Reducing Falls

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Community-based group exercise improves balance and reduces falls in

at-risk older people: a randomised controlled trial

Age and Ageing 2003; 32: 407–414 Age and Ageing Vol. 32 No. 4 # 2003,

British Geriatrics Society.

Abstract

Background: recent studies have found that moderate intensity

exercise is an effective intervention strategy for preventing falls

in older people. However, research is required to determine whether

supervised group exercise programmes, conducted in community settings

with at-risk older people referred by their health care practitioner

are also effective in improving physical functioning and preventing

falls in this group.

Objectives: to determine whether participation in a weekly group

exercise programme with ancillary home exercises over one year

improves balance, muscle strength, reaction time, physical

functioning, health status and prevents falls in at-risk community-

dwelling older people.

Methods: the sample comprised 163 people aged over 65 years

identified as at risk of falling using a standardised assessment

screen by their general practitioner or hospital-based

physiotherapist, residing in South Western Sydney,

Australia. Subjects were randomised into either an exercise

intervention group or a control group. Physical performance and

general health measures were assessed at baseline and repeated 6-

months into the trial. Falls were measured over a 12-month follow-up

period using monthly postal surveys.

Results: at baseline both groups were well matched in their physical

performance, health and activity levels. The intervention subjects

attended a median of 23 exercise classes over the year, and most

undertook the home exercise sessions at least weekly. At retest, the

exercise group performed significantly better than the controls in

three of six balance measures; postural sway on the floor with eyes

open and eyes closed and coordinated stability. The groups did

not differ at retest in measures of strength, reaction time and

walking speed or on Short-Form 36, Physical Activity Scale for the

Elderly or fear of falling scales. Within the 12-month trial period,

the rate of falls in the intervention group was 40% lower than that

of the control group (IRR=0.60, 95% CI 0.36–0.99).

Conclusions: these findings indicate that participation in a weekly

group exercise programme with ancillary home exercises can improve

balance and reduce the rate of falling in at-risk community dwelling

older people.

Keywords: accidental falls, exercise, aged, balance, physical

functioning, general practice

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Carruthers

Wakefield, UK