172 | Chapter 8 Technology An important implication for practical implementation of In Balance is the aforementioned integration of technology in fall prevention programs, which can support the chain approach of fall prevention (Figure 8.1). For instance, digital tools can be utilized for the aforementioned preliminary fall risk identification (low/medium/high fall risk), risk screenings, and remote consultations during the identifying, preparing, and screening phases (348, 349). Technology can also enhance the intervention phase itself, through telehealth platforms and mobile applications that can facilitate remote assessments and interaction with the therapist and peers (350). Additionally, technology-driven monitoring and feedback mechanisms could improve participant engagement, adherence, and outcomes (348, 350). As shown in Chapter 5 and 7, follow-up exercise programs are crucial, and technology could further support these programs. Telehealth platforms and mobile apps could enable participants to continue exercising at home, while exergames combining movement, enjoyment, and performance feedback might promote adherence to exercise among older adults (349, 351). Beyond supporting interventions, technology could also play a broader role in improving fall risk analysis. As discussed in Chapter 4, gait quality and quantity provide additional insights beyond the SPPB. Since modern smartphones and smartwatches are equipped with inertial sensors, these devices could potentially be used to assess gait performance in both clinical and daily-life settings. In addition to inertial sensors, markerless motion capture could offer potential in assessing gait performance. This could increase awareness of functional status for older adults and provide both health professionals and individuals with valuable insights into mobility and fall risk. To enhance this awareness, monitoring and (online) feedback are important, as they can help individuals recognize changes over time and encourage timely action. Although there is ongoing debate regarding the feasibility of fully online fall prevention programs, particularly due to safety concerns, research into the feasibility and safety of hybrid models (combining physical sessions with online components) may be beneficial (296, 348, 350). Such blended approaches, incorporating weekly in-person sessions in local settings with online sessions, could provide a viable alternative (296). Moreover, technology can support not only interventions but also injury prevention by improving adherence, ensuring ongoing care, and integrating innovative solutions such as hip airbags, which can offer additional protection against hip fractures during falls within the fall prevention care pathway (352). Reimbursement of fall prevention interventions A final important practical barrier that we identified is the reimbursement of fall prevention interventions (Chapters 6 and 7). For municipalities, funds are available through the Specific Allocation (SPUK) (353). The SPUK can be used for identifying older adults at risk, implementing fall-preventive physical activity interventions, coordinating the chain approach to fall prevention, and supporting other fall prevention interventions, as well as related physical
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