title: A post-hospital home exercise program improved mobility but increased falls in older people: a randomised controlled trial.
abstract: BACKGROUND
  Home exercise can prevent falls in the general older community but its impact in people recently discharged from hospital is not known. The study aimed to investigate the effects of a home-based exercise program on falls and mobility among people recently discharged from hospital.
  
  
  RESULTS
  This randomised controlled trial (ACTRN12607000563460) was conducted among 340 older people. Intervention group participants (n = 171) were asked to exercise at home for 15-20 minutes up to 6 times weekly for 12 months. The control group (n = 169) received usual care. Primary outcomes were rate of falls (assessed over 12 months using monthly calendars), performance-based mobility (Lower Extremity Summary Performance Score, range 0-3, at baseline and 12 months, assessor unaware of group allocation) and self-reported ease of mobility task performance (range 0-40, assessed with 12 monthly questionaries). Participants had an average age of 81.2 years (SD 8.0) and 70% had fallen in the past year. Complete primary outcome data were obtained for at least 92% of randomised participants. Participants in the intervention group reported more falls than the control group (177 falls versus 123 falls) during the 12-month study period and this difference was statistically significant (incidence rate ratio 1.43, 95% CI 1.07 to 1.93, p = 0.017). At 12-months, performance-based mobility had improved significantly more in the intervention group than in the control group (between-group difference adjusted for baseline performance 0.13, 95% CI 0.04 to 0.21, p = 0.004). Self-reported ease in undertaking mobility tasks over the 12-month period was not significantly different between the groups (0.49, 95% CI -0.91 to 1.90, p = 0.488).
  
  
  CONCLUSIONS
  An individualised home exercise prescription significantly improved performance-based mobility but significantly increased the rate of falls in older people recently discharged from hospital.
  
  
  BACKGROUND
  Australian New Zealand Clinical Trials Registry ACTRN12607000563460.
authors.affiliation: The George Institute for Global Health, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Catherine
authors.initials: C
authors.lastname: Sherrington
authors.affiliation: Neuroscience Research Australia, University of New South Wales, Randwick, New South Wales, Australia.
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Lord
authors.affiliation: Northern Clinical School, The University of Sydney, Sydney, New South Wales, Australia; Department of Aged Care and Rehabilitation, Royal North Shore Hospital, St Leonards, New South Wales, Australia.
authors.forename: Constance M
authors.initials: CM
authors.lastname: Vogler
authors.affiliation: Neuroscience Research Australia, University of New South Wales, Randwick, New South Wales, Australia; Prince of Wales Clinical School, University of New South Wales, Randwick, New South Wales, Australia.
authors.forename: Jacqueline C T
authors.initials: JC
authors.lastname: Close
authors.affiliation: School of Public Health, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Kirsten
authors.initials: K
authors.lastname: Howard
authors.affiliation: Department of Health Professions, Faculty of Human Sciences, Macquarie University, Macquarie Park, NSW, Australia.
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Dean
authors.affiliation: Department of Statistics, Macquarie University, Macquarie Park, New South Wales, Australia.
authors.forename: Gillian Z
authors.initials: GZ
authors.lastname: Heller
authors.affiliation: Discipline of Occupational Therapy, Faculty of Health Sciences, The University of Sydney, Lidcombe, New South Wales, Australia.
authors.forename: Lindy
authors.initials: L
authors.lastname: Clemson
authors.affiliation: Neuroscience Research Australia, University of New South Wales, Randwick, New South Wales, Australia.
authors.forename: Sandra D
authors.initials: SD
authors.lastname: O'Rourke
authors.affiliation: Neuroscience Research Australia, University of New South Wales, Randwick, New South Wales, Australia.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Ramsay
authors.affiliation: Neuroscience Research Australia, University of New South Wales, Randwick, New South Wales, Australia.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Barraclough
authors.affiliation: Neuroscience Research Australia, University of New South Wales, Randwick, New South Wales, Australia.
authors.forename: Robert D
authors.initials: RD
authors.lastname: Herbert
authors.affiliation: School of Public Health, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Robert G
authors.initials: RG
authors.lastname: Cumming
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000369:Aged, 80 and over; D005081:Exercise Therapy; D006760:Hospitalization; D006801:Humans; D055118:Medication Adherence; D008875:Middle Aged; D009068:Movement; D016896:Treatment Outcome; D016138:Walking