Preventing injuries in older people by preventing falls: a meta-analysis of individual-level data.
OBJECTIVE
Our falls prevention research group has conducted four controlled trials of a home exercise program to prevent falls in older people. The objectives of this meta-analysis of these trials were to estimate the overall effect of the exercise program on the numbers of falls and fall-related injuries and to identify subgroups that would benefit most from the program.


METHODS
We pooled individual-level data from the four trials to investigate the effect of the program in those aged 80 and older, in those with a previous fall, and in men and women.


METHODS
Nine cities and towns in New Zealand.


METHODS
One thousand sixteen community dwelling women and men aged 65 to 97.


METHODS
A program of muscle strengthening and balance retraining exercises designed specifically to prevent falls and individually prescribed and delivered at home by trained health professionals.


METHODS
Main outcomes were number of falls and number of injuries resulting from falls during the trials.


RESULTS
The overall effect of the program was to reduce the number of falls and the number of fall-related injuries by 35% (incidence rate ratio (IRR) = 0.65, 95% confidence interval (CI) = 0.57-0.75; and, respectively IRR = 0.65, 95% CI = 0.53-0.81.) In injury prevention, participants aged 80 and older benefited significantly more from the program than those aged 65 to 79. The program was equally effective in reducing fall rates in those with and without a previous fall, but participants reporting a fall in the previous year had a higher fall rate (IRR = 2.34, 95% CI = 1.64-3.34). The program was equally effective in men and women.


CONCLUSIONS
This exercise program was most effective in reducing fall-related injuries in those aged 80 and older and resulted in a higher absolute reduction in injurious falls when offered to those with a history of a previous fall.
Robertson
M Clare
MC
Department of Medical and Surgical Sciences, Otago Medical School, University of Otago, Dunedin, New Zealand. clare.robertson@stonebow.otago.ac.nz
Campbell
A John
AJ
Gardner
Melinda M
MM
Devlin
Nancy
N
D000058:Accidental Falls / Q000517:prevention & control*; D000368:Aged; D000369:Aged, 80 and over; D005081:Exercise Therapy; D005260:Female; D006304:Health Status; D006699:Home Care Services; D006801:Humans; D008297:Male; D015397:Program Evaluation; D015599:Trauma Severity Indices; D014947:Wounds and Injuries / Q000517:prevention & control*