The Effect of a Standing Intervention on Falls in Long Term Care: a Secondary Analysis of a Randomized Controlled Trial

Abstract

Background

Older adults in long term care (LTC) spend over 90% of their day engaging in sedentary behaviour. Sedentary behaviour may exacerbate functional decline and frailty, increasing the risk for falls. The purpose of this study is to explore the impact of a 22-week standing intervention on falls among LTC residents at 12-month follow-up.

Methods

This was a planned secondary analysis of the Stand if You Can randomized controlled trial. The original trial randomized 95 participants (n = 47 control; n = 48 intervention) to either a sitting control or a supervised standing intervention group (100 minutes/week) for 22 weeks. Falls data were available to be collected over 12 months post-intervention for 89 par-ticipants. The primary outcome was a hazard of fall (Yes/No) during the 12-month follow-up period.

Results

A total of 89 participants (average age 86 years ± 8.05; 71.9% female) were followed for 12-months post-intervention. Par-ticipants in the intervention group (n=44) had a significantly greater hazard ratio of falls (2.01; 95% CI = 1.11 to 3.63) than the control group (n=45) when accounting for the history of falls, frailty status, cognition level, and sex.

Conclusion

Participants who received a standing intervention over 22 weeks were twice as likely to fall 12 months after the inter-vention compared with the control group. However, the prevalence of falls did not surpass what would be typically observed in LTC facilities. It is imperative that future stud-ies describe in detail the context in which falls happen and collect more characteristics of participants in the follow-up period to truly understand the association between standing more and the risk of falls.