Introduction
Method
Results
Reference number | Study design | Groups similar at baseline | Blinding | Falls reporting |
---|---|---|---|---|
[9] | RCT | Yes | Assessors | Prospective, postal report |
RCT (factorial) | Yes | Assessors | Prospective, postal report | |
[65] | Pilot RCT | Yes | Assessor | Prospective, diary, interview |
[39] | Pilot RCT | Yes | Assessors | Prospective, calendar |
[61] | RCT | Yes | None | Prospective, postal report |
[10] | RCT | Yes | Assessors | Retrospective, recall at 3, 6 and 12 months |
[22] | RCT | No | Assessors | Prospective, falls log, telephone follow-up |
[35] | RCT | No | Assessors | Prospective, calendar, interview |
[8] | RCT | Yes | Assessors | Prospective, postal report |
[43] | RCT | Yes | Assessors | Prospective, calendar, telephone |
[44] | RCT | Yes | Assessors | Prospective, calendar, telephone |
[4] | RCT | Yes | Assessors | Prospective, postal report |
[27] | Cluster RCT | No | Unspecified | Prospective, report at baseline, 5 months and 1.5 years |
[33] | Cluster RCT | No | Unspecified | Prospective, postal/telephone report, injurious falls only |
[37] | RCT | Yes | Assessors | Prospective, postal report |
[47] | RCT | Yes | None | Retrospective, interview/telephone |
[53] | RCT | Yes | Assessors | Prospective, diary |
[56] | RCT | Yes | Assessors | Retrospective, 1-year recall |
[64] | RCT | Yes | Unspecified | Retrospective, 15-week recall |
[52] | RCT | Yes | Assessors | Prospective, calendar, telephone |
[63] | RCT | No | Unspecified | Not specified |
[29] | RCT | Yes | Assessors | Retrospective 6-month recall |
[32] | RCT | Yes | Assessors | Prospective, diary and reminders |
[42] | Cluster RCT | Yes | Unspecified | Prospective, weekly interview, monthly diary |
[2] | RCT | Yes | Assessors | Prospective, postal survey |
[62] | RCT | No | Unspecified | Prospective, calendar/telephone |
[28] | Multi-centre controlled trial | No | Unspecified | Prospective, monthly diary, weekly report |
[30] | RCT | Yes | Assessors and participants | Retrospective at baseline (6-month recall), prospective calendar, monthly telephone |
[55] | RCT | Yes | Unspecified | Prospective, diary, telephone |
[20] | Semi-RCT | Yes | Assessors | Prospective, postal report, telephone interview |
[13] | Pilot RCT | Yes | Assessors | Prospective, diary |
References | Format | Frequency | Intensity | Duration per bout | Total volume | Volume per week | Effect on falls |
---|---|---|---|---|---|---|---|
[9] | Independent | HEP 3×/week | Variable levels | HEP, 30 min | Approximately 72 h over 12 months | 1.4 h | Lower annual falls rate in IG than CG, difference = 0.47; 95 % CI [0.04, 0.90] |
Walking 3×/week | |||||||
Combination | Group, 1×/week | Unspecified | Group, 1 h | Approximately 15 h plus unspecified HEP over 15 weeks | 1 h | IRR for exercise alone = 0.79, 95 % CI [0.67, 0.94] | |
HEP, 7×/week | |||||||
[65] | Group | 1×/week | Aerobic: ‘moderate’ | 1.5 h | Approximately 24 h over 16 weeks | 1.5 h | At 6 months, IRR = 0.20, 95 % CI [0.04, 0.91] at 12 months, IRR = 0.45, 95 % CI [0.16, 1.77] |
Strength: ‘progressive resistive exercises’ | |||||||
Balance: progressive in difficulty | |||||||
[39] | Group | 1×/week | Balance group: specific, progressive balance task workstations | 1 h | Approximately 10 h over 10 weeks | 1 h | Significant reductions in falls in balance group (p = 0.000) and CG (p = 0.024) at 3 months |
CG: non-specific balance exercise with increasing speed and combinations | |||||||
[61] | Group | 2×/week | ‘Low intensity’ | 1.5 h | Approximately 15 h over 5 weeks | 3 h | IRR at 7 months = 0.54, 95 % CI [0.36, 0.79] |
[10] | Group | 2×/week | Unspecified | 40 min | Approximately 26.6 h over 20 weeks | 1.3 h | During intervention, IG had 7 falls, CG had 8 falls |
