number of pages	8
Journal	Age and Ageing
Volume	50
Issue number	4
Early online date	3 Feb 2021
DOIs	https://doi.org/10.1093/ageing/afaa288
Publication status	Published - 28 Jun 2021
Externally published	Yes

Keywords

older people
exercise promotion
primary health care
falls
physical activity

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10.1093/ageing/afaa288

https://nottingham-repository.worktribe.com/output/5093369/real-world-effectiveness-of-the-falls-management-exercise-fame-programme-an-implementation-study

Cite this

@article{02a0e101d51a432386fe1a77b11842d2,

title = "'Real world' effectiveness of the Falls Management Exercise (FaME) programme: an implementation study",

abstract = "BACKGROUND: Falls incidence increases with age alongside declines in strength and balance. Clinical trials show that the Falls Management Exercise (FaME) programme improves strength and balance, which can reduce falls and improve physical functioning.OBJECTIVE: To determine if the clinical trial efficacy of FaME translates into effectiveness in non-research settings.DESIGN AND SETTING: An implementation study of FaME in 10 local authorities across the East Midlands region of England.SUBJECTS: Adults aged 65 and over enrolled on a FaME programme.METHOD: Anonymised outcome data collected by the FaME providers were compared at baseline, end of programme and 6 months follow-up using univariate and multivariate analyses.RESULTS: For 348 adults enrolled in programmes and analysed, 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 180° (P = 0.008) improved significantly at programme completion versus 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 programme completion and was maintained at 6 months. The falls incidence rate ratio (IRR) was non-significantly lower at programme completion (IRR 0.76, 95% Confidence Interval (CI) 0.48,1.21) and follow-up (IRR 0.82 95% CI 0.48,1.39) versus baseline.CONCLUSIONS: There is modest translation of FaME efficacy into effectiveness, but not all effects persist after completion. Strategies to aid adherence and exercise maintenance are important to maximise benefits.",

keywords = "older people, exercise promotion, primary health care, falls, physical activity",

author = "Elizabeth Orton and Sarah Audsley and Carol Coupland and Gladman, {John R F} and Steve Iliffe and Natasher Lafond and Philippa Logan and Tahir Masud and Skelton, {Dawn A} and Clare Timblin and Stephen Timmons and Derek Ward and Denise Kendrick",

note = "Research funded by National Institute for Health Research | Rutland County Council | Leicestershire County Council",

year = "2021",

month = jun,

day = "28",

doi = "10.1093/ageing/afaa288",

language = "English",

volume = "50",

pages = "1290--1297",

journal = "Age and Ageing",

issn = "0002-0729",

publisher = "Oxford University Press",

number = "4",

}

TY - JOUR

T1 - 'Real world' effectiveness of the Falls Management Exercise (FaME) programme

T2 - an implementation study

AU - Orton, Elizabeth

AU - Audsley, Sarah

AU - Coupland, Carol

AU - Gladman, John R F

AU - Iliffe, Steve

AU - Lafond, Natasher

AU - Logan, Philippa

AU - Masud, Tahir

AU - Skelton, Dawn A

AU - Timblin, Clare

AU - Timmons, Stephen

AU - Ward, Derek

AU - Kendrick, Denise

N1 - Research funded by National Institute for Health Research | Rutland County Council | Leicestershire County Council

PY - 2021/6/28

Y1 - 2021/6/28

N2 - BACKGROUND: Falls incidence increases with age alongside declines in strength and balance. Clinical trials show that the Falls Management Exercise (FaME) programme improves strength and balance, which can reduce falls and improve physical functioning.OBJECTIVE: To determine if the clinical trial efficacy of FaME translates into effectiveness in non-research settings.DESIGN AND SETTING: An implementation study of FaME in 10 local authorities across the East Midlands region of England.SUBJECTS: Adults aged 65 and over enrolled on a FaME programme.METHOD: Anonymised outcome data collected by the FaME providers were compared at baseline, end of programme and 6 months follow-up using univariate and multivariate analyses.RESULTS: For 348 adults enrolled in programmes and analysed, 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 180° (P = 0.008) improved significantly at programme completion versus 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 programme completion and was maintained at 6 months. The falls incidence rate ratio (IRR) was non-significantly lower at programme completion (IRR 0.76, 95% Confidence Interval (CI) 0.48,1.21) and follow-up (IRR 0.82 95% CI 0.48,1.39) versus baseline.CONCLUSIONS: There is modest translation of FaME efficacy into effectiveness, but not all effects persist after completion. Strategies to aid adherence and exercise maintenance are important to maximise benefits.

AB - BACKGROUND: Falls incidence increases with age alongside declines in strength and balance. Clinical trials show that the Falls Management Exercise (FaME) programme improves strength and balance, which can reduce falls and improve physical functioning.OBJECTIVE: To determine if the clinical trial efficacy of FaME translates into effectiveness in non-research settings.DESIGN AND SETTING: An implementation study of FaME in 10 local authorities across the East Midlands region of England.SUBJECTS: Adults aged 65 and over enrolled on a FaME programme.METHOD: Anonymised outcome data collected by the FaME providers were compared at baseline, end of programme and 6 months follow-up using univariate and multivariate analyses.RESULTS: For 348 adults enrolled in programmes and analysed, 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 180° (P = 0.008) improved significantly at programme completion versus 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 programme completion and was maintained at 6 months. The falls incidence rate ratio (IRR) was non-significantly lower at programme completion (IRR 0.76, 95% Confidence Interval (CI) 0.48,1.21) and follow-up (IRR 0.82 95% CI 0.48,1.39) versus baseline.CONCLUSIONS: There is modest translation of FaME efficacy into effectiveness, but not all effects persist after completion. Strategies to aid adherence and exercise maintenance are important to maximise benefits.

KW - older people

KW - exercise promotion

KW - primary health care

KW - falls

KW - physical activity

UR - http://www.scopus.com/inward/record.url?scp=85109970951&partnerID=8YFLogxK

U2 - 10.1093/ageing/afaa288

DO - 10.1093/ageing/afaa288

M3 - Article

C2 - 33529311

SN - 0002-0729

VL - 50

SP - 1290

EP - 1297

JO - Age and Ageing

JF - Age and Ageing

IS - 4

ER -

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

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