Innovation in action Keep On, Keep Up Meet the digital programme supporting the health of older adults

Whilst Professor Emma Stanmore was working as an NHS District Nurse, she saw a lot of complex issues related to supporting older adults to remain independent at home.

Whilst Professor Emma Stanmore was working as an NHS District Nurse, she saw a lot of complex issues related to supporting older adults to remain independent at home.

At the top of this list of challenges was the risk of falling. Currently, one in three people over the age of 65, and one in two over 80, are likely to fall each year. The cost of this to UK healthcare is estimated to be more than £4.4 billion, as it often leads to poor health outcomes for those involved. Amongst the most common serious injuries are hip fractures, with 50% of patients never regaining their former mobility and 30% dying within a year.

Having been involved in several projects aimed at reducing falls, as both an NHS nurse and University of Manchester academic, Professor Emma Stanmore decided she could put her experience into something that would be more effective for older people to use at home. From this idea, KOKU was founded.

KOKU, short for ‘Keep On, Keep Up’, is a digital programme which can be downloaded as an app onto a Tablet or iPad. The programme takes twelve weeks to release all of the exercises (the KOKU research suggests it takes around six weeks to significantly improve your balance), and whilst it isn’t intended to replace the role of health specialists, the KOKU team are aiming to fill some of the gaps that currently exist in health systems.

A recent controlled trial showed that KOKU improved strength, balance, confidence and quality of life after twelve weeks. KOKU combines the exercises with gamified awareness-raising modules around areas like hydration and bone health to decrease the chances of fall-related fractures and medical interventions (like ambulance callouts). As data suggests that KOKU's underlying strength and balance exercises reduce falls by at least 23%, with more challenging balance exercises increasing this to 40%, it’s currently the most effective digital programme in the UK aimed at reducing fall risk.

KOKU is being used in communities, hospitals and care homes by healthcare professionals, but is also available on app stores for people to follow at home (their oldest participant so far has been a 102-year-old).

In the longer term, they're aiming for the programme to be deployed throughout the NHS and would love to scale globally. As Professor Stanmore notes, "I don't think there's anything else out there which is combining exercise with this variety of health literacy games. It's the first gamified healthy ageing digital programme.”