To what extent do older adult community exercise programs in Winnipeg, Canada address balance and include effective fall prevention exercise? A descriptive self-report study

Abstract

Background: Effective fall prevention exercise for community-dwelling older adults requires (i) challenging balance exercise, (ii) offered at least 3 hrs/ week, and (iii) on an ongoing basis, to reduce falls. Community exercise programs are a potential implementation strategy for fall prevention exercise; however, the extent to which they address balance and include effective fall prevention exercise is unknown. Study objectives were to describe program delivery, exercise design, and assessment characteristics of older adult community exercise programs in Winnipeg, Canada; determine if they included effective fall prevention exercise; determine the balance challenge and components of postural control addressed in the most- and least-frequently reported exercises. Methods: A public inventory of older adult community exercise programs served as the sampling frame for cross-sectional telephone questionnaires exploring program, exercise, and assessment characteristics. Exercises were coded independently by two investigators for balance challenge level and components of postural control. Programs were categorized by number of effective fall prevention exercise components established by evidence-based recommendations. Descriptive statistics were calculated. Results: Thirty-three eligible programs were identified and nine individuals participated. Most programs (n = 5, 56%) identified as general exercise, and two (22%) as fall prevention exercise. Most programs (n = 5, 56%) were offered two or more times/ week and reported exercise intensity as somewhat challenging. Exercise time offered ranged between 1 and 3 h/ week. Assessments were conducted in two programs (22%). Only one program (general exercise) included all components of effective fall prevention exercise. Two programs (22%) included the component of being offered at least 3 hrs/ week. Three programs (33%) included the component of being offered on an ongoing basis. Seven programs (78%) prescribed mostly moderate challenge balance exercise, and one program (11%) prescribed mostly high challenge exercise. Most of the 19 most-frequently prescribed exercises (n = 17, 89%) targeted static stability and none targeted reactive postural control. Conclusions: Most of the older adult community exercise programs participating in this study did not focus on fall prevention, and did not include all components of effective fall prevention exercise. Future studies should focus on fall prevention programs and explore factors influencing implementation of effective fall prevention exercise components to facilitate planning.