Exercise and falls prevention

Exercise programs prevent falls among people older than 60 years . Such programs also reduce the likelihood of injuries when falls do occur, according to results of a meta-analysis published online  in BMJ.

Many older adults who live at home are vulnerable to injuries sustained during falls. Such injuries can cause pain and limit functioning, are costly, and may necessitate placement in a skilled nursing or rehabilitation facility. Even minor injuries can have long-lasting consequences if they lead to loss of mobility or cause depression or other psychological distress. Studies designed to assess the efficacy of exercise programs to prevent falls have not previously assessed prevention of injury from falls.

The studies were heterogeneous. For example, 14 trials administered exercise in groups, with 6 of them adding home-based exercise, whereas the other 3 trials only used individual exercise done at home. Seven studies included high-risk participants (older and with fall history). The studies also differed in the types of exercise: some used only tai chi, whereas others incorporated gait and balance and strength/resistance training to different degrees.

The researchers found that exercise programs had significant effects in all fall categories. 

The researchers conclude that exercise programs protect against both falls and fall-related injuries, with the most pronounced effect seen on the most severe injuries. They write, "the estimated reduction is 37% for all injurious falls, 43% for severe injurious falls, and 61% for falls resulting in fractures."

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BMJ. Published online October 29, 2013. Full text