Exercise programs help prevent falls in people over 60

Falls are a major cause of accidental and unintentional injury deaths worldwide. Seniors are the most affected by fatal falls and more than 37 million falls are serious enough to require medical care each year.

A study by the Cochrane Group on Bones, Joints and Muscles, based at the University of Manchester in the UK, was conducted by a team consisting of researchers from the University of Sydney in Australia and the University of Oxford in the United Kingdom. It summarizes the results of 108 randomized controlled trials. with 23,407 participants from 25 countries. The average age of study participants was 76 years and three quarters of them were women. Eighty-one of these trials compared exercise (all types) with a control intervention (no exercise or mild, mild exercise with no reduction in falls) in individuals living alone at home, in retirement villages, or in protected housing.

The review looked at two different ways of measuring falls. First, they found that exercise reduced the number of falls by about a quarter (23% reduction). This means that if there were 850 falls among 1,000 seniors who did not do any fall prevention exercise over the course of a year, there would be 195 fewer falls among those who were undertaking a drill. fall prevention. They also found that exercise reduced the number of people who had one or more falls (number of people falling) by about one-sixth (15%). For example, if 480 people out of 1,000 had one or more falls over a year, participating in exercise programs would reduce the number of people who fall by 72.

The review found that group or home exercise programs, prescribed by a health professional (physiotherapist, for example) or a trained facilitator, were effective. The exercises were mostly performed standing, which improves balance and the ability to do daily activities such as getting up from a low chair or climbing stairs. Some effective exercise programs also used weights to make the exercises more difficult.

The results of the studies being varied, the researchers evaluated different types of exercise programs to see how they compared. There is irrefutable evidence that programs that involve mainly balance and functional exercises reduce falls, while there were fewer that involved programs involving more than one category of exercises (the most often balance and functional exercises as well as resistance exercises). Tai Chi can also prevent falls, but there is unclear evidence of the effectiveness of resistance exercises (without balance or functional exercises), such as dancing or walking.

The certainty of the evidence of the overall effect of exercise on the prevention of falls was high. However, the findings that exercise reduces fractures and the need for medical care are less certain, reflecting in part the relatively low number of studies and participants in these findings.

The side effects of exercise during the tests were poorly described, but they were not usually serious, such as joint or muscle pain. However, one trial reported a pelvic stress fracture.

Professor Cathie Sherrington of the Institute of Musculoskeletal Medicine at the University of Sydney said, "This evidence provides a better understanding of the fact that exercise can help prevent falls among older adults. Types of exercise can be beneficial It is well known that staying active promotes health, but this review identifies the types of exercise that are most likely to be effective in preventing falls. "

"Further efforts are needed to establish the impact of exercise on fractures and falls related to a fall and requiring medical attention, as such falls have significant consequences for the individual and are particularly expensive for health systems Further research is also needed to establish the effectiveness of fall prevention programs in emerging economies where the weight of falls is increasing faster than in developed countries due to rapid aging. Population. "

This Cochrane review was funded by the Cochrane Group on Bone, Joint and Muscle Trauma, based at the University of Manchester, and the Cochrane Emergency and Accident Care Network. This project was partially funded by the National Institute of Health Research (NIHR) via Cochrane Infrastructure Funding to the Cochrane Group. The review was funded by the National Institute of Health Research (UK): NIHR Cochrane Reviews of NICE Priority, Project Reference: NIHR127512. The views and opinions expressed herein are those of the authors and do not necessarily reflect those of the Systematic Studies Program, NHRI, NHS or the Ministry of Health. The Australian National Board of Health and Medical Research fellowships supported the salaries of several authors.

Editor-in-chief Joanne Elliott of the University of Manchester said, "Over the years, our Cochrane group has been instrumental in generating systematic reviews of evidence related to falls prevention interventions. in the elderly, the role of exercise and, most importantly, it shows which types of exercise are more likely to be effective in preventing falls. "

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University of Manchester