Table 2

Summary of randomised controlled falls prevention multiple intervention trials with an exercise component

Article, study aims, age, number in study, durationInterventionsCompliance to exercise componentsIntermediate and other effectsEffect on falls and fall injuriesComments
•Hornbrook et al26:•Intervention group: informed about potential home hazards and encouraged to make changes; 4 weekly 90 minute group meetings, instruction on environmental, behavioural and physical falls risk factors, 20 minutes of supervised exercise, participants were given a manual and instructed to walk 3 times a week; quarterly maintenance sessions•Participants monitored their exercises and walking sessions using a monthly checklist, but compliance rates not reported•No intermediate variables assessed•Intervention decreased odds of falling by 0.85•Analysis by individual although randomisation was by household
•To prevent falls with a programme addressing home safety, exercise and behavioural risks•Control group: informed about potential home hazards, but no repair advice or assistance was given •Average number of falls among those who fell reduced by 7% (NS)•Exercise programme not sufficiently supervised and too general
•≥65 years; n=3182; 2 years•No difference in time to first injurious fall (medical care, fracture, hospitalised)•Minimal evidence to recommend this intervention for a falls prevention programme
•Tinetti et al27:•Intervention group: specific interventions based on baseline assessment of risk factors for falling (sedative medications, ≥4 prescription medications, postural hypotension, environmental hazards, gait impairments, balance or transfer impairments, leg or arm muscle strength or range of movement impairments)•65% of the participants took part in at least 70% of the exercise sessions, 85% took part in over half the recommended sessions•At reassessment the percentage of intervention participants with risk factors still present decreased for 3 risk factors: ≥4 prescription medications (p=0.009), balance impairment (p=0.001), impairment in toilet transfer skills (p=0.05)•Reduction in proportion of fallers (p=0.04)•Good evidence to support the use of a targeted multifactorial approach for the prevention of falls
•To investigate whether the risk of falling could be reduced by modifying known risk factors•Primary physician adjusted medications; physiotherapist prescribed individually tailored home based exercise programme to be carried out twice daily for 15–20 minutes•Improved self confidence for performing daily activities without falling (p=0.02) •Adjusted incidence-rate ratio for falling lower in the intervention group (0.69; 95% CI 0.52 to 0.90)
•≥70 years, with at least 1 of the 8 targeted risk factors for falling; n=301; 1 year•Control group: equivalent number of home visits by social work students
•McMurdo et al28:•Exercise intervention group: exercise classes 3 times weekly for each of three 10 week terms a year for 2 years + 1000 mg calcium supplementation daily•46–100% attendance at exercise classes•Increase in ultradistal forearm bone mineral density in the calcium + exercise group versus calcium only group (p=0.009)•Fewer women in the exercise + calcium group fell during the 2 years (NS, but significant between 12 and 18 months, p=0.011)•Young sample (age range 60–73 years) may explain non significant effect of programme on number of fallers at two years
•To investigate the effect of weight bearing exercise on bone density and falls•Calcium group: 1000 mg calcium supplementation daily •Mean of 76% classes attended
•Women ≥60 years; n=118; 2 years