Trial reportAge and ageing2026
Effectiveness and cost-effectiveness of the Keep-On-Keep-Up digital falls prevention programme in community-dwelling older adults: results of a randomised controlled trial.
Trial report in Age and ageing, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Corrections and comments
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Authors and funding
15 authors.
Funding
Abstract
backgroundFalls are a leading cause of injury-related hospital admissions among older adults with substantial burden on health and social care systems. Digital exercise programmes may improve physical function at scale and complement traditional services. Keep-On-Keep-Up (KOKU) is an National Health Service (NHS)-approved digital programme offering progressive, evidence-based exercises and education on fall prevention.We aimed to evaluate the effectiveness and cost-effectiveness of KOKU for improving balance, physical function and reducing fall risk among community-dwelling older adults.
methodsA two-arm, parallel group randomised controlled trial was conducted with community-dwelling older adults (≥60 years). Participants were randomised (1:1) to receive KOKU alongside standard care (strength and balance exercise advice and a falls prevention leaflet) or standard care alone. The primary outcome was balance function at 12 weeks (Berg Balance Score). Secondary outcomes included lower limb strength, concerns about falling, falls, mood, pain, fatigue, healthcare utilisation, health-related quality of life and usability. A modified intention-to-treat approach was used to analyse effectiveness and cost effectiveness.
resultsA total of 202 older adults (mean age 76.8 years, 72.8% female) were enrolled (102 intervention; 100 control). Retention at 12-weeks was 89.1% (91 intervention; 89 control). Compared with standard care, KOKU significantly improved balance function at 12 weeks after adjusting for baseline scores (mean difference: 6.35, 95% confidence interval [CI]: 4.48, 8.22). KOKU was associated with lower mean falls related costs (incremental cost: -£62.98, 95% CI -£218.54 to £40.22) and a quality-adjusted life year gain of 0.020 (95% CI 0.003 to 0.035).
conclusionThe KOKU programme improves balance with preliminary evidence of cost-effectiveness among community-dwelling older adults. These findings support the integration of digital innovation into routine care to improve balance and strength, thereby reducing functional decline while delivering value for money.
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