Effectiveness of an mHealth Exercise Program on Fall Incidence, Fall Risk, and Fear of Falling in Nursing Home...

Area of Science:

• Gerontology
• Digital Health Interventions
• Geriatric Medicine

Background:

• Nursing home populations are growing, presenting challenges like physical decline and high fall risk.
• Falls in older adults lead to significant morbidity and mortality.
• Existing interventions often struggle with adherence and effectiveness in this demographic.

Purpose of the Study:

• To evaluate the effectiveness of the BeSt Age App, a tablet-based, staff-supported mHealth intervention.
• To assess the impact of the app on fall incidence, fall risk (Berg Balance Scale [BBS], Timed Up and Go [TUG]), and fear of falling.
• To determine the feasibility of a staff-mediated mHealth approach for fall prevention in nursing home residents.

Main Methods:

• A 12-week cluster-randomized controlled trial involving 229 nursing home residents across 19 German facilities.
• Participants were assigned to an intervention group (IG) using the BeSt Age App or a control group (CG).
• Intervention involved twice-weekly, tablet-guided exercise sessions led by staff; data analyzed using mixed models and generalized estimating equations (intention-to-treat).

Main Results:

• The intervention group showed significantly greater improvement in Berg Balance Scale (BBS) scores compared to the control group (p = 0.005).
• No significant differences were observed between groups in Timed Up and Go (TUG) performance, fall incidence, or fear of falling.
• Effect size for BBS improvement was small (d = 0.22).

Conclusions:

• A staff-mediated mHealth intervention using the BeSt Age App is feasible for nursing home residents.
• The app demonstrated effectiveness in improving one functional indicator of fall risk (BBS scores).
• Further research is needed to enhance interventions targeting TUG, fall incidence, and fear of falling in this population.