A randomized controlled trial of fall prevention by a high-intensity functional exercise program for older people living in residential care facilities.
OBJECTIVE
Falls are particularly common among older people living in residential care facilities. The aim of this randomized controlled trial was to evaluate the effectiveness of a high-intensity functional exercise program in reducing falls in residential care facilities.


METHODS
Participants comprised 191 older people, 139 women and 52 men, who were dependent in activities of daily living. Their mean+/-SD score on the Mini-Mental State Examination was 17.8+/-5.1 (range 10-30). Participants were randomized to a high-intensity functional exercise program or a control activity, consisting of 29 sessions over 3 months. The fall rate and proportion of participants sustaining a fall were the outcome measures, subsequently analysed using negative binominal analysis and logistic regression analysis, respectively.


RESULTS
During the 6-month follow-up period, when all participants were compared, no statistically significant differences between groups were found for fall rate (exercise group 3.6 falls per person years [PY], control group 4.6 falls per PY), incidence rate ratio (95% CI) 0.82 (0.49-1.39), p=0.46, or the proportion of participants sustaining a fall (exercise 53%, control 51%), odds ratio (95% CI) 0.95 (0.52-1.74), p=0.86. A subgroup interaction analysis revealed that, among participants who improved their balance during the intervention period, the exercise group had a lower fall rate than the control group (exercise 2.7 falls per PY, control 5.9 falls per PY), incidence rate ratio (95% CI) 0.44 (0.21-0.91), p=0.03.


CONCLUSIONS
In older people living in residential care facilities, a high-intensity functional exercise program may prevent falls among those who improve their balance.
Rosendahl
Erik
E
Department of Community Medicine and Rehabilitation, Geriatric Medicine and Physiotherapy, Umeå University, Umeå, Sweden. erik.rosendahl@ltu.se
Gustafson
Yngve
Y
Nordin
Ellinor
E
Lundin-Olsson
Lillemor
L
Nyberg
Lars
L
D000058:Accidental Falls / Q000517:prevention & control*; D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D053580:Muscle Strength / Q000502:physiology; D017063:Outcome Assessment, Health Care; D004856:Postural Balance / Q000502:physiology; D012112:Residential Facilities