Standing tall

The reopening of gyms marks a new chapter in the UK’s recovery from covid. Admittedly, at the time of writing, only those in England have reopened, with Scotland due to follow suit on 26 April. In Wales the gym re-opening time has been brought forward to 3 May, whilst those in Northern Ireland are currently awaiting an announcement.

Nevertheless there are signs that, with sports and other outdoor activities also opening up to training and even competition, fitness in the UK may no longer have to rely on walks, cycles and solitary home exercising. Not that exercising in the home doesn’t have its place. Particularly as we get older, regular stretching and mobility training could be beneficial in the long term. And, where better to carry out those exercises than in the home, albeit under regular supervision and check-ups from a physiotherapist or other health professional.

But does regular exercise really bring the expected benefits? That was the question asked by a two year randomised control trial which assessed the effectiveness of ‘Standing Tall;’ an e-health balance exercise programme delivered through an app, which aimed to reduce the incidence of falls in older people. The trial, the results of which were reported in the BMJ, [1] revealed no statistical difference after twelve months between the control and intervention groups. However, when viewed over twenty-four months, the intervention group had a 16% lower rate of falls and 20% fewer injurious falls.

The report’s authors concluded that the results showed that “a tailored e-health exercise programme is an effective intervention in preventing falls in older people.” This backs up other studies which have demonstrated the way in which balance exercise programmes can be an effective way of reducing falls amongst those who live in the community. The challenge for health professionals is to find a way of ensuring that individuals follow recommended programmes. The report’s authors say that without some kind of physiotherapist led intervention or home visit programme just 21% of individuals stick to exercise plans.

Of course the need for such interventions can place a strain on health resources; not something which would be recommended at a time when a return to general exercising will inevitably bring with it increased demand. Perhaps that’s where e-programmes can help, delivering prompts as required and helping people to maintain a regular exercise programme.

It’s another example of the way in which technology can benefit the health service. In recent years we’ve seen how SMS text and other electronic reminders can help to boost appointment take up. And we’ve also experienced the benefits which electronic diaries and digital patient records can bring; in particular in reducing administration time; or in the case of digital records in enabling a more holistic treatment regime thanks to the easy availability of records across disciplines.

The more that individuals can integrate simple exercises into their daily routine the better. Even the basic balance exercises shown on the NHS website [2] could make a difference in the long term. Every fall prevented not only helps individuals to live a more productive and healthy lifestyle, it also reduces demand on health services.  It’s time to step up, stand tall and get exercising.

[1] BMJ 2021;373:n740