E-health StandingTall balance exercise for fall prevention in older people: results of a two year randomised controlled trial.

Falls are a major concern for older adults living independently, and finding exercise programmes people will actually keep doing at home is a persistent challenge. This trial compared a home-based, app-delivered balance exercise programme called StandingTall against a health-education-only control over two years in people aged 70 and older. At 12 months, the primary outcomes, how often people fell and the proportion who fell, were not statistically different between groups.

Over the full two years, however, the exercise group had a statistically significant 16% lower rate of falls and fewer people experiencing an injurious fall, while the proportion who fell at all did not differ significantly. Balance and quality-of-life measures showed some early improvements. The main limitation is that the headline 12-month result was null, and the positive two-year findings were secondary outcomes that emerged only with longer follow-up, so the benefit should be read cautiously rather than as a clearly established effect.

If you're an older adult wondering whether a phone or tablet-based balance exercise app could help prevent falls, this study offers a mixed but somewhat encouraging picture. Researchers followed over 500 people aged 70 and older for two years, comparing those doing a home exercise programme called StandingTall with those who only received health education.

After the first year, there wasn't a statistically significant difference in how often people fell or how many fell, so we can't say the programme clearly worked at that point. But by two years, the exercise group had a lower rate of falls overall, and fewer of them had falls that caused injury, compared to the education-only group. Balance also improved somewhat in the exercise group at six and twelve months.

Because the clearest benefits appeared only after two years and were secondary findings rather than the study's main question, these results should be seen as promising but not conclusive.

This is a summary of research, not medical advice. Talk to your own healthcare provider about anything affecting your care.

This trial addresses whether a self-managed, app-delivered balance exercise programme can meaningfully reduce falls in independently living older adults, a question relevant to scaling fall prevention beyond supervised clinic-based models. Across 503 participants randomised to StandingTall plus health education versus health education alone, the primary 12-month outcomes (fall rate and proportion who fell) showed no statistically significant between-group difference, though the fall rate trended lower in the intervention group.

Over 24 months, a secondary analysis found a statistically significant 16% lower fall rate and a 20% lower proportion with injurious falls in the intervention group, alongside measurable gains in standing balance at 6 and 12 months and a small improvement in quality-of-life utility score at 6 months. These findings inform expectations about e-health exercise interventions: benefits for fall rate and injury reduction may take longer than 12 months to emerge and were not reflected in the proportion of people who fell at all, which never reached significance at either timepoint. Since the primary endpoint was null and the positive results are secondary and accrued only with extended follow-up, this does not establish that StandingTall reliably prevents falls, and the trial does not clarify why the 24-month fall-rate effect appeared without a parallel change in how many individuals fell at least once.

Adherence data (around half to two-thirds of participants reaching roughly two hours per week) also suggest real-world engagement challenges with self-managed programmes.