55 * EXERCISE FOR REDUCING FEAR OF FALLING IN OLDER PEOPLE LIVING IN THE COMMUNITY: A COCHRANE SYSTEMATIC REVIEW

Abstract

Introduction: This systematic review examines the evidence to prescribe exercise to reduce fear of falling in older people.Method: Nine bibliographic databases were searched for published or current randomised control trials (RCT) and quasi-randomised trials (QRT) from 1887 to August 2013 (Cochrane Bone, Joint and Muscle Trauma Group Specialised Register, the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, PsycINFO, AMED, The WHO International Clinical Trials Registry Platform, and Current Controlled Trials). Trials were included where fear of falling was recorded as a primary or secondary outcome in community dwelling older people aged 65 years and older, not restricted to a specific medical condition, participants were provided with single component exercise interventions and control group included routine care which did not increase exercise. Reference lists of included studies were searched and experts in the field contacted to suggest relevant unidentified studies.Results: Thirty studies met the inclusion criteria (2,578 participants, mean age 70 to 84 years, 70% women). Structured exercise programmes were associated with a significant reduction in fear of falling immediately post-intervention (SMD 0.24, 95% CI 0.14 to 0.34). There was no significant effect of exercise interventions on fear of falling beyond the end of the intervention period (three studies included data up to six months and two included data at six months and beyond). Structured exercise programmes were associated with a significant reduction in the rate of falls (pooled rate ratio 0.70, 95% CI 0.56 to 0.89); however, there was no significant effect on depressive symptoms (four studies), self-reported physical activity levels (four studies) or adherence rates (16 studies).Conclusions: Exercise is an effective means to reduce fear of falling in older people living in the community whilst the exercise is being prescribed but there is a lack of evidence on the duration of the effect. [ABSTRACT FROM AUTHOR]