Falls among the elderly in senior living communities pose significant risks, often leading to severe injuries, reduced mobility, and a decreased quality of life. To address this critical issue, the SUNBEAM program—Strength and Balance Exercise in Senior Living—was developed. This evidence-based program has shown remarkable success, including a 55% reduction in falls. In this blog, we explore the implementation, key findings, and broader implications of the SUNBEAM program for fall prevention in these settings.

Overview of the SUNBEAM Program

The SUNBEAM program was designed to address the high incidence of falls in senior living communities through a structured exercise regimen focusing on strength and balance. The study involved 221 participants from 16 communities in New South Wales and Queensland, with an average age of 86. Participants were divided into two groups: an exercise group receiving progressive resistance and balance training, and a usual care group.

Implementation of the SUNBEAM Program

Participants in the exercise group engaged in a comprehensive regimen that included:

• Progressive Resistance Training: Utilizing HUR’s SmartTouchTechnology, participants performed exercises on five specific machines—Adduction/Abduction, Leg Press Incline, Dip/Shrug, Leg Extension/Leg Curl, and Abdomen/Back Extension. Each session lasted one hour, conducted twice a week for 25 weeks, followed by a six-month maintenance program.
• Balance Exercises: These exercises combined complex static and dynamic standing exercises, aimed at improving postural control and overall balance.

Key Findings and Results

The SUNBEAM program yielded significant outcomes, highlighting its effectiveness in fall prevention:

• Reduction in Falls: The exercise group experienced a 55% reduction in fall rates compared to the usual care group. Notably, fewer participants in the exercise group (46%) experienced falls compared to the usual care group (69%).
• Injury Reduction: There was a significant decrease in falls involving injuries within the exercise group.
• Improvement in Physical Performance: The exercise group scored higher on the Short Physical Performance Battery (SPPB) at 12 months, indicating enhanced physical function.
• Impact on Cognitive Decline: Participants with cognitive impairments, including dementia, showed a 50% reduction in falls, a 40% reduction in multiple falls, and a 44% reduction in injurious falls.  These participants also exhibited improvements in static and dynamic balance, as well as sit-to-stand ability.
• Cost-Effectiveness: An economic analysis revealed that the SUNBEAM program could save senior living communities up to $670 per fall avoided, considering both acute and long-term costs.

Insights from Dr. Jennie Hewitt and the SUNBEAM Program’s Development

Dr. Jennie Hewitt, a key figure behind the SUNBEAM program, transitioned from a sports physiotherapy background to aged care physiotherapy. Her realization that exercise was underfunded in aged care sparked her passion to change the landscape and provide residents with access to the best care practices. The success of the SUNBEAM trial, conducted across 16 communities, has provided robust evidence supporting the benefits of resistance and balance training in reducing fall rates among the elderly.

The Importance of Balance in Fall Prevention

Balance is crucial in maintaining stability and preventing falls. It relies on the body’s ability to control posture and respond to sensory inputs from vision, vestibular, and proprioceptive systems. Aging often leads to decreased muscle strength, slower reaction times, and cognitive decline, all of which contribute to impaired balance and an increased risk of falling.

The Balance Intensity Scale (BIS)

Developed by researchers at Monash University, the Balance Intensity Scale (BIS) is a pioneering tool to assess and train balance with appropriate intensity. The BIS helps create a safe yet progressive training environment, allowing for the monitoring and advancement of balance exercises. This tool, along with resources like training videos and score sheets, is available to providers to enhance balance training among the elderly.

SUNBEAM Program's Success

The SUNBEAM program’s success underscores the critical role of structured exercise programs in fall prevention within senior living communities. By combining progressive resistance training with targeted balance exercises, the program has demonstrated substantial reductions in fall rates, injuries, and associated costs. Moreover, the inclusion of participants with cognitive impairments highlights the program’s broad applicability and effectiveness. As senior living communities continue to adopt and implement such evidence-based programs, the well-being and quality of life of older adults can be significantly improved.

The findings from the SUNBEAM program, alongside innovations like the Balance Intensity Scale, represent a significant step forward in fall prevention, offering a blueprint for future initiatives aimed at enhancing the safety and mobility of seniors in residential care settings.

Dr. Hewitt's SUNBEAM program is available as an additional module on the HUR SmartBalance.  The SUNBEAM module offers static and dynamic balance exercises, as well as specific reactive games with additional cognitive challenges.