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Evidence Summary

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Exercise can prevent falls in older people

Sherrington C, Michaleff ZA, Fairhall N, et al. Exercise to prevent falls in older adults: an updated systematic review and meta-analysis. Br J Sports Med. 2016 Oct 4. [Epub ahead of print]

Review question

Does exercise prevent falls In older people?

Background

Injuries from falls are common among older people. While many falls cause little or no harm, some result in broken bones, long-term pain, disability, hospitalization, and even death.

How the review was done

The reviewers found 88 studies (randomized controlled trials) of exercise programs that were published up to January 2016.

The studies included 19,478 people 65 years of age and older. They took place in in the general community (61 studies), nursing homes (10 studies) and hostels (4 studies), or included people with Parkinson disease (6 studies), stroke (3 studies), cognitive impairment (3 studies), or people recently discharged from hospital (3 studies).

Studies compared an exercise program with no exercise. The intensity or type of exercise was tailored to the individual people in 51 of the studies. Exercise in small groups of fewer than 10 participants was supervised by an instructor in 44 of the studies.

People were followed for an average of 25 to 51 weeks.

What the researchers found

People in the exercise groups had fewer falls than people in the no exercise groups in studies of those living in the general community, with Parkinson disease, or with cognitive impairment.

There were no differences in falls between exercise and no exercise in studies of people living in nursing homes or hostels, people with stroke, or those recently discharged from hospital.

The most successful exercise programs for people living in the community were those that included 3 or more hours of exercise per week and that had a high challenge to balance (e.g., standing with both legs close together, with one foot in front of the other, or on one leg; reaching, shifting body weight from one leg to another, or stepping onto a higher surface; or standing without using arms for support or holding onto a surface with only one hand or one finger instead of the whole hand).

Conclusion

Exercise programs can reduce falls compared with no exercise in older adults living in the community, with Parkinson disease, or with cognitive impairment.

Exercise vs no exercise in older adults

Study population

Number of studies

Effect of exercise vs no exercise on rate of falls*

People living in the general community

61

There were about 21% fewer falls in the exercise groups.

People living in nursing homes or hostels

14

Groups did not differ for falls

People with Parkinson disease

6

There were about 53% fewer falls in the exercise groups.

People who had a stroke

3

Groups did not differ for falls

People with cognitive impairment

3

There were about 45% fewer falls in the exercise groups.

People discharged from hospital

3

Groups did not differ for falls

*Rate ratio.




Glossary

Cognitive impairment
Trouble remembering, learning new things, concentrating, or making decisions that affect everyday life.
Randomized controlled trials
Studies where people are assigned to one of the treatments purely by chance.

Related Web Resources

  • Too fit to fracture: Managing osteoporosis through exercise

    Osteoporosis Canada
    If you have osteoporosis, it is recommended to exercise regularly. A physical therapist or kinesiologist can give you advice on what type of exercise is best for you. You should do a combination of strength, posture, balance, and aerobic exercise.
  • Improving housing to improve health - warmth and space are key

    Evidently Cochrane
    Poor housing is associated with poor health. Research shows cold, damp and overcrowded homes can have a negative impact on your respiratory health.
  • Evidently Advent - Fear of falling

    Evidently Cochrane
    Try exercise (such as Tai Chi) and home safety changes to help prevent falling. Exercise may have small benefits for improving fear of falling. Resource includes a video.
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