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:
1Institute for Musculoskeletal Health, University of Sydney, Sydney, New South Wales, Australia cathie.sherrington@sydney.edu.au.
2Institute for Musculoskeletal Health, University of Sydney, Sydney, New South Wales, Australia.
3School of Public Health, The University of Sydney, Sydney, New South Wales, Australia.
4Faculty of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia.
5Nuffield 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
BACK
