Effectiveness of a Multidisciplinary Pilot Group Program to Reduce Falls Risk in Community-Dwelling Older Adults with Frailty
Abstract
Introduction
Falls among older adults living with frailty represent a significant public health concern. This pilot study evaluated a six-week, multidisciplinary team (MDT)-led group intervention delivered in a day hospital setting providing comprehensive geriatric assessment. The program targeted community-dwelling adults aged ≥65 years with a Clinical Frailty Scale [CFS] score of 4–5. Group sessions (90 minutes weekly) comprised of education, exercise, and social engagement. Educational topics provided included frailty, falls prevention, nutrition, physical and cognitive health, social prescribing, and community supports. Exercise component comprised of physiotherapy-led training emphasizing strength, balance, and endurance.
Methods
Participants were identified following geriatric assessment and met inclusion criteria: age ≥65, CFS 4–5, ability to mobilise with supervision, and capacity to engage in group activities. Severe cognitive or communication impairments were exclusion criteria. Pre- and post-intervention outcome measures included CFS, gait speed, Five Times Sit-to-Stand (5TSTS), grip strength, EQ-5D quality of life, and Short Falls Efficacy Scale (FES).
Results
Group pre-intervention mean CFS was 4, gait speed 0.88 m/s, and 5TSTS 20.6 seconds. Mean grip strength was 13.7 kg (right) and 12.8 kg (left), with EQ-5D health status at 63%. Post-intervention, mean CFS improved to 3, mean gait speed increased to 1.07 m/s, and mean 5TSTS improved to 15 seconds. Grip strength rose to 18.6 kg (right) and 14.8 kg (left), while EQ-5D improved to 73%. Falls efficacy scores demonstrated overall improvement in confidence.
Conclusion
The MDT-led group program proved effective in reducing falls risk and improving quality of life among older adults with frailty. Additionally, the program demonstrated the practicality of integrating social interaction, education, and exercise therapy within a single session, thereby addressing the biopsychosocial dimensions of patient care. These findings highlight both the feasibility and scalability of this model for implementation in day hospitals and community rehabilitation settings.
Comments
Important research - What type of endurance and strength
I'm interested in more details about the endurance and strength training in this setting?
What entails a "day hospital setting"? Are the participants residents of the hospital?
Comment reply: Endurance training and day hospital setting query
Our day hospital setting is an ambulatory service within an acute hospital. Clients are community dwellers and are seen on appointment based system. Our main aim of the day hospital is admission avoidance, follow-up pathway post in-patient admission in acute care. Our service is geriatrician led with a full MDT including, Social Work, Physiotherapy, Clinical Nutrition, Speech and Language Therapy, Nursing and Occupational Therapy. Weekly 90-minute sessions included 30-minutes of social, education and exercise components. Each educational topic was facilitated by a different member of the MDT. For the purpose of our programme, we had input from Social Prescribing to support clients to be linked in with community supports after completing the programme.
The exercise component was based on a circuit style exercise class led by Physiotherapy. Strength training was based on weighted exercises with dumbbells and ankle weights. Endurance exercises were carried out on a seated stationary upper limb and lower limb bike with adjustable resistance. Our participants spent 5-minutes at each station and rotated throughout the 30-minute exercise session.