Pilot evaluation of the Lifestlye-Integrated Functional Exercise Program as a falls prevention intervention for older people with vision impairment.

The LiFE program is a structured approach to improving the balance and strength of people at high risk of falls. The program is designed in such a way that participants incorporate the 8 balance and 7 strength activities into their daily lives and routines to gradually form habits (Clemson, Munro, Fiatarone Singh 2013). Lally and Gardner (2011) argue that habit formation is largely dependent on repetitive behavior being conducted in a consistent environment. Participants of the LiFE program are taught these activities within their own home thus maintaining the consistency of the environment (Clemson et al 2012; Lally and Gardner 2011). Additionally daily routines provide the ‘cue’ that participants need to promote the performance of the activity (Lally and Gardner 2011). The balance activities are the tandem stand, tandem walking, one-leg stand, leaning from side-to-side, leaning forwards and backwards, stepping over objects, stepping over objects sideways and stepping in different directions. The strength activities aim to increase the load on the legs and include; bending knees, sit to stand, standing on toes and heels, walking up stairs, walking sideways and tightening muscles (Clemson, Munro, Fiatarone Singh 2013). These activities will be taught by Orientation and Mobility Instructors employed by Guide Dogs NSW/ACT. These instructors are familiar in working with the vision impaired population and will thus appropriately tailor these activities to the needs of the participants. The LIFE program will be conducted over 5 home visits (with one each week) as well as 2 booster visits and 2 phone calls (one each fortnight as the participant becomes more familiar with the program) over the course of 3 months. It is expected that each of the 5 home visits will be conducted over an hour, whereas the booster visits and phone calls should not take longer than half an hour. Overall the duration of the program is 3 months. However there will also be a follow up assessment at the end of the 3 month period and at 12 months from the baseline assessment, to measure any improvements to the participants’ balance and strength abilities. Thus the total duration of the study is 12 months.