title: Effects of a Multimodal Exercise Program on Physical Function, Falls, and Injuries in Older Women: A 2-Year Community-Based, Randomized Controlled Trial.
abstract: OBJECTIVE
  To investigate the effects of multimodal supervised exercise on physical functioning, falls, and related injuries in older women.
  
  
  METHODS
  Two-year randomized controlled trial.
  
  
  METHODS
  Tampere, Finland.
  
  
  METHODS
  Women aged 70 to 80 who had fallen in the previous year (n = 409).
  
  
  METHODS
  Participants were randomly assigned to an exercise or control group (ClinicalTrial.gov NCT00986466). Exercisers participated in group exercise classes twice a week for 12 months and once a week for the subsequent 12 months and home exercises. Controls maintained their current physical activity.
  
  
  METHODS
  Physical functioning assessed at baseline and at 6-month intervals during the intervention. Falls and related injuries monitored with fall diaries.
  
  
  RESULTS
  Intention-to-treat analyses showed that exercise led to significant improvements in physical functioning. Leg strength differed significantly between the groups (mean change: 14.1%, 95% confidence interval (CI) = 8.0 to 20.2 in exercisers; 1.6%, 95% CI = -4.5 to 7.7 in controls; P < .001). Chair stand time also differed significantly between groups (7.4%, 95% CI 3.8 to 10.8% in exercisers; 2.4%, 95% CI = -1.6 to 6.2) in controls; P = .02). Between-group differences were significant for fast walking speed (P = .003) and probability of completing the backward walking test (P < .001), favoring exercisers. Timed Up-and-Go and grip strength did not differ between groups. There was no difference in the total falls incidence rate ratio (IRR = 1.0, 95% CI = 0.79 to 1.26), but exercisers were less likely to have medically attended injurious falls (IRR = 0.45, 95% CI = 0.27 to 0.78; P = .004).
  
  
  CONCLUSIONS
  Twenty-four months of multimodal exercise enhanced physical functioning in women aged 70 to 80 with a history of falls. Although the total number of falls was not lower than in controls, the rate of medically attended injurious falls was more than 50% lower.
authors.affiliation: UKK Institute for Health Promotion Research, Tampere, Finland.
authors.forename: Radhika
authors.initials: R
authors.lastname: Patil
authors.affiliation: UKK Institute for Health Promotion Research, Tampere, Finland.|Research Department, Tampere University Hospital, Tampere, Finland.
authors.forename: Kirsti
authors.initials: K
authors.lastname: Uusi-Rasi
authors.affiliation: UKK Institute for Health Promotion Research, Tampere, Finland.
authors.forename: Kari
authors.initials: K
authors.lastname: Tokola
authors.affiliation: UKK Institute for Health Promotion Research, Tampere, Finland.
authors.forename: Saija
authors.initials: S
authors.lastname: Karinkanta
authors.affiliation: UKK Institute for Health Promotion Research, Tampere, Finland.|Department of Trauma, Musculoskeletal Surgery and Rehabilitation, Tampere University Hospital, Tampere, Finland.|Medical School, University of Tampere, Tampere, Finland.
authors.forename: Pekka
authors.initials: P
authors.lastname: Kannus
authors.affiliation: UKK Institute for Health Promotion Research, Tampere, Finland.
authors.forename: Harri
authors.initials: H
authors.lastname: Sievänen
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D001823:Body Composition; D004185:Disability Evaluation; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005387:Finland; D015577:Geriatric Assessment; D006305:Health Status Indicators; D006801:Humans; D004856:Postural Balance / Q000502:physiology; D016896:Treatment Outcome
keywords: fall-related injuries; falls; multimodal exercise; physical functioning; randomized controlled trial