In a groundbreaking development, the national TOP UP clinical trial, a collaboration between University of Sydney researchers and aged care providers, has demonstrated significant improvements in mobility and fall prevention among elderly participants. The trial, which was recently published in the Medical Journal of Australia, highlights the potential of telehealth physical therapy programs, particularly in regional and rural areas with limited access to physical therapists.
The study’s first author, Dr. Rik Dawson, emphasized the trial’s success, stating, “As a physical therapist, I see many older patients who have gradually lost strength and mobility over time and are afraid to return to regular exercise for fear of falling. Over six months, this program helped people to walk better and fall less.”
Key Findings of the TOP UP Trial
The trial involved 242 individuals aged 65 and older across 27 sites in Australia, with an average participant age of 82 years. Notably, 47% of participants had mild-to-moderate cognitive impairments, including dementia. The trial’s results were compelling:
- Improved Mobility: Participants’ ability to stand up and walk improved by more than 2 points on a standard 12-point test used by physical therapists.
- Reduced Falls: About 1 in 3 participants experienced a fall, compared to nearly 1 in 2 in the control group receiving standard physical therapy care.
- Decreased Pain: Participants reported a 1-point reduction on the 10-point pain scale.
- Enhanced Quality of Life: Quality of life improved by 6 points out of a 100-point scale, reflecting better daily comfort, confidence, and activity levels.
- High Recommendation Rate: An impressive 94% of participants would recommend the program to others.
Innovative Approach to Elderly Care
The trial’s success is attributed to the innovative combination of expert advice from physical therapists via video consultations and in-person support from care workers or family members. This approach created a safe and accessible environment for seniors to exercise, improve mobility, and regain independence.
Professor Cathie Sherrington, senior author of the study, remarked, “We saw remarkable improvements across multiple measures of health and quality of life from people who undertook the TOP UP program, and 94% of participants would recommend it to others.”
Professor Sherrington added, “Australia is in desperate need of more qualified health care professionals who can help our aging population, particularly in rural and regional towns, access the care they need to live life comfortably, confidently, and independently. TOP UP helps bridge that gap and we’re excited to continue building on these strong results.”
Personal Stories and Future Prospects
One of the program’s early participants, Rita, a 95-year-old resident of Sydney’s Inner West, shared her positive experience. “Because of my health, there’s no way I can go out to see a physical therapist,” she said. “I think TOP UP is fabulous. I wouldn’t have imagined that I would be given the opportunity to get physical therapy. Physically, I can walk further. My breathing is better. I’m stronger, and it gives you more independence.”
The trial’s promising results have prompted Dr. Dawson to begin the process of commercializing the research. The team is also working with industry partners, including Whiddon, Uniting AgeWell, Ashfield Baptist Homes, and Maranatha House, to expand the TOP UP program and make it accessible to more aged care residents.
Implications for Aged Care in Australia
This development comes at a time when more than one-third of people over 70, and most people over 85, live with a mobility-related disability. The TOP UP program offers a scalable solution to address the shortage of healthcare professionals in rural and regional areas, providing elderly individuals with the care they need to maintain an active and independent lifestyle.
As the researchers continue to refine and expand the program, the potential for telehealth physical therapy to transform aged care in Australia is becoming increasingly evident. With the success of the TOP UP trial, the future looks promising for seniors seeking to improve their mobility and quality of life.
