Practicing Getting Up from the Floor to Reduce Fear of Falling and Improve Floor-Rise Ability in Community-Dwelling Older Adults: a Pilot Study

The Impact of Floor-rise Training on Fear of Falling and Independent Floor-rise Ability in Older Adults Living in the Community: a Pilot Cluster Randomised Controlled Trial with Multiple Methods.

Goal:

This pilot study aims to determine whether practicing getting down to and standing up from the floor reduces fear of falling (FoF) and improves older adults' ability to complete this task. The study compares this to a control group that watches educational videos on the same topic. This practice is referred to as Floor-Rise Training (FRT).

Main Questions:

1. Can a short FRT intervention reduce fear of falling?
2. Can a short FRT intervention improve the ability to rise from kneeling, sitting, and lying positions?
3. Does watching an instructional video on FRT improve fear of falling or floor-rise ability?

Study Design:

Researchers will compare:

• A group receiving 20 minutes of FRT weekly for 5 weeks.
• A control group watching FRT videos followed by discussions over the same period. Changes in floor-rise ability and FoF will be assessed to determine the effectiveness of FRT.

Participants:

Participants will be recruited from five Otago exercise classes (a falls prevention program without FRT) in Renfrewshire. Each class will be randomly assigned to either:

• The FRT intervention group (3 classes).
• The control group (2 classes) watching videos that include an FRT demonstration. Participants will complete questionnaires (to assess FoF) and timed floor-rise tests before and after the intervention. Some may also be invited to focus groups to share their experiences with the intervention, videos and with our recruitment procedures.

Study Overview

• Status: Completed
• Conditions: Fear of Falling; Falls; Older Adults (65 Years and Older); Floor-Rise Ability; Post-Fall Recovery
• Intervention / Treatment: Behavioral: Floor-Rise Training; Behavioral: Video Demonstration

• Study Type: Interventional
• Enrollment (Actual): 61
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United Kingdom
  • Scotland
    • Glasgow, Scotland, United Kingdom, G4 0BA
      • Glasgow Caledonian University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Aged 65 or older
• Able to provide written informed consent
• Currently engaged with ROAR and attending the Otago exercise classes

Exclusion Criteria:

• Requiring a walking frame indoors to mobilise
• Have any medical condition that renders it inadvisable to descend to the floor (e.g. such as awaiting knee replacement surgery)
• Any uncontrolled medical condition requiring medical input
• BM I≥ 30 kg/m2
• Lacking capacity to consent to participate
• Unable to comprehend FRT instructions

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Floor-Rise Training Group; Participants practiced getting up from the floor using a structured approach called the Backward Chaining Method (BCM). Sessions lasted 20 minutes weekly for 5 weeks, led by an instructor.	Behavioral: Floor-Rise Training; Practicing getting up from the floor using the Backward Chaining Method (BCM) for 20 minutes per week for 5 weeks; Other Names: Backward Chaining Method
Active Comparator: Video Demonstration Group; Participants watched a 20-minute instructional video called "Upwards and Onwards", available on the NHS Inform website. The video explains how to get up from the floor safely and how to practice. It was divided into shorter sections over 5 weeks, with group discussions ensuring a total of 20 minutes per week.	Behavioral: Video Demonstration; Watching a 20-min video on floor-rise technique and over 5 weeks, with discussions. This video explains how to get up safely from the floor and how to practice.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Falls Efficacy Scale-International (FES-I)	A 16-item questionnaire that assesses concern about falling during daily activities. Scores range from 16 (no concern) to 64 (severe concern). A lower score indicates a lower fear of falling.	Baseline and 1 week following the intervention (6 weeks post-baseline).

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Timed Floor-Rise (Supine to Standing)	Time taken (in seconds) for a participant to rise independently from a supine position (lying on their back) to a standing position using a sturdy chair. Faster time indicates improved ability.	Baseline and 1 week following the intervention (6 weeks post-baseline).
Timed Floor-Rise (Sitting to Standing)	Time taken (in seconds) for a participant to rise from a sitting position on the floor to standing using a sturdy chair. Faster time indicates improved ability.	Baseline and 1 week following the intervention (6 weeks post-baseline).
Timed Floor-Rise (Kneeling to Standing)	Time taken (in seconds) for a participant to rise from a kneeling position to standing using a sturdy chair. Faster time indicates improved ability.	Baseline and 1 week following the intervention (6 weeks post-baseline).
Perceived Ability to Manage Falls (PAMF)	The PAMF is a 5-item questionnaire measuring confidence in independently recovering from a fall. Scores range from 4 to 20, with higher scores indicating greater confidence.	Baseline and 1 week following the intervention (6 weeks post-baseline).
Fear of Falling Visual Analog Scale (VAS) - Indoor	Participants mark with an "x" on a 0-100 scale measuring fear of falling indoors, with higher scores indicating greater fear.	Baseline and 1 week following the intervention (6 weeks post-baseline).
Fear of Falling Visual Analog Scale (VAS) - Outdoor	Participants mark with an "x" on a 0-100 scale measuring fear of falling outdoors, with higher scores indicating greater fear.	Baseline and 1 week following the intervention (6 weeks post-baseline).
Activity Avoidance (VAS)	Participants mark with an "x" on a 0-100 scale measuring the percentage of activities avoided due to fear of falling, with higher scores indicating greater avoidance.	Baseline and 1 week following the intervention (6 weeks post-baseline).

Collaborators and Investigators

• Sponsor: Glasgow Caledonian University
• Investigators: Study Director: Dawn A Skelton, PhD, Glasgow Caledonian University

Study record dates

Study Major Dates

• Study Start (Actual): January 15, 2024
• Primary Completion (Actual): March 1, 2024
• Study Completion (Actual): March 19, 2024

Study Registration Dates

• First Submitted: February 7, 2025
• First Submitted That Met QC Criteria: February 7, 2025
• First Posted (Actual): March 25, 2025

Study Record Updates

• Last Update Posted (Actual): March 25, 2025
• Last Update Submitted That Met QC Criteria: February 7, 2025
• Last Verified: February 1, 2025

More Information

Terms related to this study

• Other Study ID Numbers: AHP/A23/004

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: De-identified participant-level data for primary and secondary outcome measures
• IPD Sharing Time Frame: Starting 6 months after publication and ending 5 years after publication.
• IPD Sharing Access Criteria: Qualified researchers affiliated with academic institutions will be able to access the de-identified participant-level data for primary and secondary outcome measures and study protocol by contacting the principal investigator.
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No