Dr Lesley Day
Director, Falls Prevention Research Unit
"Evidence from our work and that of others shows that exercise can prevent falls and, importantly, maintain independence among older people."
Three key factors are important to ensure an older person maximises the falls preventing effect of their exercise routine.
Second, the person should exercise twice a week for at least 25 weeks, for around 60 minutes per session.
Third, walking programs should only occur in addition to a balance challenging program, and if it is clear that a walking program will not unduly increase an individual's risk.
Many community health agencies offer falls preventing exercise programs for older people. They are often advertised in the local paper. An older person considering taking up an exercise program should discuss it with their doctor first.
Falls remain a significant threat to the safety, health and independence of our older citizens. It is estimated that every year around one in three people aged over 65 and living in their own home will have a fall. Alarmingly, this rate increases with age.
Preventing falls is an important part of promoting healthy and independent ageing, and reducing medical and support service costs.
Monash has been pursuing research in this area for more than 20 years, and we have recently established the Falls Prevention Research Unit (FPRU) to consolidate our expertise. FPRU continues our work to assess the effectiveness of falls interventions for older people, to model the population-level impact of proven interventions, and to maximise the translation of research to policy.
In partnership with the Victorian Department of Health, we are using a systematic research and evaluation framework to guide more effective investment in falls prevention for older people.
In late 1990s, FPRU researchers conducted one of the seminal works in preventing falls among older people. In collaboration with the City of Whitehorse, our experts conducted a randomised controlled trial testing the effectiveness of three falls prevention interventions for older people. Findings published in the British Medical Journal showed for the first time that the effect of these interventions was additive rather than multiplicative. The findings also revealed that exercise focusing on balance improvement could significantly reduce the number of falls in people aged over 70.
The 15-week group NoFalls Exercise Program has a strong focus on balance enhancement, strengthens the muscles critical for posture and balance, stimulates visual and vestibular systems, increases reaction time and enables relearning the elements of a balance task.
In collaboration with Active Ageing, our researchers have since developed and implemented a ‘Train the Trainers' program that has helped educate more than 500 NoFalls class leaders. More than 3000 copies of the related exercise manual have been distributed in Australia.
Translating falls prevention research into practice
While we know that exercise, in addition to some other strategies, prevents falls, there is a considerable gap between this research evidence and actual practice. According to the Australia Bureau of Statistics, participation in sport and physical activity is lowest among people aged 65 years and over, with just over half reporting that they had not participated at least once in the previous 12 months.
Researchers from FPRU are currently leading a university-government partnership to help bridge this gap. Part of this work involves understanding the motivators for older people to participate in exercise and take up other falls preventing programs. On the other side of the equation, there are many government programs and services for older people which could incorporate falls prevention. The FPRU translational research is also working to understand how to achieve incorporation.
Community falls prevention program sustainability resource package
Many falls prevention programs are implemented through local councils, community health services and other community organisations. Often they are funded for a limited time and are at risk of finishing when funding ceases. The resources available here assist organisations to sustain falls prevention activities beyond the funding period.
The resources were tested in actual situations by local Victorian organisations and provide information to plan program sustainability from the beginning. This improves the likelihood of maintaining falls prevention programs longer term. The package also has the capacity to be a model for sustaining other health promoting interventions.
The package comprises guidelines and a workbook, a presentation for staff training, a supporting document which summarises the rationale for the guidelines, and a guidance sheet on how to use these materials. This package is available below for free download.