Here's the most recent systematic review of exercise interventions for falls (more recent than the last Cochrane update in 2003). The important thing to highlight here is that all the included studies used falls over 12 months as the primary outcome measure, rather than physical performance measures:
Physical activity interventions to prevent falls among older people: update of the evidence
Sherrington C, Lord SR, Finch CF.
Prince of Wales Medical Research Institute, The University of New South Wales, Australia.
Injuries resulting from falls are a significant public health issue, particularly for older people. This review provides an update of the evidence on the effects of various physical activity (PA) or exercise intervention strategies for the prevention of unintentional falls among older people. Six systematic reviews, and three randomised controlled trials not incorporated in previous reviews, were located with a literature search. There is clear evidence that a targeted supervised home exercise program of strength and balance exercise and walking practice, prescribed by a trained health professional, can prevent falls among older community dwellers. There is also an indication that untargeted group exercise (ie, not individually prescribed) can prevent falls among community dwellers, particularly if it involves Tai Chi or other exercises which challenge balance. There is some indication that individual prescription of PA is more important in frailer groups. Further investigation is required to establish the effects of PA in residential aged care, and the relative effects of different types of PA in different populations. In addition, multidisciplinary, multifactorial. health/environmental risk factor screening/intervention programs have been found to be effective in preventing falls. For many individuals with physical risk factors for falls (eg, impaired strength, balance or functional ability), PA alone is likely to reduce the risk of falls. For those with additional risk factors (eg, visual impairments, psychoactive medication use), other interventions may also be required.
You have to laugh, l recently purchased a copy of "Falls in Older people: Risk Factors and Strategies for Prevention ", my father sat in the factory lunch room and read a page or two while the kettle boiled.:morning:
Page 5 gives a "Definition of the older person"
"The term is used for age-groups starting from as low as 50 years. However, the most frequently used is people aged 65 years and over. Within this age- band, commonly accepted subgroups are those aged 65 -74 years, 75 - 84 and 85 years and older"
My father put down the book and said..... "It's all about perspective isn't it, the 35 year old researcher thought 55 years was old and the 55 year old researcher thought 75 years was old, let these researchers know l am just shy of middle age at 74 years of age.:empathy:
After considerable research, I have discovered a new, fundamental law of nature, Age Relativity.
I have determined that, every year, my definitions for "old" and "young" increase by exactly one year of age.
For example, when I was 10 years old, I thought that 15 was old, but when I became 20, I thought 15 was young.
When I was 30, I though that 35 was old but when I became 40, I thought that 35 was young.
Therefore, every year, my definitions for "old' and "young" have increased by exactly one year.
So that now that I'm 51, even 46 year olds are young, while 56 year olds are still old.
This new fundamental law of nature has been established and confirmed utilizing multiple interviews of my patients and other individuals who will tolerate my questions.
My paper on Age Relativity will soon be published in the Journal of Ageless Theories. ;):pigs::rolleyes:
Preventing falls in older adults: new interventions to promote more effective change-in-support balance reactions.
Maki BE, Cheng KC, Mansfield A, Scovil CY, Perry SD, Peters AL, McKay S, Lee T, Marquis A, Corbeil P, Fernie GR, Liu B, McIlroy WE J Electromyogr Kinesiol. 2008 Apr;18(2):243-54
Exercise training can improve spatial characteristics of time-critical obstacle avoidance in elderly people.
Weerdesteyn V, Nienhuis B, Duysens J Hum Mov Sci. 2008 Jun 2;
Does a functional activity programme improve function, quality of life, and falls for residents in long term care? Cluster randomised controlled trial
Ngaire Kerse, Kathy Peri, Elizabeth Robinson, Tim Wilkinson, Martin von Randow, Liz Kiata, John Parsons, Nancy Latham, Matthew Parsons, Jane Willingale, Paul Brown, and Bruce Arroll BMJ 2008;337:a1445, doi: 10.1136/bmj.a1445 (Published 9 October 2008)