[22] | Independent | 2×/week | Variable levels | Approximately 15 min | Approximately 12 h over 6 months | 0.5 h | IRR = 0.72, 95 % CI [0.33–1.57] |
[35] | Group | Extensive intervention, 2×/week | Extensive intervention: progression according to RPE and ACSM guidelines | Extensive intervention, 40–50 min | Extensive intervention: approximately 60–72 h over 12 months | Extensive intervention, 1.2–1.4 h minimal intervention: unspecified | Extensive intervention: RR = 1.03, 95 % CI [0.78, 1.35] minimal intervention: RR = 0.90, 95 % CI [0.69, 1.17] |
Minimal intervention, 1 HEP training class | Minimal intervention: unspecified | Minimal intervention: unspecified | Minimal intervention: unspecified | ||||
[8] | Independent | HEP, 3×/week | Variable levels | HEP, 30 min | Approximately 144 h over 2 years | 1.4 h | RH for all falls in IG = 0.69, 95 % CI [0.49, 0.97] |
Walking, 3×/week | |||||||
[43] | Independent | HEP, 3×/week | Variable | HEP, 30 min | Approximately 78 h over 12 months | 1.5 h | IRR = 0.54, 95 % CI [0.32, 0.90] |
Walking, 2×/week | |||||||
[44] | Independent | HEP, 3×/week | Variable | HEP, 30 min | Approximately 78 h over 12 months | 1.5 h | IRR = 0.70, 95 % CI [0.59, 0.84] |
Walking, 2×/week | |||||||
[4] | Group | 3×/week | Endurance group, 75 % HR reserve ×30–35 min | 1 h | Approximately 72–78 h over 24–26 weeks | 2.8–3.3 h | RH of time to first fall = 0.53, 95 % CI [0.30, 0.91] |
Strength group, 2 sets × 10 reps; 1st set 50–60 % 1RM, 2nd set 75 % 1RM | |||||||
E + S group, 20 min endurance, 1 set 75 % 1RM | |||||||
[27] | Group | 3×/week | Unspecified | 40 min | Approximately 40 h over 5 months | 1.9 h | At 1.5 years, OR = 0.13, 95 % CI [0.06, 0.273] |
[33] | Group | 6×/week | Unspecified | 1 h | Approximately 312 h over 12 months | 6 h | Injurious falls reduced by 44 % in CG, 75 % in tai chi villagers and 94 % in tai chi practitioners |
[37] | Group | 3×/week | Low intensity for 1st week (RPE = 11), moderate thereafter (RPE = 13) | 1.5 h | Approximately 27 h over 6 weeks | 4.5 h | Baseline fallers reporting no falls at follow-up: IG = 87 %; CG = 34.5 % |
[47] | Group | 3×/week | Strength, 12 reps, sets and resistance increased | 1.5 h | Approximately 54 h over 12 weeks | 4.5 h | Lower activity-adjusted 3-month fall rate in IG than CG (6 falls/1,000 h activity vs. 16.2 falls/1,000 h, p = 0.03) |
Endurance: up to 70 % HR reserve | |||||||
Balance: ‘increasing in difficulty’ | |||||||
[53] | Combination | IG: class, 1×/week | IG: variable levels in HEP; more challenging in class | IG: class, 1 h | IG: approximately 72 h over 36 weeks | 2 h | IRR = 0.46, 95 % CI [0.34, 0.63] |
HEP, 2×/week | CG: low-intensity HEP | HEP, 20–40 min | CG: unspecified | ||||
CG: HEP ×2/week | CG, unspecified | ||||||
[56] | Combination | Group, 1×/fortnight | Resistance training: ‘moderate’ | Group, 1 h | Approximately 49 h over 6 months | 1.9 h | After 20 months 13.6 % in IG fell vs. 54.5 % in CG |
HEP, 3×/week | Tai chi: progressive duration, up to 30 min | HEP, 30 min | |||||
[64] | Combination | 3×/week | Unspecified | 1 h | Approximately 45 h over 15 weeks | 3 h | Mean number of falls and injurious falls reduced in telecommunication and community groups, p < 0. 01 (values not given) |
[52] | Group | 3×/week | Aerobic: ‘moderate’ | 1 h | Approximately 156 h over 12 months | 3 h | IRR = 0.75, 95 % CI [0.52, 1.09] |
Strength: ‘progressive resistance training’ | |||||||
Balance: progressive difficulty | |||||||
[63] | Group | 3×/week | Tai chi: unspecified resistance group: ‘medium’ | Unspecified | Unspecified over 12 months | Unspecified | Numbers of falls during study period: tai chi group, 15/60; resistance group, 24/60; CG, 31/60 (non-significant differences) |
