Remote fall prevention training for community-dwelling older adults: comparison with face-to-face and effect of delivery sequence-A randomized controlled trial

Objectives This study compared the effects of remote versus face-to-face fall prevention training, assessed the impact of sequence in a combined-modality program (remote-first versus face-to-face first), and evaluated improvements 6 months post-intervention. Methods In this randomized controlled trial, community-dwelling adults (65+) were randomized into face-to-face or remote Otago-based training for 3 months, then switched modalities for another 3 months. Outcomes included adherence, satisfaction, adverse events, physical tests, self-reported measures and falls, assessed at baseline, 3, 6, and 12 months. Results Face-to-face training led to greater short-term improvements in BBS and Sit-to-Stand scores (p = 0.04, 0.01); however, these differences diminished post-modality transition, indicating no sequence effect. Physical gains were partly maintained at follow-up. No significant group difference in fall outcomes was observed (RR = 1.11, p = 0.66). Attendance and satisfaction were similarly high. Two non-severe falls per modality occurred during training. Conclusions Remote training is acceptable and safe for community-dwelling adults. Combined-modality programs incorporate the advantages of remote and face-to-face. Trial registration ClinicalTrials.gov registration number NCT05018455.