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

Area of Science:

• Gerontology
• Public Health
• Exercise Science

Background:

• Falls incidence increases with age, linked to declines in strength and balance.
• The Falls Management Exercise (FaME) program has demonstrated efficacy in clinical trials for improving strength, balance, and reducing falls.
• Translating clinical trial efficacy into real-world effectiveness is crucial for public health interventions.

Purpose of the Study:

• To evaluate the effectiveness of the FaME program in non-research settings.
• To determine if the efficacy of FaME observed in clinical trials translates to broader community implementation.
• To assess the impact of FaME on falls incidence, physical functioning, and adherence in older adults.

Main Methods:

• An implementation study of the FaME program conducted across 10 local authorities in England.
• Inclusion of adults aged 65 and over participating in the FaME program.
• Anonymized outcome data collected at baseline, program completion, and 6-month follow-up, analyzed using univariate and multivariate methods.

Main Results:

• Significant improvements were observed in confidence in balance, fear of falling, functional reach, and timed-up-and-go at program completion (P < 0.001).
• Improvements in these measures were not maintained at the 6-month follow-up.
• Strength and balance activity minutes increased by 55% and were maintained at 6 months, while falls incidence rate ratio showed a non-significant reduction.

Conclusions:

• The FaME program demonstrates a modest translation of efficacy into effectiveness in real-world settings.
• Not all beneficial effects of the FaME program persist after its completion.
• Strategies to improve adherence and promote long-term exercise maintenance are essential for maximizing the benefits of the FaME program in older adults.