Author: Kumar A1, Delbaere K2, Zijlstra GA3, Carpenter H1, Iliffe S4, Masud T5, Skelton D6, Morris R4, Kendrick D1
Affiliation: <sup>1</sup>Division of Primary Care, University of Nottingham, Nottingham, UK.
<sup>2</sup>NeuRA, University of New South Wales, New South Wales, Australia.
<sup>3</sup>Department of Health Services Research, Maastricht University and CAPHRI School for Public Health and Primary Care, Maastricht, The Netherlands.
<sup>4</sup>Research Department of Primary Care and Population Health, University College London, London, UK.
<sup>5</sup>Nottingham University Hospitals NHS Trust, Nottingham, UK.
<sup>6</sup>Institute of Allied Health Research, Glasgow Caledonian University, Glasgow, UK.
Conference/Journal: Age Ageing.
Date published: 2016 May
Other:
Volume ID: 45 , Issue ID: 3 , Pages: 345-52 , Special Notes: doi: 10.1093/ageing/afw036. , Word Count: 262
OBJECTIVE: to determine the effect of exercise interventions on fear of falling in community-living people aged ≥65.
DESIGN: systematic review and meta-analysis. Bibliographic databases, trial registers and other sources were searched for randomised or quasi-randomised trials. Data were independently extracted by pairs of reviewers using a standard form.
RESULTS: thirty trials (2,878 participants) reported 36 interventions (Tai Chi and yoga (n = 9); balance training (n = 19); strength and resistance training (n = 8)). The risk of bias was low in few trials. Most studies were from high-income countries (Australia = 8, USA = 7). Intervention periods (<12 weeks = 22; 13-26 weeks = 7; >26 weeks = 7) and exercise frequency (1-3 times/week = 32; ≥4 times/week = 4) varied between studies. Fear of falling was measured by single-item questions (7) and scales measuring falls efficacy (14), balance confidence (9) and concern or worry about falling (2). Meta-analyses showed a small to moderate effect of exercise interventions on reducing fear of falling immediately post-intervention (standardised mean difference (SMD) 0.37, 95% CI 0.18, 0.56; 24 studies; low-quality evidence). There was a small, but not statistically significant effect in the longer term (<6 months (SMD 0.17, 95% CI -0.05, 0.38 (four studies) and ≥6 months post-intervention SMD 0.20, 95% CI -0.01, 0.41 (three studies)).
CONCLUSIONS: exercise interventions probably reduce fear of falling to a small to moderate degree immediately post-intervention in community-living older people. The high risk of bias in most included trials suggests findings should be interpreted with caution. High-quality trials are needed to strengthen the evidence base in this area.
© The Author 2016. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
KEYWORDS: exercise; falls; fear; older people; systematic review
PMID: 27121683 [PubMed - in process]