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Emerging concept: ‘central benefit model’ of exercise in falls prevention
  1. Teresa Liu-Ambrose1,2,3,
  2. Lindsay S Nagamatsu1,2,3,4,
  3. Chun Liang Hsu1,2,3,
  4. Niousha Bolandzadeh1,2,3
  1. 1Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
  2. 2Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, University of British Columbia, Vancouver, BC, Canada
  3. 3Brain Research Centre, University of British Columbia, Vancouver, BC, Canada
  4. 4Department of Psychology, University of British Columbia, Vancouver, BC, Canada
  1. Correspondence to Teresa Liu-Ambrose, University of British Columbia, Physical Therapy, 212–2177 Wesbrook Mall, Vancouver, British Columbia, V6T 1Z3, Canada; tlambrose{at}


Falls are a common geriatric syndrome and are the third leading cause of chonic disability worldwide. Falls are not random events and occur, at least in part, due to impaired physiological function, such as impaired balance, and cognitive impairment. The clinical syndrome of falls is important for Sports and Exercise Medicine Clinicians as there is Level 1 evidence that targeted exercise prescription is an effective intervention strategy. The widely accepted dogma is that improved physical function, balance and muscle strength, underlies the effectiveness of the exercise in reducing falls. However, findings from randomised controlled trials suggest that exercise reduce falls via mechanisms other than improved physiological function. The authors propose that improved cognitive function – specifically, executive functions – and associated functional plasticity may be an important yet underappreciated mechanism by which the exercise reduces falls in older adults.

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  • Funding This work was supported by the Canadian Institutes of Health Research (MOB-93373) to TLA.

  • Competing interests None.

  • Ethics approval UBC CREB.

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

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    BMJ Publishing Group Ltd and British Association of Sport and Exercise Medicine