RT Journal Article
SR Electronic
T1 Exercise for preventing falls in older people living in the community: an abridged Cochrane systematic Review
JF British Journal of Sports Medicine
JO Br J Sports Med
FD BMJ Publishing Group Ltd and British Association of Sport and Exercise Medicine
SP bjsports-2019-101512
DO 10.1136/bjsports-2019-101512
A1 Cathie Sherrington
A1 Nicola Fairhall
A1 Geraldine Wallbank
A1 Anne Tiedemann
A1 Zoe A Michaleff
A1 Kirsten Howard
A1 Lindy Clemson
A1 Sally Hopewell
A1 Sarah Lamb
YR 2019
UL http://bjsm.bmj.com/content/early/2019/12/02/bjsports-2019-101512.abstract
AB 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.