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Open Access Highly Accessed Study protocol

The effect of walking on falls in older people: the 'Easy Steps to Health' randomized controlled trial study protocol

Alexander Voukelatos1, Dafna Merom23*, Chris Rissel3, Cathie Sherrington4, Wendy Watson5 and Karen Waller6

Author Affiliations

1 Health Promotion Service, Clinical Support Division (Western), Sydney, Australia

2 School of Biomedical and Health Sciences, University of Western Sydney, Campbelltown, Australia

3 School of Public Health, University of Sydney, Sydney, Australia

4 The George Institute for Global Health, University of Sydney, Sydney, Australia

5 Transport and Road Safety (TARS) Research, Department of Aviation (formerly NSW Injury Risk Management Research Centre), University of New South Wales, Sydney, Australia

6 Health Promotion Service, Health Reform Transitional Organisation Southern, Sydney, Australia

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BMC Public Health 2011, 11:888  doi:10.1186/1471-2458-11-888

Published: 24 November 2011

Abstract

Background

Falls in older people continue to be a major public health issue in industrialized countries. Extensive research into falls prevention has identified exercise as a proven fall prevention strategy. However, despite over a decade of promoting physical activity, hospitalisation rates due to falls injuries in older people are still increasing. This could be because efforts to increase physical activity amongst older people have been unsuccessful, or the physical activity that older people engage in is insufficient and/or inappropriate. The majority of older people choose walking as their predominant form of exercise. While walking has been shown to lower the risk of many chronic diseases its role in falls prevention remains unclear. This paper outlines the methodology of a study whose aims are to determine: if a home-based walking intervention will reduce the falls rate among healthy but inactive community-dwelling older adults (65 + years) compared to no intervention (usual activity) and; whether such an intervention can improve risk factors for falls, such as balance, strength and reaction time.

Methods/Design

This study uses a randomised controlled trial design.

A total of 484 older people exercising less than 120 minutes per week will be recruited through the community and health care referrals throughout Sydney and neighboring regions. All participants are randomised into either the self-managed walking program group or the health-education waiting list group using a block randomization scheme.

Outcome measures include prospective falls and falls injuries, quality of life, and physical activity levels. A subset of participants (n = 194) will also receive physical performance assessments comprising of tests of dynamic balance, strength, reaction time and lower limb functional status.

Discussion

Certain types of physical activity can reduce the risk of falls. As walking is already the most popular physical activity amongst older people, if walking is shown to reduce falls the public health implications could be enormous. Conversely, if walking does not reduce falls in older people, or even puts older people at greater risk, then health resources targeting falls prevention need to be invested elsewhere.

Trial Registration

Australia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12610000380099