Exercise Prescription for Falls Prevention in Older Adults: A Before-After Study of an Online Educational Course for Fitness Instructors.

Abstract

Purpose: Exercise reduces falls in older adults, yet fitness instructors may lack formal education in prescribing effective fall prevention exercises. This study evaluated the quality of strength and balance exercises prescribed by fitness instructors before and after completing an online course on exercise prescription for falls prevention in older adults.

Materials and methods: In a before-after study, fitness instructors completed an exercise prescription task based on a clinical scenario immediately before and after participation in an online educational course. On each occasion, participants prescribed one strength and one balance exercise. Exercises were assessed using a rubric informed by evidence-based guidelines. Pre-post changes in exercise quality were analyzed using paired t-tests for strength and balance exercises separately.

Results: Seventy-seven fitness instructors completed the course, with 55 included in the analysis. Participants were predominantly female (86%), with a mean age of 51 years (SD 12.6) and a median of 12 years since qualification (IQR 7-23). Exercise quality improved by 9.1% (97.5% CI 6.6-11.6) for strength and 7.3% (97.5% CI 3.5-11.0) for balance exercises.

Conclusions: An online educational course was associated with improved exercise prescription quality, although the magnitude and educational significance of these improvements remain uncertain. Further research is needed to confirm these findings and determine whether improvements in exercise prescription translate to changes in practice and improved outcomes for older adults.