title: The effect of an individualized fall prevention program on fall risk and falls in older people: a randomized, controlled trial.
abstract: OBJECTIVE
  To determine whether an individualized falls prevention program comprising exercise, visual, and counseling interventions can reduce physiological falls risk and falls in older people.
  
  
  METHODS
  Randomized, controlled trial of 12 months' duration.
  
  
  METHODS
  Falls Clinic, Royal North Shore Hospital, Sydney, Australia.
  
  
  METHODS
  Six hundred twenty people aged 75 and older recruited from a health insurance company membership database.
  
  
  METHODS
  Participants in the extensive intervention group (EIG) received individualized interventions comprising exercise and strategies for maximizing vision and sensation; the minimal intervention group (MIG) received brief advice; and the control group (CG) received no intervention.
  
  
  METHODS
  Accidental falls, vision, postural sway, coordinated stability, reaction time, lower limb muscle strength, sit-to-stand performance, and physiological profile assessment (PPA) falls risk scores.
  
  
  RESULTS
  At the 6-month follow-up, PPA falls risk scores were significantly lower in the EIG than in the CG. EIG subjects assigned to the extensive exercise intervention group showed significant improvements in tests of knee flexion strength and sit-to-stand times but no improvements in balance. EIG subjects assigned to the extensive visual intervention group showed significant improvements in tests of visual acuity and contrast sensitivity. The rate of falls and injurious falls within the trial period were similar in the three groups.
  
  
  CONCLUSIONS
  The individualized intervention program reduced some falls risk factors but did not prevent falls. The lack of an effect on falls may reflect insufficient targeting of the intervention to an at-risk group.
authors.affiliation: Prince of Wales Medical Research Institute, University of New South Wales, Randwick, New South Wales, Australia. S.Lord@unsw.edu.au
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Lord
authors.forename: Anne
authors.initials: A
authors.lastname: Tiedemann
authors.forename: Kirsten
authors.initials: K
authors.lastname: Chapman
authors.forename: Bridget
authors.initials: B
authors.lastname: Munro
authors.forename: Susan M
authors.initials: SM
authors.lastname: Murray
authors.forename: M
authors.initials: M
authors.lastname: Gerontology
authors.forename: Gymnast Recreat
authors.initials: GR
authors.lastname: Ther
authors.forename: Catherine
authors.initials: C
authors.lastname: Sherrington
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000368:Aged; D000369:Aged, 80 and over; D003376:Counseling; D015444:Exercise; D005260:Female; D006801:Humans; D008297:Male; D012307:Risk Factors; D014785:Vision, Ocular