https://bura.brunel.ac.uk/handle/2438/32876 2026-08-31T02:59:27Z https://bura.brunel.ac.uk/handle/2438/33659 Title: Action simulation as an intervention to improve balance, mobility and gait in healthy older adults: A scoping review Authors: Grilc, Neza; Cocks, Adam; Kal, Elmar; Ellmers, Toby J; Valappil, Ashika Chembila; Bruton, Adam Abstract: Falls in older adults are a significant public health concern. Action simulation interventions involving action observation and/or motor imagery have been proposed as alternative or adjunct strategies to physical exercise for reducing fall risk. These approaches may minimize barriers to physical practice and may specifically target deficits in motor planning that are linked to falls. The purpose of this scoping review is to examine how action simulation interventions have been applied and evaluated in healthy older adults. A systematic search of six databases and repositories was conducted. Studies were included if they used action simulation interventions in healthy, community-dwelling adults aged 60+ years and examined movement outcomes related to balance, gait or functional mobility. Nineteen studies with 587 older adults were included. Motor imagery was the most common action simulation intervention (n = 11 [58%]), and most studies were randomized controlled trials (n = 14 [74%]). Only one study examined long-term effects on balance and gait performance (i.e., 1-month post-intervention). Studies varied widely in the outcomes examined, including static and dynamic balance, gait, mobility, and psychological outcomes, and reported findings were heterogeneous across studies and outcome domains. Limited reporting of intervention implementability was identified across the included studies. Overall, this review highlights the heterogeneity of how action simulation interventions have been applied and evaluated to improve balance, mobility and gait outcomes in older adults. However, if action simulation techniques are to be adopted as a fall prevention strategy, more studies examining acceptability are needed. Description: Data availability: Research Link Provided: Extracted Data (Original data: https://osf.io/64v9w/overview?view_only=4834c9d0f8944e1bb172553114914b6c) (Open Science framework) 2026-07-25T00:00:00Z https://bura.brunel.ac.uk/handle/2438/33604 Title: Move Together Buckinghamshire: protocol for a pragmatic mixed-methods evaluation of a community physical activity programme for older adults with long-term conditions Authors: Norris, Emma; Hings, Rebecca; Bailey, Daniel; Victor, Christina; Anokye, Nana; Banstola, Amrit; Korakaki, Dynameni Androulaki; Carrillo, Alejandra; Mansfield, Louise Abstract: Introduction: Physical inactivity is highly prevalent in older adults living in deprived communities, with many living with long-term health conditions. Community-based and tailored physical activity behaviour change programmes are needed to support increased physical activity in this population. This project aims to conduct a pragmatic pre-post mixed-methods evaluation of a community-based physical activity intervention (Move Together Buckinghamshire). Methods and analysis: Move Together Buckinghamshire is a 3-year community-based physical activity programme for inactive adults aged over 50 years with at least one long-term health condition living in deprived areas of Buckinghamshire, England. Across the 12-week programme, users will receive: (i) one 45-minute in-person one-to-one consultation with a Physical Activity Referral Specialist (PARS), (ii) three check-in contacts with their allocated PARS taking place by email, phone or text and (iii) access to an online platform to identify and book physical activity opportunities in their local area. The programme’s recruitment target is 3000 service users over the 3-year programme. This pragmatic evaluation will assess the first 18 months of programme delivery using a mixed-methods design. A quantitative outcome evaluation will be conducted for secondary data routinely collected within the programme to assess the primary outcome of physical activity (using the single-item physical activity measure), and secondary outcomes of health-related quality of life, loneliness and confidence to engage in physical activity (assessed at baseline, during and at the end of the 12-week programme and at 6-month and 12-month follow-up). A qualitative process evaluation will use focus groups and interviews with service users and interviews with PARS staff delivering the programme and strategic decision-makers. An economic analysis will be undertaken to estimate the resources and costs required to design, set up and deliver the Move Together Buckinghamshire. Ethics and dissemination: This study has been approved by the College of Health, Medicine and Life Sciences Research Ethics Committee at Brunel University of London. Informed written consent will be obtained from all participants of the evaluation. Results will be disseminated in peer-reviewed publications, scientific conferences, reports, webinars and through local community outlets. Registration details: This study has been preregistered on Open Science Framework: https://doi.org/10.17605/OSF.IO/EV24C Description: Data statement: Anonymised raw data collected in this study will be uploaded to Brunel Figshare and Open Science Framework.; Public health protocol. 