Randomised controlled trial of the effectiveness of community group and home-based falls prevention exercise programmes on bone health in older people: the ProAct65+ bone study

Rachel L. Duckham*, Tahir Masud, Rachael Taylor, Denise Kendrick, Hannah Carpenter, Steve Iliffe, Richard Morris, Heather Gage, Dawn A. Skelton, Susie Dinan-Young, Katherine Brooke-Wavell

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

26 Citations (Scopus)

Abstract

Background: exercise can reduce osteoporotic fracture risk by strengthening bone or reducing fall risk. Falls prevention exercise programmes can reduce fall incidence, and also include strengthening exercises suggested to load bone, but there is little information as to whether these programmes influence bone mineral density (BMD) and strength. 

Objective: to evaluate the skeletal effects of home (Otago Exercise Programme, OEP) and group (Falls Exercise Management, FaME) falls prevention exercise programmes relative to usual care in older people. 

Methods: men and women aged over 65 years were recruited through primary care. They were randomised by practice to OEP, FaME or usual care. BMD, bone mineral content (BMC) and structural properties were measured in Nottingham site participants before and after the 24-week intervention.

Results: participants were 319 men and women, aged mean(SD) 72(5) years. Ninety-two percentage of participants completed the trial. The OEP group completed 58(43) min/week of home exercise, while the FaME group completed 39(16) and 30(24) min/week of group and home exercise, respectively. Femoral neck BMD changes did not differ between treatment arms: mean (95% CI) effect sizes in OEP and FaME relative to usual care arm were -0.003(-0.011,0.005) and -0.002(-0.010,0.005) g cm-2, respectively; P = 0.44 and 0.53. There were no significant changes in BMD or BMC at other skeletal sites, or in structural parameters. 

Conclusions: falls prevention exercise programmes did not influence BMD in older people. To increase bone strength, programmes may require exercise that exerts higher strains on bone or longer duration.

Original languageEnglish
Pages (from-to)573-579
Number of pages7
JournalAge and Ageing
Volume44
Issue number4
Early online date23 Apr 2015
DOIs
Publication statusPublished - 1 Jul 2015

Keywords

  • aged
  • bone mineral density
  • exercise
  • men
  • older people
  • osteoporosis
  • prevention
  • primary care
  • women
  • x-ray absorptiometry

ASJC Scopus subject areas

  • Ageing
  • Geriatrics and Gerontology

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