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Icon: Exercise-based interventionsExercise-based Interventions: Stay Safe, Stay Active

Barnett, et al.

This study used weekly structured group sessions of moderate-intensity exercise, held in community settings, with additional exercises performed at home. Participants were 40 percent less likely to fall and one-third less likely to suffer a fall-related injury compared with those who did not receive the intervention.


Participants were individuals at risk for falling because of lower limb weakness, poor balance, and/or slow reaction time. All were aged 67 or older and lived in the community. About two-thirds of participants were female.

Geographic Locale

Southwest Sydney, Australia


Improve balance and coordination, muscle strength, reaction time, and aerobic capacity.

Program Setting

Classes were conducted in local indoor lawn bowling and sports clubs that hosted community programs for various sports and exercise activities, comparable to United States. community exercise, sports, and recreation facilities. Many lawn bowling and sports clubs also included other indoor attractions such as restaurants, meeting facilities, and movies.


The classes were designed by a physical therapist to address physical fall risk factors: balance and coordination, strength, reaction time, and aerobic capacity. Each class began with 5 to 10 minutes of warm-up that included stretching of the major lower limb muscle groups and 10 minutes of cool-down that included gentle stretching, relaxation, and controlled-breathing practice. Each class included music chosen by the participants.

The classes included the following types of exercises:

  • Balance and coordination exercises, including modified Tai Chi exercises, practice in stepping and in changing direction, dance steps, and catching and throwing a ball
  • Strengthening exercises, including exercises that used the participant’s weight (e.g., sit-to-stand, wall press-ups) and resistance-band exercises that worked both upper and lower limbs
  • Aerobic exercises, including fast-walking practice with changes in pace and direction

As the classes progressed, the complexity and speed of the exercises and the resistance of the bands were steadily increased.

Participants also took part in a home exercise program using content from the exercise class and recorded their participation in a home exercise diary.


A total of 37 1-hour classes were conducted once a week over a 1-year period.

Delivered by

Nationally accredited exercise instructors who had been trained to conduct this exercise program by a licensed physical therapist (accredited by Australia’s National Association for Gentle Exercise). The study used currently accredited exercise leaders who already had a good understanding of the exercise principles.

Before classes began, regular meetings were held with the exercise leaders to discuss the content and how the classes would be run, giving leaders ownership in the program. Training included approximately 6 hours of additional meetings, discussion, and practice sessions before beginning the program. During the classes, instructors were visited by the physical therapist for support once each term.

Minimum Level of Training Needed

Information was not provided by the principal investigator.

Key Elements

  • This study used health practitioners to assess and recruit participants. General practitioners are in an ideal position to both identify older people at risk of falls and to support their participation in an exercise program when appropriate.
  • The program used existing services and facilities in the community, so it is likely to be sustainable and transferable to other settings.

Available Materials

In addition to the guidance received during the exercise sessions, participants received:

  • A home exercise program based on class content*
  • A “hot tips” sheet listing practical strategies for avoiding falls such as where to place hands and feet if a loss of balance occurs*

* See Appendix D-1.

Study Citation

Barnett A, Smith B, Lord S, Williams M, Baumand A. Community-based group exercise improves balance and reduces falls in at-risk older people: A randomized controlled trial. Age and Ageing. 2003 Jul;32(4):407-14.


Practitioners interested in using this intervention may contact the principal investigator for more information:

Anne Barnett, MPH
Physiotherapy Department
Bankstown Hospital, Locked Mailbag 1600
Bankstown NSW 2200, Australia
Tel: +61 (9) 722 7154
Fax: +61 (9) 722 7125

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