Cochrane · systematic review · CD012424
Exercise for preventing falls in older people living in the community
Sherrington, C, Fairhall, NJ, Wallbank, GK, et al. · Cochrane Database of Systematic Reviews · 2019 · Cochrane Library
Bone, Joint and Muscle TraumaAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
31
current version
GRADE rated
28
No studies
3
Included studies
NR
No studies 3 · 9.7%Ungraded 0 · 0%Very low 15 · 48.4%Low 6 · 19.4%Moderate 2 · 6.5%High 5 · 16.1%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Summary of findings: exercise (all types) versus control (e.g. usual activities)
Population: Older people living in the community (trials focusing on people recently discharged from hospital were not included)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Rate of falls (falls per person‐years) Summary of findings: exercise (all types) vs control (e.g. usual activities) | Rate ratio 0.77 [0.71, 0.83] | 59 studies · 12981 participants | High |
Number of people who experienced one or more falls Summary of findings: exercise (all types) vs control (e.g. usual activities) | RR 0.85 [0.81, 0.89] | 63 studies · 13518 participants | High |
Number of people who experienced one or more fall‐related fractures Summary of findings: exercise (all types) vs control (e.g. usual activities) | RR 0.73 [0.56, 0.95] | 10 studies · 4047 participants | Low Downgraded: imprecision, publication bias |
Number of people who experienced one of more falls that resulted in hospital admission Summary of findings: exercise (all types) vs control (e.g. usual activities) | RR 0.78 [0.51, 1.18] | 2 studies · 1705 participants | Very low Downgraded: risk of bias, imprecision |
Number of people who experienced one or more falls that required medical attention. Summary of findings: exercise (all types) vs control (e.g. usual activities) | RR 0.61 [0.47, 0.79] | 5 studies · 1019 participants | Low Downgraded: risk of bias, imprecision, publication bias |
Health‐related quality of life Summary of findings: exercise (all types) vs control (e.g. usual activities) | no estimate extracted | 15 studies · 3172 participants | Low Downgraded: risk of bias, inconsistency |
Adverse events Summary of findings: exercise (all types) vs control (e.g. usual activities) | no estimate extracted | 27 studies · 6019 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, publication bias |
Summary of findings: balance and functional exercises versus control (e.g. usual activities)
Population: Older people living in the community (trials focusing on people recently discharged from hospital were not included)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Rate of falls (falls per person‐years) Summary of findings: balance and functional exercises vs control (e.g. usual activities) | Rate ratio 0.76 [0.7, 0.81] | 39 studies · 7920 participants | High |
Number of people who experienced one of more falls Summary of findings: balance and functional exercises vs control (e.g. usual activities) | RR 0.87 [0.82, 0.91] | 37 studies · 8288 participants | High |
Number of people who experienced one or more fall‐related fractures. Summary of findings: balance and functional exercises vs control (e.g. usual activities) | RR 0.44 [0.25, 0.76] | 7 studies · 2139 participants | Low Downgraded: risk of bias, imprecision |
Adverse events Summary of findings: balance and functional exercises vs control (e.g. usual activities) | no estimate extracted | 15 studies · 4167 participants | Very low Downgraded: risk of bias, imprecision |
Summary of findings: resistance exercises versus control (e.g. usual activities)
Population: Older people living in the community (trials focusing on people recently discharged from hospital were not included)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Rate of falls (falls per person‐years) Summary of findings: resistance exercises vs control (e.g. usual activities) | Rate ratio 1.14 [0.67, 1.97] | 5 studies · 327 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Number of people who experienced 1 or more falls Summary of findings: resistance exercises vs control (e.g. usual activities) | RR 0.81 [0.57, 1.15] | 2 studies · 163 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Number of people who experienced 1 or more fall‐related fractures Summary of findings: resistance exercises vs control (e.g. usual activities) | RR 0.97 [0.14, 6.49] | 1 study · 73 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Adverse events Summary of findings: resistance exercises vs control (e.g. usual activities) | no estimate extracted | 1 study · 64 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Summary of findings: 3D (Tai Chi) exercise versus control (e.g. usual activities)
