Exercise for reducing fear of falling in older people living in the community: Cochrane systematic review and meta-analysis

Kumar, Arun and Delbaere, Kim and Zijlstra, G.A.R. and Carpenter, Hannah and Iliffe, Steve and Masud, Tahir and Skelton, Dawn A. and Morris, Richard W. and Kendrick, Denise (2016) Exercise for reducing fear of falling in older people living in the community: Cochrane systematic review and meta-analysis. Age and Ageing, 45 (3). pp. 345-352. ISSN 1469-2834

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Abstract

Objective: To determine the effect of exercise interventions on fear of falling in community-living people aged ≥65 years.

Design: Systematic review and meta-analysis. Bibliographic databases, trial registers and other sources were searched for randomised or quasi-randomised trials. Data were independently extracted by pairs of reviewers using a standard form.

Results: Thirty trials (2878 participants) reported 36 interventions (Tai Chi and yoga (n=9); balance training (n=19); strength and resistance training (n=8)). The risk of bias was low in few trials. Most studies were from high income countries (Australia=8, USA=7). Intervention periods (<12 weeks=22; 13-26 weeks=7; >26 weeks=7) and exercise frequency (1-3 times/week=32; ≥4 times/week=4) varied between studies. Fear of falling was measured by single-item questions (7) and scales measuring falls efficacy (14), balance confidence (9) and concern or worry about falling (2). Meta-analyses showed a small to moderate effect of exercise interventions on reducing fear of falling immediately post intervention (standardised mean difference (SMD) 0.37, 95% CI 0.18, 0.56; 24 studies; low quality evidence). There was a small, but not statistically significant effect in the longer term (<6 months (SMD 0.17, 95% CI -0.05, 0.38 (four studies) and ≥ 6 months post intervention SMD 0.20, 95% CI -0.01, 0.41 (three studies)).

Conclusions: Exercise interventions probably reduce fear of falling to a small to moderate degree immediately post-intervention in community-living older people. The high risk of bias in most included trials suggests findings should be interpreted with caution. High quality trials are needed to strengthen the evidence base in this area.

Item Type: Article
Additional Information: This is a pre-copyedited, author-produced PDF of an article accepted for publication in Age and Ageing following peer review. The version of record Exercise for reducing fear of falling in older people living in the community: Cochrane systematic review and meta-analysis. Arun Kumar; Kim Delbaere; G. A. R. Zijlstra; Hannah Carpenter; Steve Iliffe; Tahir Masud; Dawn Skelton; Richard Morris; Denise Kendrick Age and Ageing 2016 45 (3): 345-352 is available online at: http://ageing.oxfordjournals.org/content/45/3/345.
Keywords: Fear, Falls, Exercise, Review
Schools/Departments: University of Nottingham, UK > Faculty of Medicine and Health Sciences > School of Medicine > Division of Primary Care
Identification Number: https://doi.org/10.1093/ageing/afw036
Depositing User: Pepper, Mrs Pamela
Date Deposited: 22 Apr 2016 12:37
Last Modified: 28 Nov 2016 13:11
URI: http://eprints.nottingham.ac.uk/id/eprint/32907

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