Testing an exercise and pain education program for falls in older adults with long-term pain

Chronic musculoskeletal pain is common in older adults and is associated with reduced mobility, loss of function, poorer quality of life, fear of movement, fear of falling and a higher risk of falls. Exercise programmes are effective in preventing falls, but very few programmes combine fall-prevention exercise with pain self-management, including pain science education, for older people who live in the community and have both chronic pain and an increased risk of falling.

The goal of this pilot randomised controlled feasibility trial is to find out whether it is feasible, acceptable and safe to deliver a 12-week supervised group programme (MovePainFall) that combines multicomponent exercise with pain science and fall-prevention education, compared with a control group that maintains usual activities, in community-dwelling adults aged 65 years or over with chronic musculoskeletal pain (lasting 3 months or more).

The main questions it aims to answer are:

• Is it feasible to recruit, randomise, retain and engage participants (recruitment rate, eligibility, adherence, retention) and is the programme safe and acceptable?
• What are the preliminary effects of the programme on mobility, balance, lower-limb strength, dual-task performance, pain intensity and interference, fear of falling, fear of movement and quality of life?

Researchers will compare the MovePainFall group with the control group to estimate feasibility parameters and preliminary effect sizes that will inform the design and sample size of a future full-scale randomised controlled trial.

Participants in the MovePainFall group will:

• attend three supervised 60-minute group exercise sessions per week for 12 weeks (warm-up, strength and power, challenging balance, motor-cognitive dual-task training, functional gait and daily-living tasks, relaxation);
• attend one additional 30-45-minute group education session per week on pain neuroscience, pain self-management and fall prevention.

Participants in the control group will maintain their usual activities and routine health care and may be invited to attend the programme after the post-intervention assessment (waiting list).

All participants will be assessed by blinded assessors before randomisation and after the 12-week intervention period.