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Potential long-term impact of “On The Move” group-exercise program on falls and healthcare utilization in older adults: an exploratory analysis of a randomized controlled trial

Authors
  • Coyle, Peter C.1, 2
  • Perera, Subashan2
  • Albert, Steven M.2
  • Freburger, Janet K.2
  • VanSwearingen, Jessie M.2
  • Brach, Jennifer S.2
  • 1 University of Delaware, Newark, DE, USA , Newark (United States)
  • 2 University of Pittsburgh, Pittsburgh, PA, USA , Pittsburgh (United States)
Type
Published Article
Journal
BMC Geriatrics
Publisher
BioMed Central
Publication Date
Mar 16, 2020
Volume
20
Issue
1
Identifiers
DOI: 10.1186/s12877-020-1506-3
Source
Springer Nature
Keywords
License
Green

Abstract

BackgroundWellness program participation may reduce the risk of falling, emergency department-use, and hospitalization among older adults. “On the Move” (OTM), a community-based group exercise program focused on the timing and coordination of walking, improved mobility in older adults, but its impact on falls, emergency department-use, and hospitalizations remains unclear. The aim of this preliminary study was to investigate the potential long-term effects that OTM may have on downstream, tertiary outcomes.MethodsWe conducted a secondary analysis of a cluster-randomized, single-blind intervention trial, which compared two community-based, group exercise programs: OTM and a seated exercise program on strength, endurance, and flexibility (i.e. ‘usual-care’). Program classes met for 50 min/session, 2 sessions/week, for 12 weeks. Older adults (≥65 years), with the ability to ambulate independently at ≥0.60 m/s were recruited. Self-reported incidence of falls, emergency department visitation, and hospitalization were assessed using automated monthly phone calls for the year following intervention completion. Participants with ≥1 completed phone call were included in the analyses. Incidence rate ratios (IRRs) and 95% confidence intervals (CIs) were calculated (reference = usual-care).ResultsParticipants (n = 248) were similar on baseline characteristics and number of monthly phone calls completed. Participants in the seated exercise program attended an average of 2.9 more classes (p = .017). Of note, all results were not statistically significant (i.e. 95% CI overlapped a null value of 1.0). However, point estimates suggest OTM participation resulted in a decreased incidence rate of hospitalization compared to usual-care (IRR = 0.88; 95% CI = 0.59–1.32), and the estimates strengthened when controlling for between-group differences in attendance (adjusted IRR = 0.82; 95% CI = 0.56–1.21). Falls and emergency department visit incidence rates were initially greater for OTM participants, but decreased after controlling for attendance (adjusted IRR = 1.08; 95% CI = 0.72–1.62 and adjusted IRR = 0.96; 95% CI = 0.55–1.66, respectively).ConclusionCompared to a community-based seated group exercise program, participation in OTM may result in a reduced risk of hospitalization. When OTM is adhered to, the risk for falling and hospitalizations are attenuated. However, definitive conclusions cannot be made. Nevertheless, it appears that a larger randomized trial, designed to specifically evaluate the impact of OTM on these downstream health outcomes is warranted.Trial registrationClinical trials.gov (NCT01986647; prospectively registered on November 18, 2013).

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