title: Older people's experiences of therapeutic exercise as part of a falls prevention service: survey findings from England, Wales and Northern Ireland.
abstract: BACKGROUND
  falling, and fear of falling, significantly affect older people and their lifestyle resulting in loss of confidence, restriction of activity and deteriorating quality of life. Multi-factorial assessment and active participation in an evidence-based exercise programme are key interventions to prevent and manage falls.
  
  
  OBJECTIVE
  to examine older people's experiences of therapeutic exercise as part of a falls prevention service in NHS Trusts in England, Wales and Northern Ireland.
  
  
  METHODS
  a cross-sectional survey targeted patients and staff members delivering exercise interventions for reducing falls. A multi-disciplinary group including patient and staff representatives developed a 20-item patient questionnaire and a 12-item staff questionnaire that were distributed to 94 NHS Trusts (113 participating sites within the NHS Trusts) in October 2011.
  
  
  RESULTS
  response was 57% for the patient sample and 88% for the staff sample. The median (IQR) age of patients was 82 (77-86) years. 72% were women. Two-thirds reported attending group-based therapeutic exercise classes generally of short duration (80% <12 weeks) and low intensity (85% one class per week) at hospitals and community venues. Balance and strength exercises were prescribed; 68% reported using resistance equipment such as ankle weights and/or exercise band. Only 52% reported exercises were made more difficult as they improved. However, patient satisfaction levels were high (95% satisfied or very satisfied). Patients and staff reported limited availability of strength and balance follow-up classes.
  
  
  CONCLUSIONS
  despite high levels of patient satisfaction therapeutic exercise provision was limited and implementation of evidence-based exercise interventions by healthcare providers is incomplete and varies widely. Patients and staff wanted greater availability of long-term exercise services for falls prevention.
authors.affiliation: Clinical Effectiveness and Evaluation Unit, Royal College of Physicians, London, UK.
authors.forename: Amanda K
authors.initials: AK
authors.lastname: Buttery
authors.forename: Janet
authors.initials: J
authors.lastname: Husk
authors.forename: Derek
authors.initials: D
authors.lastname: Lowe
authors.forename: Jonathan
authors.initials: J
authors.lastname: Treml
authors.forename: Naomi
authors.initials: N
authors.lastname: Vasilakis
authors.forename: Jackie
authors.initials: J
authors.lastname: Riglin
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control / Q000706:statistics & numerical data; D000203:Activities of Daily Living / Q000523:psychology; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology / Q000523:psychology; D003430:Cross-Sectional Studies; D017598:Efficiency, Organizational; D004739:England; D055317:Evidence-Based Practice / Q000379:methods; D015444:Exercise / Q000502:physiology; D005081:Exercise Therapy / Q000379:methods / Q000523:psychology; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D009660:Northern Ireland; D004856:Postural Balance; D011788:Quality of Life; D020377:Self Efficacy; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014852:Wales
keywords: exercise; falls; falls prevention; older people; patient involvement; survey