2026-07-31T00:00:00Z https://bura.brunel.ac.uk/handle/2438/33574 Title: Clinical and cost-effectiveness of the iStep-MS physical activity and sedentary behaviour intervention for managing fatigue in people with multiple sclerosis: protocol for a multicentre randomised controlled trial Authors: Bailey, DP; Norris, E; LeWarne, MD; Cerexhe, L; Anokye, N; Banstola, A; Gwatsvaira, J; Norris, M; Ryan, M; Stuart, B; Thomson, A; Kilbride, C Abstract: Introduction: Regular physical activity and limiting sedentary behaviour are important aspects in managing multiple sclerosis (MS). Fatigue is a common and disabling symptom in MS, contributing to impairments in activities of daily living and poorer quality of life. This study aims to determine the effectiveness of a physical activity and sedentary behaviour intervention, called iStep-MS, for reducing fatigue in people with MS when delivered across the MS care pathway. Methods and analysis: This is a multicentre, two-arm randomised controlled superiority trial with embedded economic and process evaluations. The study will take place across South-East England in acute and community National Health Service settings and charity-funded MS and neurological therapy centres. Intervention deliverers will include a range of healthcare staff such as physiotherapists, occupational therapists, therapy assistants, nurses and exercise therapists. A target sample size of n=198 participants will be randomised 1:1 to the intervention (iStep-MS behaviour change intervention plus usual care) or control (usual care only) arms. Participants will be adults with any type of MS, experiencing MS-related fatigue, relapse-free for >3 months, with a Self-Reported Disability Status Scale category of ≤3.5 (no disability to moderate disability) or 4–6.5 (significant disability). The iStep-MS intervention includes four one-to-one consultation sessions in-person or online with an intervention deliverer over 3 months, incorporating behaviour change techniques aimed at increasing physical activity and reducing sedentary behaviour. The consultations are supported by a handbook designed to help individuals with MS set goals and achieve behavioural changes and a wearable activity tracker for self-monitoring. Outcomes (assessed at baseline, 3 months and 9 months) include self-reported fatigue, quality of life, MS-impact, walking capability, pain, self-efficacy and waist circumference. Sitting, standing and stepping will be measured over 8 days using the activPAL4 device. A process evaluation will assess intervention acceptability, adherence and fidelity, including questionnaires and focus groups with participants and deliverers. A cost-effectiveness analysis will evaluate the value for money of the intervention against usual care. Ethics and dissemination: Ethical approval has been granted by the NHS London—Bloomsbury Research Ethics Committee (reference 25/LO/0272). Results will be disseminated in scientific journals, conferences and to the wider public (eg, newsletters and social media). Trial registration number: ISRCTN16944301. Description: Data access statement: Datasets generated and/or analysed during the current study will be stored in a publicly available repository: https://brunel.figshare.com/. Quantitative data will be made available for a minimum of 10 years following data analysis. To protect participant confidentiality, supporting focus group transcripts will not be made publicly available.; Supplemental materials are available online at https://bmjopen.bmj.com/content/16/7/e121358#DC1, https://bmjopen.bmj.com/content/16/7/e121358#DC2, https://bmjopen.bmj.com/content/16/7/e121358#DC3, and https://bmjopen.bmj.com/content/16/7/e121358#DC4. This content has been supplied by the author(s). 2026-07-20T00:00:00Z https://bura.brunel.ac.uk/handle/2438/33482 Title: Action Simulation as an Intervention to Improve Balance, Mobility and Gait in Healthy Older Adults: A Scoping Review Authors: Grilc, N; Cocks, A; Kal, E; Ellmers, TJ; Chembila Valappil, A; Bruton, AM Abstract: Falls in older adults are a significant public health concern. Action simulation interventions involving action observation and/or motor imagery have been proposed as alternative or adjunct strategies to physical exercise for reducing fall risk. These approaches may minimize barriers to physical practice and may specifically target deficits in motor planning that are linked to falls. The purpose of this scoping review is to examine how action simulation interventions have been applied and evaluated in healthy older adults, and assess their effectiveness in improving balance, mobility, and gait. A systematic search of six databases and repositories was conducted. Studies were included if they used action simulation interventions in healthy, community-dwelling adults aged 60+ years and examined movement outcomes related to balance, gait or functional mobility. Nineteen studies with 587 older adults were included. Motor imagery was the most common action simulation intervention (n = 11 [58%]), and most studies were randomized controlled trials (n = 14 [74%]). Only one study examined long-term effects on balance and gait performance (i.e., 1-month post-intervention). The examined outcomes varied widely, including static and dynamic balance, gait, and mobility. Most interventions (n = 17 [71%]) reported significant improvement in at least one domain, but findings were inconsistent across studies, and none assessed intervention implementability. Overall, this review highlights some promising effects of action simulation on balance, mobility and gait in older adults. However, if action simulation techniques are to be adopted as a fall prevention strategy, more studies examining acceptability are needed. Description: A preprint version of the article is available at PsyArxiv (https://osf.io/rt4jw_v2). It has not been certified by peer review. 2026-06-02T00:00:00Z