JMIR Publications

ABSTRACT

Background:

Injuries from falls are a major concern among older adults. Targeted exercise has been shown to improve fall-risk, and recommendations for identifying and referring older adults for exercise-based interventions exist. However, even when very inexpensive or free, many do not utilize available fall prevention programs citing barriers related to convenience and safety. These issues are even greater amongst older adults residing in rural areas where facilities are less abundant. These realities highlight the need for different approaches to reducing falls in novel ways that increase reach and are safe and effective. Online delivery of exercise interventions offers some exciting and enticing prospects,

Objective:

Our objective was to assess the efficacy of the Strong Foundations (SF) exercise program to change markers of physical function, posture, balance, strength, and fall risk.

Methods:

SF is a once weekly (60 min), 12-week iterative program with three core components: postural alignment and control, balance and mobility, and muscular strength and power. We used a quasi-experimental design to determine changes in physical function specific to balance, postural control, and muscular strength among older adults at low or moderate risk of falling.

Results:

A total of 55 low risk and 37 moderate risk were recruited. Participants significantly improved on the 30 second Chair Stand (30CS) and Timed Up and Go (TUG) (mean change of 1.4 repetitions p= 0.006, and 0.2-seconds p=0.004 respectively), with the moderate risk group generally improving to a greater degree than the low-risk group. Additionally, Short Physical Performance Battery performance improved significantly in the moderate risk category (p=0.02). The majority of postural measures showed statistically significant improvement for both groups. Measures of “relaxed” posture showed improvements between 6% and 27%. When an “as tall as possible” posture was adopted improvements were ~36%.

Conclusions:

In this 12-week iterative web-based program, we found older adults experienced improvement not only in measures used in clinical contexts, such as the 30CS and TUG, but also contextualized gains by providing deeper phenotypical measurement related to posture, strength, and balance. In all, we found many measured improvements were attenuated by risk-level, with greater gains in those with more to benefit from such interventions. Clinical Trial: Exercise; Balance; Posture; Older Adults; Zoom; Digital Intervention; Strength; Fall PreventionClinicalTrials.gov NCT05910606 Registered on 5/24/2023