Exercise for preventing falls in older people living in the community: an abridged Cochrane systematic Review.


Author: Sherrington C1, Fairhall N2, Wallbank G2, Tiedemann A2, Michaleff ZA2, Howard K3, Clemson L4, Hopewell S5, Lamb S5

Affiliation: <sup>1</sup>Institute for Musculoskeletal Health, University of Sydney, Sydney, New South Wales, Australia cathie.sherrington@sydney.edu.au.

<sup>2</sup>Institute for Musculoskeletal Health, University of Sydney, Sydney, New South Wales, Australia.

<sup>3</sup>School of Public Health, The University of Sydney, Sydney, New South Wales, Australia.

<sup>4</sup>Faculty of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia.

<sup>5</sup>Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.
Conference/Journal: Br J Sports Med.
Date published: 2019 Dec 2
Other:
  Pages: bjsports-2019-101512   ,  Special Notes: doi: 10.1136/bjsports-2019-101512. [Epub ahead of print]   ,  Word Count: 244  
    OBJECTIVES: To assess the effects of exercise interventions for preventing falls in older people living in the community.



SELECTION CRITERIA: We included randomised controlled trials evaluating the effects of any form of exercise as a single intervention on falls in people aged 60+years living in the community.



RESULTS: Exercise reduces the rate of falls by 23% (rate ratio (RaR) 0.77, 95% CI 0.71 to 0.83; 12 981 participants, 59 studies; high-certainty evidence). Subgroup analyses showed no evidence of a difference in effect on falls on the basis of risk of falling as a trial inclusion criterion, participant age 75 years+ or group versus individual exercise but revealed a larger effect of exercise in trials where interventions were delivered by a health professional (usually a physiotherapist). Different forms of exercise had different impacts on falls. Compared with control, balance and functional exercises reduce the rate of falls by 24% (RaR 0.76, 95% CI 0.70 to 0.81; 7920 participants, 39 studies; high-certainty evidence). Multiple types of exercise (commonly balance and functional exercises plus resistance exercises) probably reduce the rate of falls by 34% (RaR 0.66, 95% CI 0.50 to 0.88; 1374 participants, 11 studies; moderate-certainty evidence). Tai Chi may reduce the rate of falls by 19% (RaR 0.81, 95% CI 0.67 to 0.99; 2655 participants, 7 studies; low-certainty evidence). We are uncertain of the effects of programmes that primarily involve resistance training, dance or walking.



CONCLUSIONS AND IMPLICATIONS: Given the certainty of evidence, effective programmes should now be implemented.



© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.



KEYWORDS: aging/ageing; exercise; fall; functional; meta-analysis



PMID: 31792067  DOI: 10.1136/bjsports-2019-101512