Exercise for falls prevention in residential aged care

INTERVENTION: Progressive resistance training (PRT) and balance exercise for residents of Aged Care Facilities. Dosage is two one hour classes per week for 6 months using pneumatic resistance equipment and closely supervised high level balance exercise. PRT will target: hip and knee flexors and extensors, abdominals, back extensors, hip abductors, hip adductors, elbow and shoulder flexors and extensors. Exercise will be individually prescribed and upgraded an exercise professional (physiotherapist or exercise physiologist) to enable participants to achieve 2‐3 sets of 10‐15 repetitions for each exercise. Balance exercises will include a combination of heel raises, stepping in different directions, reaching outside the base of support, single leg standing, step ups and balance platform work. A maintenance program including balance, weight‐bearing and functional exercises will continue for the next 6 months. Sessions will be supervised by a diversional therapist or physiotherapy assistant and run twice per week for 20 minutes. CONDITION: Falls Fear of falling and cognition Mobility and balance PRIMARY OUTCOME: Falls ‐ defined as the number of fallers and the number of falls for each participant. ; This will be measured monthly for 12 months by auditing both daily progress notes and incident forms kept at the aged care facility. ; Participants will also be asked at the time of the 6 and 12 month assessments if they have fallen since they were last assessed. SECONDARY OUTCOME: Cognition ‐ The Addenbrooke’s Cognitive Examination‐R (ACE‐R) Cost effectiveness ‐ The incremental cost‐effectiveness ratio will also be calculated relative to the control group (cost per quality of life year ‐ QALY). To perform this analysis the health benefits associated with the program will be estimated using the SF‐36 Fear of falling ‐ Falls Efficacy Scale – international (FES‐I) Mobility ‐ 1) The short physical performance battery (SPPB) will be used to evaluate, balance, gait, strength, and endurance; 2) The Step Test will be used to assess dynamic balance and agility; and 3) The University of Alabama – Life Space Assessment (UAB‐LSA) will be used to assess the extent of mobility and frequency of movement along with any assistance needed Quality of life ‐ Measured by the SF‐36 & EQ‐5D‐5L INCLUSION CRITERIA: Permanent residents of aged care facilities.