Effects of a Multimodal Exercise Program on Physical Function, Falls, and Injuries in Older Women: A 2-Year Community-Based, Randomized Controlled Trial

ObjectivesTo investigate the effects of multimodal supervised exercise on physical functioning, falls, and related injuries in older women. DesignTwo-year randomized controlled trial. SettingTampere, Finland. ParticipantsWomen aged 70 to 80 who had fallen in the previous year (n=409). InterventionParticipants were randomly assigned to an exercise or control group ( NCT00986466). Exercisers participated in group exercise classes twice a week for 12months and once a week for the subsequent 12months and home exercises. Controls maintained their current physical activity. MeasurementsPhysical functioning assessed at baseline and at 6-month intervals during the intervention. Falls and related injuries monitored with fall diaries. ResultsIntention-to-treat analyses showed that exercise led to significant improvements in physical functioning. Leg strength differed significantly between the groups (mean change: 14.1%, 95% confidence interval (CI)=8.0 to 20.2 in exercisers; 1.6%, 95% CI=-4.5 to 7.7 in controls; P<.001). Chair stand time also differed significantly between groups (7.4%, 95% CI 3.8 to 10.8% in exercisers; 2.4%, 95% CI=-1.6 to 6.2) in controls; P=.02). Between-group differences were significant for fast walking speed (P=.003) and probability of completing the backward walking test (P<.001), favoring exercisers. Timed Up-and-Go and grip strength did not differ between groups. There was no difference in the total falls incidence rate ratio (IRR=1.0, 95% CI=0.79 to 1.26), but exercisers were less likely to have medically attended injurious falls (IRR=0.45, 95% CI=0.27 to 0.78; P=.004). ConclusionTwenty-four months of multimodal exercise enhanced physical functioning in women aged 70 to 80 with a history of falls. Although the total number of falls was not lower than in controls, the rate of medically attended injurious falls was more than 50% lower.