Standing Tall: a novel technology-based balance exercise program

An unsupervised, home-based balance exercise program delivered through a tablet computer to prevent falls in older adults.

StandingTall is an engaging balance training program that is designed specifically for use by older people. It was developed using the latest insights in geriatric and translational neuroscience, and employs mobile (tablet) technology to deliver an effective method for improving balance and reducing fall risk. StandingTall includes: effective, individually-tailored exercise prescription to improve balance ability and reduce fall risk in older people; and behavioural change techniques to enhance exercise uptake and long-term adherence, with optimal usability for older people to use independently at home. By combining technology with research in fall prevention, StandingTall provides a radically new solution to support older adults to stay independent for longer and lower healthcare-related costs caused by falls.

The StandingTall team, led by Professor Kim Delbaere, has worked with over 1500 community-dwelling older people since 2015, implementing a home-based balance exercise program delivered through a tablet computer.

A conclusive randomised controlled trial in 503 individuals aged 70+ over 2 years showed a 16% lower falls rate, and a 20% lower rate of injurious falls over 2‑years in the intervention group compared to controls. Particularly encouraging were the unprecedented adherence rates. 80% of participants continued to use the program for 6 months, 68% for 1 year and 52% remained to engage with the program for 2 years. Participant response to the program was highly positive, and feedback received is being used to further improve future versions of the program.

The first StandingTall trial has paved the way for future research projects, furthering our understanding of healthy ageing and reducing the risk of falls across the community. A follow-on study, StandingTall-Plus, which added a brain training element, is now at its tail end. We are also testing StandingTall with a psychological program aimed at improving confidence in daily activities that involve balance in our Own Your Balance study. We have had the opportunity to use StandingTall in other research areas including Aboriginal and Māori communities, Parkinsons Disease, Cardiovascular Health, home and residential aged care, and within a multinational implementation study across select health districts in New South Wales, Victoria, and Northern England.

We are now working with collaborators to redevelop StandingTall to improve our user experience and include a larger range of exercise activities.

You can find updates about the programs progress and fall prevention information on the StandingTall website.

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If you would like to read the full results published in the British Medical Journal, you can access the paper here.