title: Does progressive resistance and balance exercise reduce falls in residential aged care? Randomized controlled trial protocol for the SUNBEAM program.
abstract: BACKGROUND
  Falls are common among older adults. It is reported that approximately 60% of residents of aged care facilities fall each year. This is a major cause of morbidity and mortality, and a significant burden for health care providers and the health system. Among community dwelling older adults, exercise appears to be an effective countermeasure, but data are limited and inconsistent among studies in residents of aged care communities. This trial has been designed to evaluate whether the SUNBEAM program (Strength and Balance Exercise in Aged Care) reduces falls in residents of aged care facilities.
  
  
  OBJECTIVE
  Is the program more effective and cost-effective than usual care for the prevention of falls?
  
  
  METHODS
  Single-blinded, two group, cluster randomized trial.
  
  
  METHODS
  300 residents, living in 20 aged care facilities.
  
  
  METHODS
  Progressive resistance and balance training under the guidance of a physiotherapist for 6 months, then facility-guided maintenance training for 6 months.
  
  
  METHODS
  Usual care.
  
  
  METHODS
  Number of falls, number of fallers, quality of life, mobility, balance, fear of falling, cognitive well-being, resource use, and cost-effectiveness. Measurements will be taken at baseline, 6 months, and 12 months.
  
  
  METHODS
  The number of falls will be analyzed using a Poisson mixed model. A logistic mixed model will be used to analyze the number of residents who fall during the study period. Intention-to-treat analysis will be used.
  
  
  CONCLUSIONS
  This study addresses a significant shortcoming in aged care research, and has potential to impact upon a substantial health care problem. Outcomes will be used to inform care providers, and guide health care policies.
authors.affiliation: Faculty of Health Sciences, University of Sydney, NSW, Australia.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Hewitt
authors.affiliation: Faculty of Health Sciences, University of Sydney, NSW, Australia.
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: Refshauge
authors.affiliation: Centre for Health Economic Research and Evaluation, University of Technology, Sydney, NSW, Australia.
authors.forename: Stephen
authors.initials: S
authors.lastname: Goodall
authors.affiliation: University of Queensland/Blue Care Research and Practice Development Centre, The University of Queensland, Brisbane, QLD, Australia.
authors.forename: Timothy
authors.initials: T
authors.lastname: Henwood
authors.affiliation: Faculty of Health Sciences, University of Sydney, NSW, Australia.
authors.forename: Lindy
authors.initials: L
authors.lastname: Clemson
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control* / Q000706:statistics & numerical data; D000368:Aged; D003362:Cost-Benefit Analysis; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006707:Homes for the Aged / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D004856:Postural Balance; D011788:Quality of Life; D055070:Resistance Training / Q000379:methods*; D016037:Single-Blind Method
keywords: balance; cost-effectiveness; falls; nursing care; strength; training