Large-Scale Investigation: Falls-Prevention Exercise Interventions Work

An extensive review of more than 100 randomized controlled trials (RCTs) strongly supports exercise interventions as a way to reduce both the risk of falls among adults 65 and older and the actual number of those who experience a fall. What’s less clear are some of the nuances of that finding—such as the effectiveness of resistance training or walking programs, and the differences between interventions provided by “health professionals” versus “trained providers who were not health professionals.”

The recently published Cochrane systematic review focused on 108 RCTs involving 23,407 community-dwelling adults in 25 countries. Participants were an average age of 76, and 77% were women. The majority of participants lived in the community, and RCTs that focused on participants with conditions that increased the risk of falls—Parkinson disease, stroke, multiple sclerosis, dementia, hip fracture, and severe visual impairment—were excluded.

The Cochrane reviewers analyzed various categories of exercise interventions versus control, which consisted of either no change in usual activities or an intervention not anticipated to reduce falls, such as health education, social visits, “gentle” exercises, or sham exercises. The exercise interventions were categorized as balance and functional; resistance; flexibility training; “3D” exercise including Tai Chi and Qigong; “3D” dance-based exercise; walking programs; endurance; “other”; and exercise interventions that included more than 1 of the studied categories.

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