Background
Methods
Search strategy and inclusion criteria
Outcome measures
Study selection and data collection
Risk of Bias assessment
Statistical analysis
Sensitivity and publication Bias analyses
Results
Characteristics of included studies
Authors | Study design | Ages (exercise, control) | Participants | Exercise intervention | CP | Control | Cases (exercise, control) |
---|---|---|---|---|---|---|---|
Barnett, 2003 [32], Australia | RCT; study duration: 1 yr | 74.4 ± 4.9, 75.4 ± 6.0 | 163 older people | 1 h weekly of structured exercise, including balance, coordination, aerobic capacity and muscle strength training, plus home exercise | 62.2% | Usual lifestyle | 22, 28 |
Bischoff-Ferrari, 2010 [12], Switzerland | RCT; study duration: 12 mos | 83.4 ± 7.2, 85.1 ± 6.5 | 173 patients with acute hip fracture | Daily 60 mins of balance and strength training during acute care, continuing the programme at home after discharge | 69.0% | Usual care | 9, 16 |
Campbell, 1997 [17], New Zealand | RCT; training for 1 yr, following-up for 2 yrs | 83.4 ± 2.7, 84.3 ± 3.3 | 233 older women | 30 mins of home-based programme of strength and balance retraining exercises, plus walking, 3 times per wk | NS | Usual activity levels | 27, 43 |
El-Khoury, 2015 [19], France | RCT; study duration: 2 yrs | 79.8 ± 2.8, 79.6 ± 2.8 | 706 older women | Weekly supervised progressive balance training, supplemented by six weekly individually prescribed home exercises | NS | No intervention | 305, 397 |
Elley, 2008 [20], New Zealand | RCT; study duration: 1 yr | 80.4 ± 4.8, 81.1 ± 5.3 | 312 older people | Daily strength and balance exercise | NS | Social visits | 170, 156 |
Fitzharris, 2010 [21], Germany | RCT; study duration: 3.8 mos | 76.1 | 1090 older people | Weekly strength and balance exercise class of 1 h for 15 weeks, supplemented by daily home exercises. | NS | No intervention | 358, 446 |
Freiberger, 2012 [22], Germany | RCT; training for 12 mos and following-up for 24 mos | 76.1 ± 4.1 | 280 older people fallen in the past 6 months | 1 h of strength and balance training, or plus strength training and balance exercises, or plus endurance training, 2 times per wk | 84% | No intervention | 26, 35 |
Haines, 2009 [23], Australia | RCT; study duration: 6 mos | 80.9 ± 8.9, 80.5 ± 6.5 | 53 adults with gait instability | Exercise programme combining lower limb strength and balance exercises | NS | Usual care | 15, 32 |
Iliffe, 2014 [24], UK | RCT; training for 6 mos, following-up for 1 yr | 72.9 ± 6.1&72.8 ± 5.8, 73.1 ± 6.2 | 1256 older people | Group exercise: 1 h of strength training, plus 2 times of walking per wk.; home exercise: 3 times per wk. of muscle strengthening and balance exercises plus 2 times of walking | NS | Usual lifestyle | 111, 88 |
Iwamoto, 2009 [33], Japan | RCT; study duration: 5 mos | 74.6 ± 5.6, 78.2 ± 5.6 | 68 older people | 30 mins of calisthenics, body balance training, muscle power training, and walking ability training, 3 times per wk | 100% | No intervention | 0, 4 |
Kim, 2014 [25], Japan | RCT; training for 3 mos, following-up for 1 yr | 77.8 ± 4.2, 78.0 ± 4.2 | 105 older adults with a fall history | 60 mins of muscle strength and balance training, 2 times per wk | 75.3% | No intervention | 8, 13 |
Li, 2005 [34], US | RCT; training for 26 wks, following-up for 1 yr | 76.9 ± 4.7, 78.0 ± 5.1 | 256 older people | 1 h of Tai Chi exercise, 3 times per wk | 80.0% | No intervention | 7, 17 |
Luukinen, 2007 [26], Finland | RCT; study duration: 2 yrs | 88.0 ± 3.0, 88.0 ± 3.0 | 484 older people with a fall history | 5–15 repetitions of daily home exercise or group exercise, including walking exercises or self-care exercises | NS | No intervention | 39, 41 |
MacRae, 1994 [35], US | RCT; study duration: 12 mos | 72.4 ± 0.9, 70.0 ± 0.9 | 80 older people | 1 h of strength and balance exercise, 3 times per wk | NS | Safety Education | 0, 3 |
Means, 2005 [27], US | RCT; training for 6 wks, following-up for 6 mos | 73.5 | 338 older people | 90 mins of active stretching, postural control, endurance walking, and repetitive muscle co-ordination exercises | NS | No intervention | 15, 21 |
