FallFitness exercise program provided using the train-the-trainer approach for community-dwelling older adults: a randomized controlled trial

Background Falls and fall-related injuries remain a global challenge and threat to the health of older adults. Specific strength and balance exercises are effective in preventing falls among community-dwelling older adults. Nevertheless, provision of evidence-based fall prevention interventions to a broad population represents a healthcare challenge, indicating that new models for promoting exercise among community-dwelling older adults need to be addressed. Here, we aimed to evaluate the effects of a peer-led group-based exercise intervention provided using the train-the-trainer approach and targeting physical performance, activity level, handgrip strength, quality of life, fall-related self-efficacy, fear of falling, and falling techniques compared with a control group at 8-week follow-up. Methods This randomized controlled trial (RCT) included trainers and participants who were recruited from four collaborating regional organizations for retired persons. The intervention was planned to be provided in five municipalities in Sweden, depending on the location of the registered trainers.Eligible participants included adults aged >= 60 years who could walk independently and understand written and oral information in Swedish. The FallFitness multicomponent exercise program delivered weekly strength, balance, and falling techniques over eight weeks. It was evaluated using the train-the-trainer approach. Fourteen older adults were eligible for trainer education, and 101 participants were randomly allocated for the FallFitness exercise (n = 50) or a control group (n = 51). Results After 8 weeks of peer-led training, the short multicomponent exercise program significantly improved the physical activity levels (p = 0.036) and backward and sideways falling techniques (p < 0.001) compared to those in the control group. Fear of falling significantly decreased in the exercise group (p = 0.009). Other outcomes in this study showed to be non-significant. Conclusions The multicomponent exercise program provided in eight sessions using the train-the-trainer approach may be effective in promoting physical activity and the learning of motor skills and safe landing strategies. Furthermore, the FallFitness exercise program may reduce the fear of falling and may be both time- and cost-effective.