Living in Fitness Together (LIFT): Testing an Innovative Fall Prevention Program
Condition: Accidental Falls
Study type: Interventional

Summary: 
      The purpose of this study is to test the feasibility and preliminary efficacy of a
      group-based fall prevention program for older adults.
    

Detailed description: 
      Falls are the leading cause of non-fatal and fatal injuries in older adults. The number of
      fall-related older adult deaths in 2005 reached 15,802. Overall, thirty percent of adults
      over the age of 65 fall every year, and the risk for falls increases dramatically with age.
      Direct medical costs related to falls reached $19 billion in 2000. In 2006 a national study
      found that 5.8 million older adults (16%) reported a fall in the prior 3 month period and 1.8
      million had been injured. Falls and fall-related injuries have an important impact on
      mobility, functioning, and the quality of life of older adults, and for many, result in
      catastrophic mobility decline, loss of independence and institutionalization. The trends in
      falls and aging in the population make this a critical problem for our time.

      Current evidence and guidelines recommend assessment of several important risk factors and
      providing individualized intervention for older adults at increased risk of falls. Strength,
      balance and gait training are among the most potent intervention elements. Evidence shows
      that fall risk benefits gained from exercise are completely lost within 12 weeks if exercise
      is not continued. Therefore, persistence with exercise and physical activity are critical to
      the long-term success of fall prevention treatments. The proposed project tests the
      feasibility and preliminary efficacy of an innovative group-based fall prevention program
      called Living In Fitness Together (LIFT). The program consists of group-based physical
      therapy for strength, balance, mobility and flexibility training, an individualized home
      program including walking for physical activity, and training of the group members to support
      and coach each other toward meeting their exercise and physical activity goals. It consists
      of 8 group sessions over 6 weeks plus one group booster session delivered by a physical
      therapist, occupational therapist and trained staff. The program is designed to deliver
      progressive, tailored, and challenging exercise intervention for older adults at risk for
      falls and empower older adults to meet their goals for exercise and physical activity through
      training in self-management, and peer-coaching within the exercise group. The aim of this
      project is to test the feasibility of implementing the fall prevention program with
      peer-coaching in the context of physical therapy practice, and to assess its safety and
      initial efficacy. The results of this study will be the foundation of a formal clinical trial
      of a novel program of exercise and peer- coaching for exercise adherence. This program has
      potential to be incorporated into physical therapy practice and disseminated widely, and to
      have an important impact on the number of falls and fall-related injuries that occur in older
      adults.
    

Intervention name(s): Group-based exercise and peer coaching; Usual PT and attention control grp class
Intervention type(s): Behavioral; Other
Intervention description(s): Group-based exercise and peer coaching will take place over 6 weeks plus one booster visit after 3 months, and include physical therapist-led 1 hour sessions 2 times per week for 2 weeks followed by once per week for 4 weeks (8 sessions) to include: progressive strengthening, balance and mobility exercises; patient goal setting; peer coaching training activities to teach group members ways to help each other to meet their exercise goals during and after classes are over. There will be an individualized home program including flexibility, strengthening, walking, and balance, as well as activity monitoring.; The usual PT and attention control group class will receive standard one-on-one PT strength, balance, gait and education intervention, and group classes to provide valuable information about healthy living, including nutrition, relaxation, and stress management. The attention control - healthy living group classes will take place over 6 weeks plus one booster visit after 3 months, and include 1 hour sessions 2 times per week for 2 weeks followed by once per week for 4 weeks (8 sessions).
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: aged [MeSH term]; exercise [MeSH term]