Exercise in preventing falls and fall related injuries in older people

A review of randomised controlled trials

1. Melinda M Gardner,
2. M Clare Robertson,
3. A John Campbell

Abstract

Objective—To assess the effectiveness of exercise programmes in preventing falls (and/or lowering the risk of falls and fall related injuries) in older people. 

Design—A review of controlled clinical trials designed with the aim of lowering the risk of falling and/or fall injuries through an exercise only intervention or an intervention that included an exercise component 

Main outcome measures—Falls, fall related injuries, time between falls, costs, cost effectiveness.

Subjects—A total of 4933 men and women aged 60 years and older. 

Results—Eleven trials meeting the criteria for inclusion were reviewed. Eight of these trials had separate exercise interventions, and three used interventions with an exercise programme component. Five trials showed a significant reduction in the rate of falls or the risk of falling in the intervention group. 

Conclusions—Exercise is effective in lowering falls risk in selected groups and should form part of falls prevention programmes. Lowering fall related injuries will reduce health care costs but there is little available information on the costs associated with programme replication or the cost effectiveness of exercise programmes aimed at preventing falls in older people. 

Take home message

 

Many different risk factors contribute to falls, but muscle weakness and poor balance underlie most falls. Strength training against resistance and dynamic balance retraining improve both strength and balance and in randomised controlled trials have been shown to decrease the risk of falls. Exercise programmes that are individually tailored and target those at high risk may be the most effective. 

Falls in older people are an important but often overlooked problem. A third of people aged 65 years and older fall each year and half of those in their eighties fall at least once a year.

Falls are the most common cause of injury in people aged 65 years and older and may result in institutionalisation and death

Muscle weakness and poor balance have been well established as risk factors for falls in prospective cohort studies

Appropriately targeted exercise programmes of sufficient intensity will increase and improve muscle strength, balance, and cardiovascular fitness in older people

Exercises to improve strength and balance have therefore been central to most fall prevention programmes. 

The purpose of this review is to examine the evidence for the value of exercise in preventing falls in older people.

Quelle und Full Text:  http://bjsportmed.com/content/34/1/7.full


Full Text / pdf - online im internet - Zugriff 30.09.2012 - GARDNER, M.; ROBERTSON, M.C.; CAMPBELL, J.A.:  Exercise in preventing falls and fall related injuries in older people: a review of randomised controlled trials:

http://www.stopfalls.org/files/preventingfalls.pdf

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