Personalized home-based exercise programs improve strength, balance and lower risk of falls

Hill KD, Hunter SW, Batchelow FA et al. Individualized home-based exercise programs for older people to reduce falls and improve physical performance: A systematic review and meta-analysis Maturitas. 2015;82:72-84.

Review question

Do personalized home-based exercise programs reduce falls and improve physical performance (physical activity, balance, mobility and strength) among older people?  

Background

Falls are the leading cause of injury-related hospital visits in many countries, particularly among people over age 65 and can also contribute to lower activity levels, balance and function. Previous research shows exercise programs can help reduce falls.  The purpose of this review was to measure the effectiveness of personalized exercise programs that are focused on reducing falls among community-dwelling older adults.

How the review was done

This is a systematic review and meta-analysis of 12 studies (including 11 randomized controlled trials) published between 1997 and 2014.  In total, the studies involved over 2500 people with an average age of 80 years. In each of the studies, at least half of the participants were aged 60 years and over. The studies all included some type of tailored (personalized) home-based exercise program focused on lower body strength, balance, and mobility. The amount of times participants exercised every week varied in different studies: in some, participants exercised daily and in others they exercised three to five times a week.

The programs ranged from 6 weeks to 2 years in length. The impact of the programs was measured at follow-up, which ranged from 2 months to 2 years after the programs. The researchers used 17 different measures to assess the impacts of the exercise programs on participants, including:

• Total number of falls among participants
• Number of participants who had falls
• How often participants had falls
• Number of injuries and fractures from falls
• Physical performance (e.g. balance, strength or mobility)

The researchers compared these measurements to people in a control group who received the usual care, home visits from health care workers, and education on falls prevention.

What the researchers found

People in personalized exercise programs are less likely to experience falls. The exception was one study including people who had recently left the hospital and were recovering from acute health problems; different approaches may be needed for more high risk groups such as these.

Personalized exercise programs improved balance, leg strength, function and physical activity. There was no difference in the number of injuries and fractures between people in personalized exercise program groups and control groups. There is value in promoting personalized exercise programs to older people living at home as one way to lower their risk of falling and improve balance, strength and function.

Conclusion

Personalized home-based exercise programs help lower the risk of falls and improve physical performance including balance, physical activity and leg strength for older adults in the community.