title: Effectiveness of two year balance training programme on prevention of fall induced injuries in at risk women aged 75-85 living in community: Ossébo randomised controlled trial.
abstract: OBJECTIVE
  To assess the effectiveness of a two year exercise programme of progressive balance retraining in reducing injurious falls among women aged 75-85 at increased risk of falls and injuries and living in the community.
  
  
  METHODS
  Pragmatic multicentre, two arm, parallel group, randomised controlled trial.
  
  
  METHODS
  20 study sites in 16 medium to large cities throughout France.
  
  
  METHODS
  706 women aged 75-85, living in their own home, and with diminished balance and gait capacities, randomly allocated to the experimental intervention group (exercise programme, n=352) or the control group (no intervention, n=354).
  
  
  METHODS
  Weekly supervised group sessions of progressive balance training offered in community based premises for two years, supplemented by individually prescribed home exercises.
  
  
  METHODS
  A geriatrician blinded to group assignment classified falls into one of three categories (no consequence, moderate, severe) based on physical damage and medical care. The primary outcome was the rate of injurious falls (moderate and severe). The two groups were compared for rates of injurious falls with a "shared frailty" model. Other outcomes included the rates of all falls, physical functional capacities (balance and motor function test results), fear of falling (FES-I), physical activity level, and perceived health related quality of life (SF-36). Analysis was by intention to treat.
  
  
  RESULTS
  There were 305 injurious falls in the intervention group and 397 in the control group (hazard ratio 0.81, 95% confidence interval 0.67 to 0.99). The difference in severe injuries (68 in intervention group v 87 in control group) was of the same order of magnitude (0.83, 0.60 to 1.16). At two years, women in the intervention group performed significantly better on all physical tests and had significantly better perception of their overall physical function than women in the control group. Among women who started the intervention (n=294), the median number of group sessions attended was 53 (interquartile range 16-71). Five injurious falls related to the intervention were recorded.
  
  
  CONCLUSIONS
  A two year progressive balance retraining programme combining weekly group and individual sessions was effective in reducing injurious falls and in improving measured and perceived physical function in women aged 75-85 at risk of falling.Trial registration ClinicalTrials.gov (NCT00545350).
authors.affiliation: Université Paris-Sud, UMR-S1018, F-94807, Villejuif, France Université Paris Descartes, UMR-S 1153, F-75014, Paris, France Inserm, Centre de Recherche Epidémiologie et Statistique Sorbonne Paris Cité (CRESS), U1153, F-94807, Villejuif, France.
authors.forename: Fabienne
authors.initials: F
authors.lastname: El-Khoury
authors.affiliation: UVSQ, UMR-S 1168, Université Versailles St-Quentin-en-Yvelines, France Inserm, VIMA: Vieillissement et Maladies Chroniques, U1168, F-94807, Villejuif, France AP-HP, Hôpital Sainte Périne, Centre de Gérontologie, F-75016, Paris, France.
authors.forename: Bernard
authors.initials: B
authors.lastname: Cassou
authors.affiliation: Conservatoire National des Arts et Metiers (Cnam), Centre for Research in Computer Science and Telecommunications (Cédric), EA4629, Paris, France.
authors.forename: Aurélien
authors.initials: A
authors.lastname: Latouche
authors.affiliation: UVSQ, UMR-S 1168, Université Versailles St-Quentin-en-Yvelines, France Inserm, VIMA: Vieillissement et Maladies Chroniques, U1168, F-94807, Villejuif, France A1 AP-HP, Hôpital Ambroise Paré, Unité de Recherche Clinique, Département de Santé Publique, Boulogne-Billancourt, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Aegerter
authors.affiliation: Université Paris Descartes, UMR-S 1153, F-75014, Paris, France Inserm, Centre de Recherche Epidémiologie et Statistique Sorbonne Paris Cité (CRESS), U1153, F-94807, Villejuif, France.
authors.forename: Marie-Aline
authors.initials: MA
authors.lastname: Charles
authors.affiliation: Université Paris Descartes, UMR-S 1153, F-75014, Paris, France Inserm, Centre de Recherche Epidémiologie et Statistique Sorbonne Paris Cité (CRESS), U1153, F-94807, Villejuif, France patricia.dargent@inserm.fr.
authors.forename: Patricia
authors.initials: P
authors.lastname: Dargent-Molina
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control* / Q000706:statistics & numerical data; D000061:Accidents, Home / Q000517:prevention & control* / Q000706:statistics & numerical data; D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D004779:Environment Design; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D010349:Patient Compliance / Q000706:statistics & numerical data*; D004856:Postural Balance; D011788:Quality of Life; D055070:Resistance Training / Q000379:methods*; D016896:Treatment Outcome