Citation: Arena, S.K., Wilson, C.M., Boright, L. et al. Impact of the HOP-UP-PT program on older adults at risk to fall: a randomized controlled trial. BMC Geriatr 21, 520 (2021).

Reduced falls and fall risks have been observed among older adults referred to the HOP-UP-PT (Home-based Older Persons Upstreaming Prevention-Physical Therapy) program. The purpose of this study was to describe outcomes of HOP-UP-PT program participants and then to compare these outcomes to non-participants. 

Six Michigan senior centers referred adults ≥ 65 years who were at-risk for functional decline or falls. 144 participants (n=72 per group) were randomized to either an experimental group (EG) or a control group (CG). Physical therapists (PTs) delivered physical, environmental, and health interventions to the EG over nine encounters (six in-person, three telerehabilitation) spanning seven months. The CG participants were told to continue their usual physical activity routines during the same time frame. Baseline and re-assessments were conducted at 0-, 3-, and 7-months. Descriptions and comparisons from each assessment encounter were analyzed. 

Participants ages were: EG = 76.6 (7.0) years and CG = 77.2 (8.2). While no significant differences were identified in the survey outcomes or home environment assessments, difference were identified in common fall risk indicators including the Timed Up and Go (P=0.04), Four Test Balance Scale (P=0.01), and the Short Physical Performance Battery (P=0.02) at the 3-month assessment visit. For individuals at a moderate/high fall risk at baseline, 47.8% of CG reported falling at seven months; whereas, only 6.3% of EG participants meeting the same criteria reported a fall after HOP-UP-PT participation. 

A prevention-focused multimodal program provided by PTs in older adults’ homes proved beneficial and those with the highest fall risk demonstrated a significant decrease in falls. A collaboration between PTs and community senior centers resulted in upstreaming care delivery that may reduce both the financial and personal burdens associated.