title: Fall Preventive Exercise With or Without Behavior Change Support for Community-Dwelling Older Adults: A Randomized Controlled Trial With Short-Term Follow-up.
abstract: In Western countries, falls and fall-related injuries are a well-known threat to health in the aging population. Studies indicate that regular exercise improves strength and balance and can therefore decrease the incidence of falls and fall-related injuries. The challenge, however, is to provide exercise programs that are safe, effective, and attractive to the older population. The aim of this study was to investigate the short-term effect of a home-based exercise program with or without motivational interviewing (MI) compared with standard care on physical performance, fall self-efficacy, balance, activity level, handgrip strength, adherence to the exercise, and fall frequency.
  
  
  
  A total of 175 older adults participated in this randomized controlled study. They were randomly allocated for the Otago Exercise Program (OEP) (n = 61), OEP combined with MI (n = 58), or a control group (n = 56). The participants' mean age was 83 years. The recruitment period was from October 2012 to May 2015. Measurements of physical performance, fall self-efficacy, balance, activity level, handgrip strength, adherence to the exercise, and fall frequency were done before and 12 weeks after randomization.
  
  
  
  A total of 161 participants were followed up, and there were no significant differences between groups after a period of 12 weeks of regular exercise. Within the OEP + MI group, physical performance, fall self-efficacy, physical activity level, and handgrip strength improved significantly; likewise, improved physical performance and fall self-efficacy were found in the control group. A corresponding difference did not occur in the OEP group. Adherence to the exercise was generally high in both exercise groups.
  
  
  
  In the short-term perspective, there were no benefits of an exercise program with or without MI regarding physical performance, fall self-efficacy, activity level, handgrip strength, adherence to the exercise, and fall frequency in comparison to a control group. However, some small effects occurred within the OEP + MI group, indicating that there may be some possible value in behavioral change support combined with exercise in older adults that requires further evaluation in both short- and long-term studies.
authors.affiliation: School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden.
authors.forename: Marina
authors.initials: M
authors.lastname: Arkkukangas
authors.affiliation: School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden.
authors.forename: Anne
authors.initials: A
authors.lastname: Söderlund
authors.affiliation: Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden.|Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden.|Department of Neuroscience, Physiotherapy, Uppsala University, Uppsala, Sweden.
authors.forename: Staffan
authors.initials: S
authors.lastname: Eriksson
authors.affiliation: School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden.|Centre for Clinical Research, Uppsala University, Västerås, Sweden.
authors.forename: Ann-Christin
authors.initials: AC
authors.lastname: Johansson
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000368:Aged; D000369:Aged, 80 and over; D015444:Exercise; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D018737:Hand Strength; D006801:Humans; D057187:Independent Living; D008297:Male; D062405:Motivational Interviewing; D010349:Patient Compliance; D026741:Physical Therapy Modalities; D004856:Postural Balance; D020377:Self Efficacy