University of Nottingham, Nottingham, UK.
Nottingham University Hospitals NHS Trust, UK.
Age Ageing. 2021 Jun 28;50(4):1290-1297. doi: 10.1093/ageing/afaa288.
Falls incidence increases with age alongside declines in strength and balance. Clinical trials show that the Falls Management Exercise (FaME) programme improves strength and balance, which can reduce falls and improve physical functioning.
To determine if the clinical trial efficacy of FaME translates into effectiveness in non-research settings.
An implementation study of FaME in 10 local authorities across the East Midlands region of England.
Adults aged 65 and over enrolled on a FaME programme.
Anonymised outcome data collected by the FaME providers were compared at baseline, end of programme and 6 months follow-up using univariate and multivariate analyses.
For 348 adults enrolled in programmes and analysed, the mean age was 76.8, 73% were female and 143 (41%) completed ≥75% of classes. Overall confidence in balance, fear of falling, functional reach and timed-up-and-go (all P < 0.001), and turn 180° (P = 0.008) improved significantly at programme completion versus baseline, but improvements were not maintained 6 months later. Falls risk (FRAT score) and total minutes of physical activity did not change significantly though minutes of strength and balance activity increased by 55% at programme completion and was maintained at 6 months. The falls incidence rate ratio (IRR) was non-significantly lower at programme completion (IRR 0.76, 95% Confidence Interval (CI) 0.48,1.21) and follow-up (IRR 0.82 95% CI 0.48,1.39) versus baseline.
There is modest translation of FaME efficacy into effectiveness, but not all effects persist after completion. Strategies to aid adherence and exercise maintenance are important to maximise benefits.
随着年龄的增长，力量和平衡的下降，跌倒的发生率也会增加。临床试验表明，跌倒管理锻炼（FaME）计划可以提高力量和平衡，从而减少跌倒和改善身体机能。
确定 FaME 的临床试验疗效是否转化为非研究环境中的效果。
在英格兰东米德兰兹地区的 10 个地方当局进行的 FaME 实施研究。
参加 FaME 计划的 65 岁及以上成年人。
使用单变量和多变量分析，比较 FaME 提供者匿名收集的基线、计划结束和 6 个月随访时的结果数据。
对于 348 名参加计划并进行分析的成年人，平均年龄为 76.8 岁，73%为女性，143 人（41%）完成了≥75%的课程。总体平衡信心、跌倒恐惧、功能伸手距离和计时起立行走（均 P<0.001）以及 180°转身（P=0.008）在计划完成时与基线相比显著改善，但 6 个月后没有得到维持。跌倒风险（FRAT 评分）和总分钟体力活动没有显著变化，尽管力量和平衡活动分钟数在计划完成时增加了 55%，并在 6 个月时保持不变。在计划完成时（IRR0.76，95%置信区间（CI）0.48，1.21）和随访时（IRR0.82，95%CI0.48，1.39），跌倒发生率比（IRR）均无显著降低。
FaME 的疗效有适度的转化为效果，但并非所有效果在完成后都能持续。促进坚持和锻炼维持的策略对于最大限度地提高益处很重要。
