Injury Epidemiology and Prevention Research

The physical activity implementation study in community-dwelling adults (PhISICAL) study: Investigating the implementation of the FaME falls prevention exercise programme


Falls are an important cause of disability and loss of independence in older age. It is thought about one in three adults, aged over 65, fall each year. In England, fall admissions account for 4 million hospital bed days each year, costing the NHS £2 billion. Falls can lead to loss of confidence, increased social isolation and severe injuries which for some people mean they must move into high cost residential care. As the number of older people is increasing in the UK, this problem is set to get worse.

A study in 2014 showed that improving the strength and balance of older people can be effective in reducing the number of falls people have.  This study looked at the effect of the Falls Management Exercise (FaME) programme.  The study showed that FaME increased physical activity levels and significantly reduced falls by 26 percent.

FaME is now recommended by NICE as an effective intervention for falls prevention but it has not been implemented widely yet across the UK.


The aim of this research was to study the implementation of FaME into routine practice in two very different areas of the East Midlands in order to understand the factors that make such a programme a success or not.


This was an implementation study using qualitative and quantitative methods to assess whether the outcomes for FaME participants were similar to those found in clinical trials, whether the fidelity of the programme was similar to that found in clinical trials and to understand what factors were important in enabling the programme to be a success. 


Findings from this study have been used to develop an implementation toolkit for commissioners and providers of the FaME strength and balance exercise programme to inform its implementation. The toolkit was launched in June 2019 and can be downloaded from the ARC store

  1. Orton E, Audsley S, Coupland C, Gladman JRF, Iliffe S, Lafond N et al. ‘Real world’ effectiveness of the Falls Management Exercise (FaME) programme: an implementation study. Age and Ageing. 2020 Nov 26.
  2. Carpenter H, Audsley S, Coupland C, Gladman J, Kendrick D, Lafond N, et al. PHysical activity Implementation Study In Community-dwelling AduLts (PHISICAL): study protocol. Inj Prev. 2019;25(5):453-8.



Presentations from the launch are available here:

The FaME Implementation Toolkit

Raising the Bar on Strength and Balance

Implementing and Evaluating the Falls Pathway Across Leicester, Leicestershire and Rutland

Study Summary

Injury Epidemiology and Prevention Research

The University of Nottingham

telephone: +44 (0) 115 846 6901