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

A Kumar, K Delbaere, G A R Zijlstra, H Carpenter, S Iliffe, T Masud, Dawn Skelton, R Morris, D. Kendrick

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Abstract

Objective: to determine the effect of exercise interventions on fear of falling in community-living people aged =65. 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 (2,878 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.
Original languageEnglish
Pages (from-to)345-352
Number of pages8
JournalAge and Ageing
Volume45
Issue number3
DOIs
Publication statusPublished - 15 Apr 2016

Keywords

  • falls/falling
  • fear of falling
  • older people
  • review article

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    Kumar, A., Delbaere, K., Zijlstra, G. A. R., Carpenter, H., Iliffe, S., Masud, T., Skelton, D., Morris, R., & Kendrick, D. (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), 345-352. https://doi.org/10.1093/ageing/afw036