Telehealth physiotherapy to deliver exercise in aged care settings.

Abstract

This thesis addresses critical gaps in evidence regarding fall prevention and mobility enhancement for older individuals, particularly those in aged care settings. It highlights the need for effective prevention strategies due to the health risks and economic burdens associated with falls among older adults. Challenges like funding constraints and workforce shortages hinder access to exercise in aged care. Telehealth emerges as a potential solution, but its implementation in aged care remains limited.

The thesis reviews existing evidence on fall prevention interventions, including telehealth-delivered exercise programs. It explores an Intervention Component Analysis to understand the components contributing to the success of fall prevention interventions in residential aged care. The research explores the co-design process of a telephysiotherapy program, emphasising stakeholder collaboration to tailor interventions to users' needs.

The TOP UP trial, a randomised controlled trial of telephysiotherapy, aims to improve mobility, reduce falls, and enhance quality of life among older adults in aged care. Findings indicate high feasibility and acceptance of telephysiotherapy, suggesting its potential for widespread adoption.

Qualitative insights highlight the positive impact of tailored physiotherapy and local support on exercise motivation and independence among aged care recipients. Sustained organisational commitment, training, and external funding are crucial for the successful implementation of telephysiotherapy programs in aged care settings.

If the TOP UP trial proves effective, the implementation findings of this thesis will provide valuable insights for policymakers, healthcare providers, and aged care services, aiming to enhance healthcare accessibility and improve the quality of life for older individuals. Future research should focus on large-scale studies to further explore telephysiotherapy's effectiveness and scalability in diverse aged care populations.