Effective exercise for the prevention of falls: a systematic review and meta-analysis.
OBJECTIVE
To determine the effects of exercise on falls prevention in older people and establish whether particular trial characteristics or components of exercise programs are associated with larger reductions in falls.


METHODS
Systematic review with meta-analysis. Randomized controlled trials that compared fall rates in older people who undertook exercise programs with fall rates in those who did not exercise were included.


METHODS
Older people.


METHODS
General community and residential care.


METHODS
Fall rates.


RESULTS
The pooled estimate of the effect of exercise was that it reduced the rate of falling by 17% (44 trials with 9,603 participants, rate ratio (RR)=0.83, 95% confidence interval (CI)=0.75-0.91, P<.001, I(2)=62%). The greatest relative effects of exercise on fall rates (RR=0.58, 95% CI=0.48-0.69, 68% of between-study variability explained) were seen in programs that included a combination of a higher total dose of exercise (>50 hours over the trial period) and challenging balance exercises (exercises conducted while standing in which people aimed to stand with their feet closer together or on one leg, minimize use of their hands to assist, and practice controlled movements of the center of mass) and did not include a walking program.


CONCLUSIONS
Exercise can prevent falls in older people. Greater relative effects are seen in programs that include exercises that challenge balance, use a higher dose of exercise, and do not include a walking program. Service providers can use these findings to design and implement exercise programs for falls prevention.
Sherrington
Catherine
C
Musculoskeletal Division, The George Institute for International Health, University of Sydney, Sydney, Australia. csherrington@george.org.au
Whitney
Julie C
JC
Lord
Stephen R
SR
Herbert
Robert D
RD
Cumming
Robert G
RG
Close
Jacqueline C T
JC
D000058:Accidental Falls / Q000517:prevention & control*; D000368:Aged; D002986:Clinical Trials as Topic; D015444:Exercise; D006801:Humans