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

Journal article

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.

Authors: Sherrington, C; Fairhall, N; Wallbank, G; Tiedemann, A; Michaleff, Z

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: BMJ Publishing Group
• Journal: British Journal of Sports Medicine
• Volume: 54
• Issue: 15
• Pages: 885-891
• Publication date: 2019-12-02
• Acceptance date: 2019-10-11
• DOI: 10.1136/bjsports-2019-101512
• EISSN: 1473-0480
• ISSN: 0306-3674
• Pmid: 31792067
• Language: English
• Keywords: FFR