The role of exercise therapy in the secondary prevention of falls in elderly people

Abstract

Objective: This review aimed at consolidating the evidence on efficacy of exercise-based intervention in reducing the incidence of falls in an elderly population.

Subjects and Methods: Electronic databases of PubMed, Medline, Embase, CINAHL, Cochrane Controlled Trials and PsychINFO were searched for suitable studies between 1996 and 2009. Only randomised controlled studies involving participants above 65 years of age undertaking preventive exercise intervention program reporting outcome measures were included for analysis. Studies involving additional multifactorial interventions like medication withdrawal or home hazard modification were not included.

Results: Eight randomised controlled trials were deemed suitable for inclusion. All but one trial observed significant reduction in number of falls or fallers in the intervention group when compared to the control group.

Discussion: The people who benefitted the most are those at high risk of falling, those with strength and balance deficits, women, and those over 80 years. The exercise programme was effectively delivered either at home or at a centre. One study showed the programme can be effectively monitored by a non-physiotherapy health professional with remote supervision from a physiotherapist. The programmes had a combination of balance exercises, strength exercises and endurance type exercises based on individual deficits. Future studies should focus on measuring falls relative to the activity level of the participants and analysing the cost-effectiveness of such programmes.

Conclusions: Exercise interventions when targeted at the at-risk community dwelling elderly people are likely to reduce the incidence of falls.

Keywords:

• PHYSICAL
• FALL
• COMMUNITY
• INTERVENTION