Exercise for preventing falls in older people living in the community: an abridged Cochrane systematic review
Author: Cathie Sherrington1, Nicola Fairhall2, Geraldine Wallbank2, Anne Tiedemann2, Zoe A Michaleff2, Kirsten Howard3, Lindy Clemson4, Sally Hopewell5, Sarah Lamb5
Affiliation:
1 Institute for Musculoskeletal Health, University of Sydney, Sydney, New South Wales, Australia cathie.sherrington@sydney.edu.au.
2 Institute for Musculoskeletal Health, University of Sydney, Sydney, New South Wales, Australia.
3 School of Public Health, The University of Sydney, Sydney, New South Wales, Australia.
4 Faculty of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia.
5 Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.
Conference/Journal: Br J Sports Med
Date published: 2020 Aug 1
Other:
Volume ID: 54 , Issue ID: 15 , Pages: 885-891 , Special Notes: doi: 10.1136/bjsports-2019-101512. , Word Count: 228
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.
Keywords: aging/ageing; exercise; fall; functional; meta-analysis.
PMID: 31792067 DOI: 10.1136/bjsports-2019-101512
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