Population: Older people living in the community (trials focusing on people recently discharged from hospital were not included)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Rate of falls (falls per person‐year) Summary of findings: 3D (Tai Chi) exercise vs control (e.g. usual activities) | Rate ratio 0.81 [0.67, 0.99] | 7 studies · 2655 participants | Low Downgraded: risk of bias, inconsistency |
Number of people who experienced one or more falls Summary of findings: 3D (Tai Chi) exercise vs control (e.g. usual activities) | RR 0.8 [0.7, 0.91] | 8 studies · 2677 participants | High |
Number of people who experienced one or more fall‐related fractures Summary of findings: 3D (Tai Chi) exercise vs control (e.g. usual activities) | no estimate extracted | NR | No studies |
Adverse events Summary of findings: 3D (Tai Chi) exercise vs control (e.g. usual activities) | no estimate extracted | 2 studies · 474 participants | Very low Downgraded: risk of bias, inconsistency |
Summary of findings: 3D (dance) exercise versus control (e.g. usual activities)
Population: Older people living in the community (trials focusing on people recently discharged from hospital were not included)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Rate of falls (falls per person‐years) Summary of findings: 3D (dance) exercise vs control (e.g. usual activities) | Rate ratio 1.34 [0.98, 1.83] | 1 study · 522 participants | Very low Downgraded: risk of bias, imprecision |
Number of people who experienced one or more falls Summary of findings: 3D (dance) exercise vs control (e.g. usual activities) | RR 1.35 [0.83, 2.2] | 1 study · 522 participants | Very low Downgraded: risk of bias, imprecision |
Number of people who experienced one or more fall‐related fractures Summary of findings: 3D (dance) exercise vs control (e.g. usual activities) | no estimate extracted | NR | No studies |
Adverse events Summary of findings: 3D (dance) exercise vs control (e.g. usual activities) | no estimate extracted | 1 study · 522 participants | Very low Downgraded: risk of bias, imprecision |
Summary of findings: walking programme (general physical activity) versus control (e.g. usual activities)
Population: Older people living in the community (trials focusing on people recently discharged from hospital were not included)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Rate of falls (falls per person‐years) Summary of findings: walking programme (general physical activity) vs control (e.g. usual activities) | Rate ratio 1.14 [0.66, 1.97] | 2 studies · 441 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Number of people who experienced one or more falls Summary of findings: walking programme (general physical activity) vs control (e.g. usual activities) | RR 1.05 [0.71, 1.54] | 2 studies · 441 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Number of people who experienced one or more fall‐related fractures Summary of findings: walking programme (general physical activity) vs control (e.g. usual activities) | RR 0.66 [0.11, 3.76] | 1 study · 97 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Adverse events Summary of findings: walking programme (general physical activity) vs control (e.g. usual activities) | no estimate extracted | NR | No studies |
Summary of findings: multiple categories of exercise versus control (e.g. usual activities)
Population: Older people living in the community (trials focusing on people recently discharged from hospital were not included)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Rate of falls (falls per person‐years) Summary of findings: multiple categories of exercise vs control (e.g. usual activities) | Rate ratio 0.66 [0.5, 0.88] | 11 studies · 1374 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Number of people who experienced one or more falls Summary of findings: multiple categories of exercise vs control (e.g. usual activities) | RR 0.78 [0.64, 0.96] | 17 studies · 1623 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Number of people who experienced one or more fall‐related fractures Summary of findings: multiple categories of exercise vs control (e.g. usual activities) | RR 0.85 [0.62, 1.16] | 3 studies · 1810 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Adverse events Summary of findings: multiple categories of exercise vs control (e.g. usual activities) | no estimate extracted | 10 studies · 1177 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |