The effect of an individualized fall prevention program on fall risk and falls in older people: a randomized, controlled trial.
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.
Lord
Stephen R
SR
Prince of Wales Medical Research Institute, University of New South Wales, Randwick, New South Wales, Australia. S.Lord@unsw.edu.au
Tiedemann
Anne
A
Chapman
Kirsten
K
Munro
Bridget
B
Murray
Susan M
SM
Gerontology
M
M
Ther
Gymnast Recreat
GR
Sherrington
Catherine
C
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