An exercise program delivered via an app on a tablet could be a convenient and enjoyable way to prevent falls among older people living at home with dementia.
Limited research shows balance and strength training could help reduce falls among older people, which led Associate Professor Kim Delbaere, a principal research scientist at Neuroscience Research Australia (NeuRA) and her team to develop an individually tailored balance training program that takes users through exercises using on-screen text, video demonstrations and voice-overs.
StandingTall is progressive in terms of times people exercise as well as the intensity of the exercise, and includes regular balance assessments to keep it challenging yet safe.
A feasibility study of StandingTall has been conducted on 15 people over the age of 60 living with mild to moderate dementia in their own homes to determine whether the app is feasible and safe.
Dr Morag Taylor, Dementia Research Development Fellow at NeuRA and lead author on the study, hopes the app can be a game-changer in home care.
“Broadly across the population people aren’t getting enough exercise. But for older people, exercise can be hugely important in preventing falls,” Dr Taylor told Community Care Review.
Those living in the community with dementia have a two- to three-fold increased risk of hip fracture compared to those without dementia and are much more likely to end up in residential aged care or to die after fall-related injury hospitalisation.
“We need innovative and cost-effective strategies to prevent falls,” said Dr Taylor. “Home-based exercise is accessible to all, it’s enjoyable and eliminates the need to access transport, which has previously been identified as a barrier to exercise participation due to availability and cost factors.
“Exercise programs also work better if supported, but regular home visits can be unsustainable. StandingTall comes with an inbuilt coach – plus caregivers can get involved and supervise.”
The recommended dose of exercise for fall prevention in older people who are cognitively healthy is three hours per week of moderate to high challenge balance activities. Participants in the study started at 40 minutes of exercise per week, working up to two hours per week over the course of the 12-week period.
During this time, they received guidance to ensure safe use of the program and exercise progression according to their individual goals.
Adherence to the program was variable; at the end of the study participants were undertaking an average of 65 minutes per week, which excluded resting time and watching instructions. Five out of 15 were exercising for 115 minutes or more each week.
Dr Taylor was satisfied with the study’s success and hopes it will lead to a larger trial that will look specifically at whether the app can prevent falls.
“Overall, our findings indicate that home-based, individually tailored exercise using the StandingTall program with the assistance of caregivers, had acceptable usability and scored well on enjoyment,” she said. “The study showed it is feasible and safe for older people with dementia in the community.”