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Why does exercise reduce falls in older people? Unrecognised contributions to motor control and cognition?
  1. Catherine Sherrington,
  2. Nicholas Henschke
  1. Musculoskeletal Division, The George Institute for Global Health, University of Sydney, Sydney, New South Wales, Australia
  1. Correspondence to A/Professor Catherine Sherrington, Musculoskeletal Division, The George Institute for Global Health, PO Box M201, Missenden Road, Sydney, NSW 2050, Australia;csherrington{at}

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Falls in older people are a major public health problem and there is clear evidence that well-designed exercise interventions can prevent falls.1 ,2 Over 100 randomised trials1 of interventions to prevent falls have been undertaken, but more needs to be understood about the mechanisms for effects of interventions, about appropriate interventions to older people with different risk factors for falls, and about population-wide implementation of interventions.

Liu-Ambrose et al 3 propose that exercise may prevent falls due to its impact on cognitive function, specifically executive functions and functional plasticity. There is mounting evidence about the role of cognitive factors in falls and about the impact of exercise on cognition.

Central and peripheral neurological changes are also key to exercise-related improvements in strength and balance.

Benefits of resistance training not limited to muscle hypertrophy

The scientific literature concerning mechanisms underlying strength increases through resistance training has focused largely on the role of muscle mass. However, it is increasingly recognised that the gains in strength are due to a combination of both morphological and neurological factors.4 ,5 The primary morphological adaptations are an increase in the cross-sectional area of the whole muscle and individual muscle fibres. Neurological adaptations are essentially …

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  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.