Older adults preferences for, adherence to and experiences of two self-management falls prevention home exercise programmes: A comparison between a digital programme and a paper booklet

• DOI: 10.21203/rs.2.12118/v1
• Publication Date: 2019-07-30T18:55:56Z
• Authors: Linda Mansson; Lillemor Lundin-O...; Dawn A Skelton; Rebecka Janols; Helena Lindgren; Erik Rosendahl; Marlene Sandlund
• Keywords: Male; self-management; falls prevention; Independent living; Geriatrik; digital health; 03 medical and health sciences; 0302 clinical medicine; Self-management; 80 and over; Humans; Physiotherapy; Exercise; Accidental falls; Aged; Aged, 80 and over; exercise; Self-Management; 4. Education; Falls prevention; RC952-954.6; 16. Peace & justice; Fysioterapi; Exercise Therapy; 3. Good health; aged; mHealth; Geriatrics; eHealth; Accidental Falls; Female; Pamphlets; accidental falls; Geriatrics and Gerontology; Digital health; Research Article

Abstract Background: Fall prevention exercise programmes are known to be effective, but access to these programmes is not always possible. The use of eHealth solutions might be a way forward to increase access and reach to a wider population. In this feasibility study the aim was to explore the choice of programme, adherence, and self-reported experiences comparing two exercise programmes – a digital programme and a paper booklet. Methods: A participant preference trial of two self-managed fall prevention exercise interventions. Community-dwelling adults aged 70 years and older exercised independently for four months after one introduction meeting. Baseline information was collected at study start at the introduction meeting, including a short introduction of the exercise programme, a short physical assessment and completion of questionnaires. During the four months intervention period, participants self-reported their performed exercises in an exercise diary. At a final meeting, questionnaires about their experiences as well as post-assessments were completed. For adherence analyses data from diaries were used and four subgroups for different levels of participation were compared. Exercise maintenance was followed up with a survey 12 months after study start. Results: Sixty-seven participants, with a mean age of 77±4 years were included, 72% were women, and 43% chose the digital programme. Attrition rate was 17% in the digital programme group and 37% in the paper booklet group. In both groups 50-59% reported exercise at least 75% of the intervention period. The only significant difference for adherence was in the subgroup that completed ≥75% of exercise duration, the digital programme users exercised more minutes per week (p=.001). Participants in both groups were content with their programme but digital programme users reported a significantly higher (p=.026) degree of being content, and feeling supported by the programme (p=.044). At 12 months follow-up 67% of participants using the digital programme continued to exercise regularly compared with 35% for the paper booklet (p=.036). Conclusions: This study showed that both the digital and paper programme could be used as a self-managed, independent fall prevention exercise programme. The digital programme seems to facilitate long-term maintenance in regular exercise.