Evaluation and implementation of a mobile exercise application to promote strength and balance and reduce falls among seniors

Accidental falls are the most common cause of injury in old age and generates high societal costs, suffering for the individual and fear of falling which may affect quality of life. Research consistently shows that exercise interventions are effective in reducing falls among community-living seniors.

However, methods to reach seniors with knowledge and support in how to exercise, need to be developed.

In our previous research we have, in co-creation with seniors, developed an app "Safe Step" to help seniors in self-management of fall preventive exercises. Previous research shows that falls can be prevented by group exercises or supervised home exercises.

There is however a need to evaluate if falls can be reduced by a self-managed exercise app and if additional community support enhance implementation.

Hence, the proposed project includes two parts, a randomized controlled trial (RCT) and a pragmatic trial.In the RCT (study 1), no personal contact is made with the 1400 participants who are recruited throughout Sweden by advertising.

Participants are randomized to one of two groups, both receive educational films with fall preventive information each month, the intervention group get, in addition, access to the Safe Step app for self-management of exercises.

In the pragmatic trial (study 2), Safe Step is launched in the municipality of Östersund and supplemented by start-up meetings at Friskis & Svettis and assistance from IT-guides. In both trials the same outcome measures are used to allow comparisons.

Participants are followed during one year with digital questionnaires at 3, 6, 9 and 12 months to evaluate self-reported effects on balance and strength, fear of falling and quality of life. Falls are reported every month. Reach of the interventions will be described by sociodemographic parameters in comparison to the population.

In addition exercise adherence and cost-effectiveness will be estimated. In the RCT the primary outcome is effects on falls rate.