What were we trying to do?

StandingTall-er was an implementation study of the evidence based StandingTall programme across the North of England and Australia. 

 

StandingTall was an engaging balance training programme that was designed specifically for use by older adults. It employed technology (tablet or desktop) to deliver an effective method for improving balance and reducing fall risk. It included: 

 

• evidence-based, individually-tailored and progressive exercise prescription to improve balance ability and reduce fall risk in older adults, and
• behavioural change techniques to enhance exercise uptake and long-term adherence, with optimal usability for older adults to use independently at home. 

 
Exercise is recognised as a key component of fall prevention and StandingTall fills a gap by offering a mechanism to deliver a personalised and accessible exercise programme for individuals, ongoing protection from falls as well as positive functional outcomes. We also knew that the use of technology can increase health service accessibility to large populations varying in socio-economic status including those living in regional and remote areas and those shielding during the Covid-19 epidemic. 

 

We were looking to recruit 400 patients across the North of England to explore how Standing Tall-er can be used in practice, with particular focus on Greater Manchester. 

 

 

Why was this important?

Falls and fall-related injuries can lead to mobility-related disability and loss of independence in older people, which in turn results in increased demand for health services related to fall-injury unless effective and cost-efficient preventative strategies are implemented. In England, fall-related health care burden, currently costs £3.4 billion, and it’s predicted to greatly increase in the coming decades due to the ageing population.

 There is clear evidence that falls in older people can be prevented with appropriately-designed exercise programmes. A Cochrane review concluded that exercise interventions are amongst the most effective strategies to reduce fall rates in older people. Despite strong evidence that falls can be prevented, older people and many health professionals are often not aware that exercise is an effective strategy for preventing falls. There is a clear gap between evidence and action both in Australia and England, which we wanted to address as part of this research project. 

 

The evidence from the Standing Tall randomised controlled trial conducted in Australia suggests that the app worked in increasing adherence and falls prevention.

 

How we did it?

We recruited older adults to use the app over a 6 month period with some support from a health professional or exercise specialist.

 

We asked participants, health professionals, exercise professionals and service leads to complete surveys at key timepoints and to take part in an interview about their experiences.

 

Who were we working with?

• Greater Manchester Integrated Care Partnership
• Neuroscience Research Australia (NeuRA) 
• Academic Health Science Networks (now Health Innovation Networks) across the North
• Northern Health Science Alliance

 

 

Downloadable resources

• Publications
  • Morag E.T., Meghan, A., Hawley-Hague, H., Todd, C., et al. (2024). Implementation of a digital exercise programme in health services to prevent falls in older people. Age and Ageing 
  • Ambrens, M., Macniven, R., Perram, A., Andrews, S., Hawley-Hague, H., et al (2024). How Perceptions of Aging Influence Physical Activity and Exercise in Older Age: Exploring the Behavior of People Aged 70+ Years Engaged in Fall Prevention Activities. Journal of Applied Gerontology
  • Taylor, M.E., Todd, C., O'Rourke, S., Hawley-Hague, H., et al. (2021) Implementation of the StandingTall programme to prevent falls in older people: a process evaluation protocol. BMJ Open.

 

 

Conact information

 

 

 

 

Programme Manager
 

Alison Littlewood
alison.j.littlewood@manchester.ac.uk