Pang, 2018 [28], China | RCT; 8-wk training and 6-mon follow-up | 68.1 ± 9.0 vs 69.6 ± 10.8 | 84 stroke survivors | 3 weekly 60-mins of balance and dynamic mobility training programme | 93 | Sham exercise | 1, 6 |
Patil 2015 [29], Finland | RCT; study duration: 2 yrs | 74.4 ± 2.9, 74.0 ± 3.1 | 409 older women with a history of falls | Twice weekly balance, weight bearing, strengthening, and functional exercises for the first 12 mos, and once weekly group and home exercise for remaining 12 mos | 73% & 66% | Usual physical activity | 115, 111 |
Reinsch, 1992 [36], US | RCT; study duration: 1 yr | 73.3 ± 7.9, 75.9 ± 7.3 | 230 older people | 1 h of stand-up/step-up exercises to improve strength and balance, 3 times per wk | NS | No intervention | 11, 12 |
Robertson, 2001 [37], New Zealand | RCT; study duration: 1 yr | 80.8 ± 3.8, 81.1 ± 4.5 | 240 older people | Muscle strengthening and balance exercise, 3 times a wk., plus a walking programme, 2 times a wk., training for 12 mos | 71.0% | Usual care | 42, 49 |
Rosendahl, 2008 [38], Sweden | RCT; training for 3 mos, following-up for 6 mos | 85.3 ± 6.1, 84.2 ± 6.8 | 191 older people | 29 sessions of progressively high intensity weight-bearing exercise to improve lower-limb strength, balance and gait ability | NS | The control activity program | 64, 81 |
Schnelle, 2003 [39], US | RCT; study duration: 8 mos | 87.3 ± 8, 88.6 ± 6.7 | 190 older people | 5 sessions of walking or repeating sit-to-stand up, 5 days per wk | NS | Usual care | 13, 21 |
Smulders, 2010 [40], Netherlands | RCT; training for 3 mos, following-up for 1 yr | 70.5 ± 5.0, 71.6 ± 4.4 | 96 older people with fall history | Weight-bearing and walking exercises, and gait correction and fall prevention training programmes | 92.8% | Usual lifestyle | 20, 33 |
Taylor-Piliae, 2014 [30], US | RCT; study duration: 12 wks | 71.5 ± 10.3, 68.2 ± 10.3 | 145 survivors of stroke | 1 h of Taichi exercise, 3 times per wk | 82.0% | Usual care | 9, 13 |
Uusi-Rasi, 2015 [31], Finland | RCT; Study duration: 2 yrs | 74.8 ± 2.9, 73.8 ± 3.1 | 409 women with a history of fall | Balance challenging, weight bearing, strengthening, and functional exercises, plus home-training program | 72.8% | Take placebo | 12, 26 |
von Stengel, 2009 [41], Germany | RCT; study duration: 18 mos | 68.6 ± 3.0, 68.1 ± 2.7 | 151 postmenopausal women | Resistance training, plus impact and aerobic weight-bearing exercises, 4 days per wk | 75.0% | Light physical exercises | 17, 24 |
Meta-analysis
Study quality, sensitivity, and publication bias analyses
Authors | Sequence generation | Allocation concealment | Blindinga | Incomplete outcome data | Baseline comparability |
---|---|---|---|---|---|
Barnett, 2003 [32], | Unclear | Low | Low | Low | Low |
Bischoff-Ferrari, 2010 [12] | Low | Low | Low | Low | Low |
Campbell, 1997 [17] | Low | Low | Unclear | High | Low |
El-Khoury, 2015 [19] | Low | Low | Low | Low | Low |
Elley, 2008 [20] | Low | Low | Low | Low | Low |
Fitzharris, 2010 [21] | Low | Low | Low | Unclear | Low |
Freiberger, 2012 [22] | Low | Low | Low | Low | Low |
Haines, 2009 [23] | Low | Low | Low | Low | Low |
Iliffe, 2014 [24] | Low | Low | High | Low | High |
Iwamoto, 2009 [33] | Unclear | Unclear | Unclear | Low | High |
Kim, 2014 [25] | Low | Low | Low | Low | Low |
Li, 2005 [34] | Low | Unclear | Low | Low | Low |
Luukinen, 2007 [26] | Low | Unclear | Low | Low | Low |
MacRae, 1994 [35] | Unclear | Low | Low | Low | Low |
Means, 2005 [27] | Low | Unclear | Unclear | Low | High |
Pang, 2018 [28], | Low | Low | Low | Low | Low |
Patil 2015 [29] | Unclear | Unclear | Unclear | Low | Low |
Reinsch, 1992 [36] | Unclear | Unclear | Unclear | Low | Unclear |
Robertson, 2001 [37] | Low | Low | Low | Low | Low |
Rosendahl, 2008 [38] | Low | Low | Low | Low | Low |
Schnelle, 2003 [39] | Low | Low | Low | Low | Low |
Smulders, 2010 [40] | Low | Unclear | Low | High | Low |
Taylor-Piliae, 2014 [30] | Low | Low | Low | Low | Low |
Uusi-Rasi, 2015 [31] | Low | Low | Low | Low | Low |
von Stengel, 2009 [41] | Low | Low | Low | Low | Low |