Impact of Multicomponent Home-Based Exercise on Fear of Falling in Older people with a History of Falls: Insights from the GAITCARE Project

Elisabet Huertas-Hoyas¹Marta Neira Álvarez^2*Agustín Curiel-Regueros²Luisa Ruiz-Ruiz^3,4Rafael García-Molina⁵Cristina Alonso Bouzón⁶Eva Rincon Herrera⁶Sara García De Villa⁷Antonio R. Jiménez-Ruiz^3,4

• ¹Universidad Rey Juan Carlos Departamento de Fisioterapia Terapia Ocupacional Rehabilitacion y Medicina Fisica, Alcorcón, Spain
• ²Fundacion para la Investigacion e Innovacion Biomedica Hospital Universitario Infanta Leonor y Hospital Universitario Sureste, Madrid, Spain
• ³Centro de Automatica y Robotica, Madrid, Spain
• ⁴Fundacion General CSIC, Madrid, Spain
• ⁵Hospital Universitario Nuestra Senora del Perpetuo Socorro, Albacete, Spain
• ⁶Fundacion para la Investigacion Biomedica del Hospital Universitario de Getafe, Getafe, Spain
• ⁷Universidad Rey Juan Carlos Escuela Superior de Ciencias Experimentales y Tecnologia, Móstoles, Spain

Aims: To compare the effectiveness of an 8-week multicomponent exercise program delivered at home with digital support versus conventional in-person hospital exercise sessions in reducing FOF. Materials and methods: The GAITCARE project is a multicenter quasi-experimental trial in three hospitals. Participants were assigned by hospital to either: (1) VIVIFIL App group—individualized daily home exercise with remote supervision; or (2) In person group—face to face exercise at hospital day-care units. The primary outcome was FOF measured by the Short Falls Efficacy Scale–International (Short FES-I). Secondary outcomes included adherence and app satisfaction. Results: 127 participants were included (64 in App group, 63 in-person group), aged 70–93 (mean 82.36). FOF (SFES-I) was present in 68.3% of the in-person group and 54.7% of the App group. The 8-week intervention reduced FOF scores in both groups, reaching statistical significance only in the in-person group. However, the App group also showed a clinically relevant reduction (~20%) despite starting with slightly lower baseline FOF, suggesting potential benefits of remote delivery. . The in-person group showed higher adherence at weeks 4, 8, and 12 (follow-up). Baseline physical activity influenced adherence, with sedentary participants showing lower adherence. Digital delivery with remote supervision showed good feasibility and was generally well accepted by participants. Conclusions: FOF is prevalent in older adults with falls and can be significantly reduced by face-to-face group exercise, which also achieves higher adherence. Enhancements in telematic applications are necessary to improve adherence in digital interventions targeting FOF.