A digital exercise programme improved balance in older adults

Design

Two-arm randomised controlled trial with cost-effectiveness analysis

Population

202 community-dwelling adults aged 60 and over

Primary outcome

Balance function (Berg Balance Scale) at 12 weeks

Effect

Mean difference 6.35 points (95% CI 4.48 to 8.22) favouring the digital programme

Strength and balance exercise prevents falls, but delivering it at scale is hard. This randomised trial tested Keep-On-Keep-Up (KOKU), an NHS-approved digital exercise and falls-education programme, against standard care in 202 community-dwelling adults aged 60 and over.

At 12 weeks, KOKU improved balance on the Berg Balance Scale by a mean of 6.35 points (95% CI 4.48 to 8.22) over standard care, a clinically meaningful gain, with good retention. It was associated with lower falls-related costs and a small quality-adjusted life-year gain, giving preliminary evidence of cost-effectiveness.

The practical implication is that a digital programme can deliver the balance and strength work that prevents falls, complementing rather than replacing in-person services, and extending reach to older adults who cannot easily attend classes. It is a single trial with a 12-week horizon, so longer-term falls outcomes still need confirmation.

• Randomised trial of the NHS-approved KOKU digital programme vs standard care, 202 adults aged 60 and over.
• Balance improved by a mean 6.35 points on the Berg Balance Scale (95% CI 4.48 to 8.22) at 12 weeks.
• Associated with lower falls-related costs and a small quality-adjusted life-year gain.
• Use digital exercise to complement, not replace, in-person falls services.
• A single 12-week trial; longer-term falls outcomes need confirmation.

Why it matters

It offers a scalable way to deliver the strength and balance exercise that prevents falls, reaching people traditional services miss.

Don't overread it

A single trial with a 12-week endpoint and balance as the primary outcome; it shows improved balance and preliminary value, not a proven long-term reduction in falls.

The statistics, in plain English

A 6.35-point Berg Balance gain with the interval clear of zero is a real, clinically useful improvement; a 12-week trial shows the balance benefit but not yet whether it translates into fewer falls over the long term.

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