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Got It, Hide thisIn older people living in aged care homes, exercise programs reduce falls by the end of the program but not after the program ends
Dyer SM, Suen J, Kwok WS, et al. Exercise for falls prevention in aged care: systematic review and trial endpoint meta-analyses. Age Ageing. 2023 Dec 1;52(12):afad217.
Review questions
In older people living in aged care homes, does exercise reduce falls? Does exercise still have an effect after it is stopped?
Background
Many older people have falls. Falls can lead to serious injury and affect a person’s quality of life. We know that exercise can prevent falls in older people who live in the community. This review looked at whether exercise programs can prevent falls in older people who live in aged care homes and whether effects continue after exercise programs are stopped.
How the review was done
The researchers did a systematic review of studies available up to December 2022. They found 19 randomized controlled trials that included 3202 people. Most people were 65 years of age or older, and most were women.
The key features of the studies were:
- people lived in aged care homes that provided nursing care;
- people were mobile enough to participate in easy exercises and could follow instructions;
- exercise programs were compared with no exercise or usual care;
- exercise programs were intended to reduce falls;
- most exercise programs were supervised and provided by physiotherapists, professional instructors, or researchers;
- exercise programs typically used a combination of exercises including strength and resistance training, gait and balance exercises, or functional training; some used a single exercise type, such as Tai Chi;
- most exercises were done for 30 to 60 minutes/session with 2 or 3 sessions/week; and
- most people did the exercise programs for 3 to 6 months.
What the researchers found
Compared with no exercise or usual care, exercise programs:
- reduced falls and number of people who fell by the end of the program; and
- did not reduce falls or number of people who fell at 3 to 12 months after the end of the program.
Evidence about the effects of exercise programs on risk for fractures was very low quality.
Conclusion
In older people living in aged care homes, exercise programs reduce falls by the end of the program, but the benefit is lost once the exercise program stops.
Exercise program vs. no exercise or usual care in older people living in aged care homes
| Outcomes | Time point | Number of trials (and people) | Effect of exercise program | Quality of the evidence |
| Number of falls | At end of program | 13 trials (1695 people) | Reduced number of falls by 32%* | Moderate |
|
| At 3 to 12 months after end of program | 8 trials (1416 people) | No effect | High |
| Number of people who had a fall | At end of program | 12 trials (1888 people) | Reduced number of people who fell by 16%* | Moderate |
|
| At 6 to 12 months after end of program | 8 trials (1505 people) | No effect | Moderate |
| Number of people who had a fracture | At end of program | 2 trials (407 people) | No effect | Very low |
|
| At 6 to 12 months after end of program | 2 trials (359 people) | No effect | Very low |
Glossary
Studies where people are assigned to one of the treatments purely by chance.
A comprehensive evaluation of the available research evidence on a particular topic.
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