• Steve Iliffe, Denise Kendrick, Richard Morris, Mark Griffin, Deborah Haworth, Hannah Carpenter, Tahir Masud, Dawn A Skelton, Susie Dinan-Young, Ann Bowling, Heather Gage, and ProAct65+ research team.
• University College London, London.
• Br J Gen Pract. 2015 Nov 1; 65 (640): e731e738e731-8.

BackgroundRegular physical activity reduces falls, hip fractures, and all-cause mortality, but physical activity levels are low in older age groups.AimTo evaluate two exercise programmes promoting physical activity among older people.Design And SettingPragmatic three-arm, parallel-design cluster randomised controlled trial involving 1256 people aged ≥65 years (of 20 507 invited) recruited from 43 general practices in London, Nottingham, and Derby.MethodPractices were randomised to the class-based Falls Management Exercise programme (FaME), the home-based Otago Exercise Program (OEP), or usual care. The primary outcome was the proportion reaching the recommended physical activity target 12 months post-intervention. Secondary outcomes included falls, quality of life, balance confidence, and costs.ResultsIn total, 49% of FaME participants reached the physical activity target compared with 38% for usual care (adjusted odds ratio 1.78, 95% confidence interval [CI] =1.11 to 2.87, P = 0.02). Differences between FaME and usual care persisted 24 months after intervention. There was no significant difference comparing those in the OEP (43% reaching target at 12 months) and usual-care arms. Participants in the FaME arm added around 15 minutes of moderate-to-vigorous physical activity per day to their baseline level; this group also had a significantly lower rate of falls (incident rate ratio 0.74, 95% CI = 0.55 to 0.99, P = 0.042). Balance confidence was significantly improved in both intervention arms. The mean cost per extra person achieving the physical activity target was £1740. Attrition and rates of adverse reactions were similar.ConclusionThe FaME programme increases self-reported physical activity for at least 12 months post-intervention and reduces falls in people aged ≥65 years, but uptake is low. There was no statistically significant difference in reaching the target, or in falls, between the OEP and usual-care arms.© British Journal of General Practice 2015.

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