Key Takeaways

  • Physical activity is an effective way to reduce older adults' risk of falling.

  • EnhanceFitness, a program helping older adults stay active, is available in person, via interactive livestream and in hybrid formats.

  • The pandemic's pause on in-person programs led to new ways of bringing EnhanceFitness to older adults.

Physical activity is an extremely effective way to reduce the risk of falling. It is also so much more!

Being active is one of the simplest ways people can improve and maintain their health. Physical activity has been shown to reduce risk and support self-management of many chronic conditions, improve sleep, boost immune responses, and foster better mental health and general well-being.1,2,3

EnhanceFitness, an evidence-based program managed by Sound Generations and developed in collaboration with the University of Washington Health Promotion Research Center, offers a low-barrier way for individuals to stay active and improve health outcomes as they age.

“It just gives you more energy to be able to go throughout your day. And it continues. …[N]ot just:  ‘Well, the class is over so everything’s ended.’ No. Your stamina keeps up. You just have a better outlook. It’s just a good, uplifting thing to do.” -- An EnhanceFitness Participant from rural Washington state

When the pandemic paused in-person programs across the nation in March 2020, EnhanceFitness administrators, researchers, delivery organizations, leaders and participants came together to come up with adaptations to keep people moving in their homes. And in the process, we learned a lot together.

What are the benefits of Enhance®Fitness?

Now offered by hundreds of organizations across the country, class participants benefit from continuous research, evaluation and feedback from delivery organizations that inform ongoing program development.

A full hour of fun, classes focus on cardiovascular exercise, strength training, dynamic and static balance, and flexibility, meeting the Physical Activity Guidelines for Americans. The multicomponent program is proven to:

  • Improve physical function
  • Decrease depression
  • Protect against falls and fall injury
  • Provide a social benefit
  • Promote a physically active lifestyle
  • Reduce medical care utilization costs
  • Decrease unplanned hospitalizations
  • Decrease mortality rates

The participant-centered approach focuses on aging adults and adults with disabilities who might find that other fitness programs do not consider or accommodate the obstacles they may have in daily life and activity such as joint pain.

What is the relationship between arthritis, pain, and falling? 

Research shared by the Arthritis Foundation has linked joint pain to an increased falls risk: 

  • People with pain in their knee or hip were 53% more likely to fall
  • People with pain in two  joints had a 74% higher chance of falling
  • People with three to four painful joints were 85% more likely to fall4

And that pain medication? It can make you unsteady on your feet. 

How at-home workouts can help rural older adults reduce falls risk

University of Washington researchers piloting livestream EnhanceFitness prepared a toolkit for rural health care provider Arbor Health that supported their recruitment of patients with knee osteoarthritis identified through electronic health records. The toolkit included a letter to the participants, a brochure, flyers, and content for print and social media to support promoting the class.

Once enrolled, participants completed their baseline assessments in person and each received a set of cuff weights to use for their at-home workout. Support of a technical assistant during the workouts was key for troubleshooting technical challenges and monitoring safety. Findings indicated the program was feasible and acceptable, with all participants reporting they were “very satisfied” with the class. Anxiety, pain, and physical function all showed significant improvement over 12 weeks.

A larger CDC-funded study is now underway to compare in-person and livestream EnhanceFitness.5

Some early takeaways on reaching rural older adults with the livestream version of EnhanceFitness:

  • Start with a digital needs assessment survey to see if particpants have what they need to easily access the classes
  • Follow that assessment with a one-on-one orientation to give participants specific instructions
  • Be sure to have a technical assistant available to troubleshoot and give support during class time
  • Open class 10 minutes early to give participants a bit of time to socialize
  • Spotlight the instructor during the class
  • End the class in gallery view to encourage discussion

For more tips, read Remotely Delivered Exercise to Rural Older Adults With Knee Osteoarthritis: A Pilot Study

As one Enhance Fitness participant from rural Washington state said, "My wife and I started attending EnhanceFitness classes prior to COVID. When COVID hit, as soon as we had an opportunity to attend via Zoom, we took it! …

[W]e have both had surgeries which EnhanceFitness aided in the healing/recovery process. The instructor’s knowledge has been invaluable in making any needed adjustments for us and other members of the class.” 

Where can I find an EnhanceFitness class?

EnhanceFitness is offered in-person online around the country. Find a class near you.


1. National Institute on Aging. Real-Life Benefits of Exercise and Physical Activity. Found on the internet at

2. Booth FW, Roberts CK, Laye MJ. Lack of exercise is a major cause of chronic diseases. Compr Physiol. 2012 Apr;2(2):1143-211. doi: 10.1002/cphy.c110025. PMID: 23798298; PMCID: PMC4241367. Found on the internet at

3. HelpGuide. The Mental Health Benefits of Exercise. Updated August 2022. Found on the internet at

4. Doré AL, Golightly YM, Mercer VS, Shi XA, Renner JB, Jordan JM, Nelson AE. Lower-extremity osteoarthritis and the risk of falls in a community-based longitudinal study of adults with and without osteoarthritis. Arthritis Care Res (Hoboken). 2015 May;67(5):633-9. doi: 10.1002/acr.22499. PMID: 25331686; PMCID: PMC4404178. Found on the internet at

5. Harborview Injury Prevention & Research Center. Reducing Arthritis Pain by Improving Access to Group Exercise During COVID-19. University of Washington. Jan. 24, 2022. Found on the internet at