NIHR ARC NWC 2023 intern Michelle Thirlwall, who is based within the Integrated Musculoskeletal, Pain and Rheumatology Service (IMPReS) at East Lancashire Hospitals NHS Trust (ELHT), is aiming to identify the main reasons why patients over the age of 60, who are at risk of falls, continue to engage or not with their balance and strength exercises provided by Musculoskeletal (MSK) Physiotherapists.

Michelle, who works alongside the ARC NWC Improving Population Health and Patient Centred Complex Care themes, said: “One in three over 65 and one in two over the age of 80 will fall at least once a year, costing the NHS 2.3 billion. Locally in the East Lancashire area, A and E attendances due to falls and hip fractures are above national average.”

“MSK physiotherapists receive patient referrals of soft tissue injuries or fractures post falls, and 30% of our caseload are over the age of 60. Previous research has suggested that balance and strength exercises have been shown to reduce the risk of falls by 24%, 35% if adding on resistance work. Additional research has also shown that in the over 70s, 66% had not participated in group exercise and 78% had not completed home exercises, in the last 5 years.”

This key research project which is entitled ‘The barriers and facilitators to exercise engagement in people over 60 at risk of falls: an exploratory study,’ is being undertaken as there is a notable absence in this research area for people over the age of 60 who live in the North West.

Secondary aims of the research project include highlighting any patient preferences, concerns or health inequalities that exist with exercising or falling. It will also involve looking at communication with health professionals about their risk of falls and exercises.

Michelle highlighted, “The World Health Organization has highlighted frailty as a national priority and this research may contribute toward exercise compliance and sustainability in the future.

It may also contribute to the development of falls pathways in MSK Physiotherapy and ELHT, including earlier identification and management of patients at risk of falls and proactively embed a positive patient safety culture, with an aim of every health professional screening for risk of falls in suitable patients effectively.”

When asked how members of the public and patients have been consulted in the development project Michelle said: “I have a Patient and Public Involvement group, including members over the age of 70, at risk of falls. They have been a crucial part of the research process as they have identified exercise to reduce falling to be important, as well as reviewing my patient facing documents and protocol so far. They will continue to be involved in the dissemination of the results.”

Michelle is currently going through the Ethics stage of her project with both the NHS and University of Central Lancashire (UCLAN) and is aiming to recruit as wide a sample as possible to help her identify any health inequalities from a range of perspectives from participants in interviews.

“Following the completion of the internship, I have just been successful in gaining a two-year research scholarship with NIHR CRN GM, which means I can continue to develop my research through a combination of training, time and networking opportunities, alongside my MSK clinical role. A personal aim is also to increase the profile of research and its importance in clinical effectiveness and safety in the NHS. I am excited to see where my research career goes, and am fortunate to be working alongside the ELHT research and development team, as well as NIHR CRN GM, NIHR ARC NWC, and University of Central Lancashire’s Professor Liz Lightbody and Professor Louise Connell.”

Watch a video about Michelle providing an overview of her project here:

If you would like to learn more about Michelle’s work please use: Michelle.Thirlwall@elht.nhs.uk

View Michelle’s poster here: