TOP UP evaluation: telephysiotherapy exercise intervention to increase mobility and reduce falls in aged care
Tracks
Ballroom 1
Enablement / Reablement
Exercise
Falls / Fall Preventaion
Rehabilitation
Technology
| Wednesday, November 13, 2024 |
| 11:00 AM - 11:15 AM |
Speaker
Dr Rik Dawson
Post Doctoral Researcher
Institute For Musculoskeletal Health
TOP UP evaluation: telephysiotherapy exercise intervention to increase mobility and reduce falls in aged care
Abstract
Background
Deteriorating mobility and falls negatively affect older people's quality of life. Physiotherapy-led exercise programs are effective but hard to access in regional areas. Telehealth has emerged as a promising model of care in primary settings, yet its implementation in aged care remains understudied. We aim to discuss the implementation and effectiveness outcomes of the TOP UP study.
Method
This type 1 hybrid effectiveness-implementation randomised controlled trial spanning 2021-2023 enrolled 242 individuals aged 65+ receiving aged care services in community or residential settings. Participants were randomised to either a 6-month telehealth program (TOP UP) or a wait-list control group. The intervention comprised 10 physiotherapy Zoom sessions with local aged care worker support and access to online exercise videos. Consumer co-design principles and behavioral change theory informed the study's development.
Results
The program significantly improved mobility and lowered the risk of falling by 37% (risk ratio 0.63, 95% CI 0.43 to 0.92). The program delivered positive implementation outcomes, with 18% converting from screening to enrollment, a 77% completion rate, and 94% endorsing the program. Adverse events were minimal, with only one reported fall during exercise. Qualitative analysis revealed key factors influencing implementation, including expanded exercise opportunities at home via online videos, enhanced engagement with senior-friendly resources, and motivation bolstered by local support and health coaching from physiotherapists. The of TOP UP on quality of life will be explored.
Implications
Adoption of a telephysiotherapy program in aged care requires tailored online resources, local support, staff and client education, ongoing organizational, and more policy investment.
Deteriorating mobility and falls negatively affect older people's quality of life. Physiotherapy-led exercise programs are effective but hard to access in regional areas. Telehealth has emerged as a promising model of care in primary settings, yet its implementation in aged care remains understudied. We aim to discuss the implementation and effectiveness outcomes of the TOP UP study.
Method
This type 1 hybrid effectiveness-implementation randomised controlled trial spanning 2021-2023 enrolled 242 individuals aged 65+ receiving aged care services in community or residential settings. Participants were randomised to either a 6-month telehealth program (TOP UP) or a wait-list control group. The intervention comprised 10 physiotherapy Zoom sessions with local aged care worker support and access to online exercise videos. Consumer co-design principles and behavioral change theory informed the study's development.
Results
The program significantly improved mobility and lowered the risk of falling by 37% (risk ratio 0.63, 95% CI 0.43 to 0.92). The program delivered positive implementation outcomes, with 18% converting from screening to enrollment, a 77% completion rate, and 94% endorsing the program. Adverse events were minimal, with only one reported fall during exercise. Qualitative analysis revealed key factors influencing implementation, including expanded exercise opportunities at home via online videos, enhanced engagement with senior-friendly resources, and motivation bolstered by local support and health coaching from physiotherapists. The of TOP UP on quality of life will be explored.
Implications
Adoption of a telephysiotherapy program in aged care requires tailored online resources, local support, staff and client education, ongoing organizational, and more policy investment.
Biography
Rik Dawson is an experienced aged care physiotherapist. Formerly the managing director of Agewell Physiotherapy, a practice that employed physiotherapists and occupational therapists to provide care for the elderly across Australia, Rik sold his practice in 2020. Rik is the Vice President of the Australian Physiotherapy Association (APA) and is a post-doctoral researcher at the Institute for Musculoskeletal Health at the University of Sydney. Rik’s research focuses on the effectiveness, cost-effectiveness, acceptability and implementation of physiotherapy, exercise and telehealth to reduce falls, improve mobility and enhance quality of life for older people in hospitals, aged care and in the community. Rik has represented the APA at the Royal Commission in Aged Care Quality and Safety, the Australian Commission on Safety and Quality in Health Care to assist in developing the quality standards and the Department of Health’s Aged Care Funding Reform Working Party. Rik is also a qualified Yoga instructor, which enables him to promote well-being among older adults.
Session Chair
Claudia Meyer
Senior Research Fellow
Bolton Clarke