[29] | Independent | 3×/week | Strength, 1–2 sets × 15 reps, ‘moderate intensity’ | Unspecified | Unspecified over 6 months | Unspecified | At 12 months, 0 falls in IG, 1 fall in CG |
[32] | Independent | 3×/week | 3 sets × 8 reps, 60–80 % 1RM | Unspecified | Unspecified over 10 weeks | Unspecified | RR = 0.96, 95 % CI [0.67, 1.36] |
[42] | Group | Exercise group, 3×/week | ‘Low intensity’ | Both groups, 1 h | Exercise group: approximately 156 h over 12 months | Exercise group, 3 h exercise and CBT group, 2 h | No significant difference in the number of fallers between all groups at 12 months (p = 0.53) |
Exercise and CBT group, 2×/week | Exercise and CBT group: approximately 104 h over 12 months | ||||||
[2] | Combination | Group, 1×/week | Unspecified | Group, 1 h | Approximately 37 h plus HEP over 12 months | 0.7 h (excluding HEP) | IRR = 0.60, 95 % CI [0.36, 0.99] |
HEP, variable | |||||||
[62] | Combination | Tai chi: group, 2×/week | Tai chi: progressively more difficult forms | Tai chi: group, 22.5 min | Tai chi: approximately 64 h over 15 weeks | 4.3 h | RR of multiple falls for tai chi group = 0.53, 95 % CI [0.32, 0.86] |
HEP, ×7/week | Balance: sway targets progressed; floor movements added | HEP, 30 min | Balance: approximately 11.25 h over 15 weeks | ||||
Balance, 1×/week | Balance, 45 min | ||||||
[28] | Combination | Group, 1×/week | Strength: gravity-resisted | Group, 2 h | Approximately 64 h over 17 weeks | 3.8 h | Mean number of falls significantly lower in IG than CG, p = 0.036 |
HEP, 7×/week | HEP, 15–20 min | ||||||
[30] | Combination | IG: group, 2×/week | IG: aerobic, 70–80 % HRmax | IG: group, 1 h | IG: approximately 203 h over 18 months | IG, 2.6 h CG, 1 h | RR of falls = 0.54, 95 % CI [0.35, 0.84] RR of injurious falls = 0.33, 95 % CI [0.15, 0.74] |
HEP, 2×/week | Strength, 1–3 sets × 8–15 reps | HEP, 20 min | |||||
CG, 1×/week | HEP, 1–2 sets × 6–15 reps | CG, 1 h | CG: approximately 78 h over 18 months | ||||
CG, 5–10 min walking at 50–60 % HRmax | |||||||
[55] | Combination | Class, 1×/month; unspecified HEP | Class: unspecified | Class, 1 h | Approximately 17 h group exercise over 17 months | Unspecified | Hazard ratio for time to first fall in exercise group = 0.67; 95 % CI [0.42–1.07] |
HEP: ‘gentle’ | |||||||
[20] | Combination | Group, 2×/week | Unspecified | Group, 1 h | Approximately 32 h over 16 weeks | 2 h | Falls in fitness group: RR = 0.64, 95 % CI [0.38, 1.06] |
HEP, 7×/week | |||||||
[13] | Independent | Unspecified | Individualised | Unspecified | Unspecified over 6 months | Unspecified | RR = 0.21, 95 % CI [0.06, 0.67] |
Reference number | Gait, balance and functional training | Strength/resistance | Flexibility | 3-D | General physical activity | Endurance | Other training |
---|---|---|---|---|---|---|---|
[9] | ✓ | ✓ | ✓ | ✓ | |||
✓ | ✓ | ✓ | |||||
[65] | ✓ | ✓ | ✓ | ✓ | ✓ | ||
[39] | ✓ | ✓ | ✓ | ||||
[61] | ✓ | Martial arts fall techniques | |||||
[10] | ✓ | ✓ | ✓ | ||||
[22] | ✓ | ✓ | |||||
[35] | ✓ | ✓ | |||||
[8] | ✓ | ✓ | ✓ | ✓ | |||
[43] | ✓ | ✓ | ✓ | ✓ | |||
[44] | ✓ | ✓ | ✓ | ✓ | |||
[4] | ✓ | ✓ | |||||
[27] | ✓ | ||||||
[33] | ✓ | ||||||
[37] | ✓ | ✓ | ✓ | ||||
[47] | ✓ | ✓ | ✓ | ||||
[53] | ✓ | ✓ | ✓ (CG) | ✓ (CG) | ✓ | ||
[56] | ✓ | ✓ | ✓ | ✓ | |||
[64] | ✓ | ||||||
[52] | ✓ | ✓ | ✓ | ✓ | |||
[63] | ✓ (RT) | ✓ (TC) | |||||
[29] | ✓ | ✓ | ✓ | Impact training | |||
[32] | ✓ | ||||||
[42] | ✓ | ✓ | |||||
[2] | ✓ | ✓ | ✓ | ✓ | |||
[62] | ✓ (CBT) | ✓ (TC) | |||||
[28] | ✓ | ✓ | ✓ | ||||
[30] | ✓ | ✓ | ✓ | ✓ | ✓ (CG) | ✓ | |
[55] | ✓ | ✓ | |||||
[20] | ✓ | ✓ | ✓ | ✓ | Competence, perceptual (PG) | ||
[13] | ✓ | ✓ |