Case study: Falling Past Time, the Netherlands
Falling Past Time (Vallen Verleden Tijd) is a five-week exercise programme for adults with a history of falls who live at home.
What does the programme involve?
Falling Past Time involves a range of balance and coordination exercises, which are integrated into an obstacle course to simulate daily life.1 While the original programme was not aimed at people with severe musculoskeletal conditions,1 a multidisciplinary team has since developed a version that is safe for people with osteoporosis.2
What has the programme achieved?
Falling Past Time has significantly reduced the risk of falls among people with osteoporosis:
- Clinical trials have found that the programme reduced falls among people with osteoporosis by 39%.2
- It remains effective in real-world settings when delivered by trained physiotherapists, reducing falls among older people by 32%.3
The programme has now been widely adopted. It is one of five falls prevention programmes recommended by the Ministry of Health, Welfare and Sport,4 and a two-day training course is available for healthcare professionals who want to deliver the intervention in their own practice.5
What lessons can be learnt from this programme?
Well-coordinated exercise programmes can significantly reduce falls, a major cause of fragility fractures among people with osteoporosis, and large-scale implementation of falls prevention programmes is feasible. When physiotherapists or other healthcare professionals are trained to deliver them, these programmes can be rolled out widely, ensuring access for people at risk of falls and potentially reducing the number of fragility fractures in the population.
The information in this case study is based on research conducted for the 2020 publication Osteoporosis and fragility fractures: a policy toolkit.
- Weerdesteyn V, Rijken H, Geurts ACH, et al. 2006. A Five-Week Exercise Program Can Reduce Falls and Improve Obstacle Avoidance in the Elderly. Gerontology 52(3): 131-41
- Smulders E, Weerdesteyn V, Groen BE, et al. 2010. Efficacy of a Short Multidisciplinary Falls Prevention Program for Elderly Persons With Osteoporosis and a Fall History: A Randomized Controlled Trial. Arch Phys Med Rehabil 91(11): 1705-11
- Weerdesteyn V, Smulders E, Rijken H, et al. 2009. Preserved Effectiveness of a Falls Prevention Exercise Program After Implementation in Daily Clinical Practice. J Am Geriatr Soc 57(11): 2162-64
- National Institute for Public Health and the Environment. Interventieoverzicht Valpreventie. Available from: https://interventies.loketgezondleven.nl/interventieoverzicht2/Valpreventie [Accessed 01/09/20]
- Dutch Institute of Allied Health Care. Nijmegen Falls Prevention Program (Vallen Verleden Tijd). Available from: https://www.npi.nl/cursussen-en-opleidingen/611-verdiepingscursus-vallen-verleden-tijd [Accessed 01/09/20]