Comparing the impact of active floor-rise training with video demonstration on fear of falling and independent floor-rise ability in older adults living in the community: a pilot cluster randomised controlled trial

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BACKGROUND: Many older adults cannot rise from the floor independently after a fall, increasing risks of long-lies and reliance on emergency services. OBJECTIVE: Investigate whether floor-rise training (FRT) reduces fear of falling (FoF) and improves floor-rise ability in older adults. DESIGN: Multi-centre, cluster-randomised controlled before-after pilot trial. SETTING: Five community-based Otago exercise classes run by a third-sector organisation. PARTICIPANTS: Sixty-one community-dwelling older adults (aged ≥65 years) attending weekly Otago classes were randomised (FRT n = 27, control n = 34). Forty-nine completed to follow-up and were analysed (FRT n = 22, control n = 27). No adverse events occurred. METHODS: Classes were cluster-randomised (3:2 allocation). Intervention: 5 weekly 20-minute FRT sessions utilising backward-chaining. Controls viewed a FRT demonstration video followed by discussion (20-minutes total), without physical practise. Primary outcome: Falls Efficacy Scale-International (FES-I). Secondary outcomes: timed floor-rise and independent floor-rise ability (from supine, side-sitting, half-kneeling), Perceived Ability to Manage Risk of a Falls or Actual Falls (PAMF), FoF and activity avoidance, measured via visual analogue scales (1-item-question). RESULTS: Primary outcome (FES-I), FoF and activity avoidance showed no significant differences. However, FRT participants significantly reduced floor-rise times compared to controls: supine (13.1 s to 7.1 s, P = .001), side-sitting (8.0 s to 4.6 s, P = .046), and half-kneeling (3.9 s to 1.5 s, P < .001). Post-intervention, 100% of FRT participants could rise from supine versus 63% of controls (P = .007). PAMF scores increased significantly in the FRT group (13.6 to 16.3, P = .033). CONCLUSION: Although FoF did not change, a brief FRT intervention significantly improved floor-rise ability and PAMF. Integrating FRT into fall prevention programmes may reduce long-lie consequences.

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