title: The effect of walking on falls in older people: the 'Easy Steps to Health' randomized controlled trial study protocol.
abstract: BACKGROUND
  Falls in older people continue to be a major public health issue in industrialized countries. Extensive research into falls prevention has identified exercise as a proven fall prevention strategy. However, despite over a decade of promoting physical activity, hospitalisation rates due to falls injuries in older people are still increasing. This could be because efforts to increase physical activity amongst older people have been unsuccessful, or the physical activity that older people engage in is insufficient and/or inappropriate. The majority of older people choose walking as their predominant form of exercise. While walking has been shown to lower the risk of many chronic diseases its role in falls prevention remains unclear. This paper outlines the methodology of a study whose aims are to determine: if a home-based walking intervention will reduce the falls rate among healthy but inactive community-dwelling older adults (65 + years) compared to no intervention (usual activity) and; whether such an intervention can improve risk factors for falls, such as balance, strength and reaction time.
  
  
  METHODS
  This study uses a randomised controlled trial design.A total of 484 older people exercising less than 120 minutes per week will be recruited through the community and health care referrals throughout Sydney and neighboring regions. All participants are randomised into either the self-managed walking program group or the health-education waiting list group using a block randomization scheme.Outcome measures include prospective falls and falls injuries, quality of life, and physical activity levels. A subset of participants (n = 194) will also receive physical performance assessments comprising of tests of dynamic balance, strength, reaction time and lower limb functional status.
  
  
  CONCLUSIONS
  Certain types of physical activity can reduce the risk of falls. As walking is already the most popular physical activity amongst older people, if walking is shown to reduce falls the public health implications could be enormous. Conversely, if walking does not reduce falls in older people, or even puts older people at greater risk, then health resources targeting falls prevention need to be invested elsewhere.
  
  
  BACKGROUND
  Australia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12610000380099.
authors: Health Promotion Service, Clinical Support Division (Western), Sydney, Australia.
authors: Alexander
authors: A
authors: Voukelatos
authors: Dafna
authors: D
authors: Merom
authors: Chris
authors: C
authors: Rissel
authors: Cathie
authors: C
authors: Sherrington
authors: Wendy
authors: W
authors: Watson
authors: Karen
authors: K
authors: Waller
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D056044:Actigraphy / Q000295:instrumentation; D000368:Aged; D006293:Health Promotion; D006801:Humans; D009517:New South Wales; D040242:Risk Reduction Behavior; D011795:Surveys and Questionnaires; D016138:Walking / Q000502:physiology*