Exercise for reducing fear of falling in older people living in the community: Cochrane systematic review and meta-analysis.
Author: Kumar A1, Delbaere K2, Zijlstra GA3, Carpenter H1, Iliffe S4, Masud T5, Skelton D6, Morris R4, Kendrick D1
Affiliation:
1Division of Primary Care, University of Nottingham, Nottingham, UK.
2NeuRA, University of New South Wales, New South Wales, Australia.
3Department of Health Services Research, Maastricht University and CAPHRI School for Public Health and Primary Care, Maastricht, The Netherlands.
4Research Department of Primary Care and Population Health, University College London, London, UK.
5Nottingham University Hospitals NHS Trust, Nottingham, UK.
6Institute 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]
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