SUNBEAM Falls Prevention Protocol is now available on HUR Smart Balance Platform
Sunbeam Strength and Balance exercises combined in HUR Smart Touch
Sunbeam Protocol and Research
The Sunbeam “Strength and Balance Exercise in Aged Care” protocol was created to respond to lead researcher, Dr Jennie Hewitt’s, observation on the impact of falls in residential aged care.
With 60-63 % of residents in aged care falling annually, and with 2.51 falls per person annually, a variety of exercise programs were offered to aim to reduce falls, yet there seemed to be a lack of scientific evidence for exercise programs that treated exercise as medicine, including prescribed type, dosage and frequency of exercise, consisting of strength and balance exercises.
The research questions became clear:
- Can a supervised progressive resistance training and balance group-based exercise program be more effective than usual care for prevention of falls among residents over a 12-month follow-up period.
- Can these programs result in improvements in secondary outcomes, such as quality of life, cognition, mobility, and confidence?
- Are exercise programs cost effective?
HUR Australia was excited and privileged to be a partner of the Sunbeam trial. The original research was done using a selected range of strength training equipment, that allowed for the control of training, as well as monitoring of the progress.
The individually prescribed progressive resistance and balance training program was run on 16 participating residential care sites, with 221 residents with an average age of 87 years, and up to 101 years, for 50 hours over a 25-week period, supervised by Dr Hewitt and implemented by Dr Hewitt and other registered physiotherapists, followed by a six-month maintenance program run by local care home staff.
The results of the trial changed the residential care exercise rehabilitation space. The outcome of the Sunbeam strength and balance program implementation showed:
- A 55% reduction in falls rate for the exercise group, and 50 % reduction in falls Participants with cognitive decline / dementia
- Fewer fallers in the exercise group (46%) vs the usual care group (69%)
- Improved Physical Performance measured with SPPB (Short Physical Performance Battery) also for participants with cognitive decline
- A potential cost saving of up to $670 per fall avoided for the intervention group with a potential estimated $120 million cost saving for Australian healthcare economy for the first year due to the short- and long-term benefits, if the program was rolled out nationally.
Product development – introducing HUR Smart Balance Sunbeam module
The original trial was done using HUR pneumatic strength equipment with balance exercises run as chair-based group therapy exercises. However, the implementation of the balance exercises to the HUR SmartBalance system, would also allow for the inclusion of the balance and cognitive exercises under the HUR Smart Touch umbrella, allowing for training and data control.
HUR Australia, supported by HUR Finland, worked together with Dr Hewitt to design and implement the balance exercises into the HUR Smart Balance game selection as a separate module, including a number of static and dynamic balance exercises, as well as specific reactive games with an additional cognitive challenge.
This development was done in a close collaboration with Dr Hewitt who states:
“We know that a combination of strength and balance exercise is needed to keep older people on their feet. I’m my experience, people seem to love working out on the resistance training equipment and show a real sense of pride and achievement as they progress. Achieving a therapeutic dose of high challenge balance exercise, however, has been more difficult to achieve when implementing the Sunbeam Program.
We have now developed games and activities, designed to increase engagement and participation in balance exercises, with the aim of hitting an optimal dose of both the strength and balance components required to reduce falls.”
The Sunbeam HUR Smart Balance module consists of three training series:
- Static balance
- Dynamic Balance – Rocking
- Dynamic Balance – Stepping
The static balance module trains postural stability and allows for the monitoring of centre of pressure (COP) data in eight different standing positions, progressing in difficulty from standing with feet apart, to single legged standing.
During the twenty second trial, COP data is visible to the trainee, also including a forced exit from training as a safety feature, in case the trainee’s COP has a rapid change. If the trainee feels safe after the incident, the training can continue. A score is given to every training set.
The purpose of the dynamic – rocking selection, is to practice the side lean. Initially the trainee creates the training zone, by reaching as far as possible, in three different conditions. When the zone is created, the training is completed by rocking side-to-side within the training zone.
The dynamic balance – stepping mode introduces a cognitive challenge to stepping. In the “colors” game a text states the colour that is to be matched to the colour dot appearing in one of the corners, by stepping on it.
In the first spelling game a clue of a word to be written is given. In the easy version the program gives the trainee clues of the word to be written, a function which is removed in the advanced game. Initially the words are easy four-letter words, advancing to longer words with more stepping functions.
The Sunbeam Balance module was introduced at the national Aged & Community Care Providers Association (ACCPA ) national conference in Adelaide, in October 2023, with the first installation of the module to a residential site in South Australia in November 2023.
We are very excited about this new product development, and are always happy to tell you more about any of our products.
On behalf of HUR Australia,
Dr Tuire Karaharju-Huisman
Physiotherapist, Accredited Exercise Physiologist (ESSAM), PhD (Biomechanics)
Research Lead, Area Account Manager (Vic, Tas, SA)