Journal
PHYSICAL THERAPY
Volume 102, Issue 1, Pages -Publisher
OXFORD UNIV PRESS INC
DOI: 10.1093/ptj/pzab236
Keywords
Accidental Falls; Aged; Exercise Therapy; Geriatrics
Categories
Funding
- Mitacs Research Training Awards
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This study reviewed exercise interventions for fear of falling among community-dwelling older adults, finding that most trials did not adequately report exercise principles and intensity. The results showed a significant small to moderate effect size of exercise interventions in reducing fear of falling, emphasizing the importance of designing and reporting components of therapeutic exercise programs.
Objective Fear of falling (FOF) contributes to activity restriction and institutionalization among older adults, and exercise interventions are linked to reduction in FOF. Adhering to exercise principles and adapting optimal exercise parameters are fundamental to optimizing the effectiveness of exercise interventions. The purpose of this review was to describe FOF exercise interventions in community-dwelling older adults, evaluate the extent to which these interventions followed the exercise principles and reported exercise parameters, and quantify the effect of these interventions on reducing FOF. Methods Randomized controlled trials (RCTs) of FOF exercise interventions in older adults (>= 65 years) were identified from 4 databases. The methodological quality of RCTs was assessed using the Physiotherapy Evidence Database scale. A random-effect model was used in the meta-analysis. Results Seventy-five RCTs were included in this review. With regard to reporting exercise principles, specificity was reported in 92% of trials, progression in 72%, reversibility in 32%, overload in 31%, diminished return in 21%, and initial value in 8%. For exercise parameters, 97% of RCTs reported exercise type; 89%, frequency; and 85%, time. Only 25% reported the intensity. The pooled effect of exercise interventions on FOF among all included studies was a standard mean difference of -0.34 (95% CI = -0.44 to -0.23). Conclusion This study showed a significant small to moderate effect size of exercise interventions in reducing FOF among community-dwelling older adults. Most exercise principles and intensity of exercises were not adequately reported in included trials. Impact These inadequate reports could undermine efforts to examine the optimal dosage for exercise prescription. More attention must be given to designing and reporting components of therapeutic exercise programs to facilitate evidence-based practice.
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