Standing Tall

A balance exercise programme delivered using an app to prevent falls in older people and advance healthy ageing

Falls in older people are a major public health issue. One third of people aged 65 years and over fall every year and falls and fractures account for over half of all injury-related health care costs. There is clear evidence that balance exercise engagement reduces fall rates. This proposal targets a major need for older people, for whom falls are a real risk often having debilitating impacts on quality of life and life expectancy. It fits in with current national policies on fall prevention among older people.

The StandingTall programme is a self-management tool using simple mobile technology implemented via an app, to deliver innovative unsupervised, home-based balance training. The programme is individually-tailored and allows real-time coaching, with great potential for providing impactful, cost-effective, and sustainable fall prevention. The app is easy-to-use, offers varied tailored and progressive balance exercises, and is well-accepted. StandingTall has been used successfully by over 500 older people in Australia with an outstanding 76% adherence after 6 months. It can easily complement and be incorporated into existing fall prevention and self-management programmes. StandingTall is particularly appropriate for older people living in the community who prefer to exercise in their own home or are unable to access community-based exercise classes.

The research project, funded by National Health & Medical Research Council Australia, seeks to accelerate the implementation of StandingTall. It addresses the final steps needed to scale up this innovative technology for widespread use by older people across Australia and United Kingdom. The overall aim of this project is to establish integrated processes and pathways to deliver StandingTall to older people and to provide sustainable support as required. The project will inform the best model for incorporating StandingTall into existing health services and routine care. More specifically, the proposed implementation study will examine the feasibility and appropriateness of delivering StandingTall to people aged 65 years or older (especially those with increased risk and/or a history of falls), and living independently in New South Wales and Melbourne in Australia and across Northern England. This will be done by embedding the programme into referral pathways within hospitals (discharge planning) and primary care providers. Participants will be asked to complete 2 hours of exercises per week for 6 months using the StandingTall app, delivered using their own tablet or computer. The study will examine exercise adherence and identify factors that facilitate the embedding of StandingTall in usual care by increasing engagement of community and health service providers in fall prevention management.

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