Meta-analysis and GRADE profiles of exercise interventions for falls prevention in long-term care facilities.
Daniela Schoberer, Helga E Breimaier
PMID 31642090WHAT IT FOUND
Exercise did not significantly reduce falls overall, but balance-focused and longer-than-six-month programs showed promise.
Frail residents faced an increased fall risk from exercise. Technical devices showed moderate-confidence benefits, while tai chi reduced fear of falling without reducing actual falls.
Key findings
01Overall exercise interventions did not significantly reduce the rate of falls compared to no exercise.
02Exercises with a balance component significantly reduced the number of falls, though confidence in this evidence was low.
03Exercise interventions in frail residents were associated with a substantially increased risk of falling.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for RNs
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What it does not show
The overall certainty of evidence for most interventions was low or very low due to high heterogeneity between studies. Many included trials had a risk of detection bias because blinding participants or assessors to exercise interventions is difficult. Frailty was not consistently assessed across all studies, so the increased risk for frail residents is based on a smaller subset of data. The review excluded multifactorial interventions, so results apply only to exercise as a standalone treatment.
Declared interests
The authors state that no commercially funded interventions were investigated in this review.
The easy way to misread this
Do not assume that exercise is a safe, universal fall prevention strategy for all long-term care residents. The review found that exercise increased the risk of falling for frail residents, and overall exercise did not significantly reduce falls when all types were combined.