The Effects of Exercise on Falls in Elderly Patients

A Preplanned Meta-analysis of the FICSIT Trials

Michael A. Province, Evan C. Hadley, Mark C. Hornbrook, Lewis A. Lipsitz, J. Philip Miller, Cynthia D. Mulrow, Marcia G. Ory, Richard Warren Sattin, Mary E. Tinetti, Steven L. Wolf

Research output: Contribution to journalArticle

917 Citations (Scopus)

Abstract

To determine if short-term exercise reduces falls and fall-related injuries in the elderly. —A preplanned meta-analysis of the seven Frailty and Injuries: Cooperative Studies of Intervention Techniques (FICSIT)—independent, randomized, controlled clinical trials that assessed intervention efficacy in reducing falls and frailty in elderly patients. All included an exercise component for 10 to 36 weeks. Fall and injury follow-up was obtained for up to 2 to 4 years. —Two nursing home and five community-dwelling (three health maintenance organizations) sites. Six were group and center based; one was conducted at home. —Numbers of participants ranged from 100 to 1323 per study. Subjects were mostly ambulatory and cognitively intact, with minimum ages of 60 to 75 years, although some studies required additional deficits, such as functionally dependent in two or more activities of daily living, balance deficits or lower extremity weakness, or high risk of falling. —Exercise components varied across studies in character, duration, frequency, and intensity. Training was performed in one area or more of endurance, flexibility, balance platform, Tai Chi (dynamic balance), and resistance. Several treatment arms included additional nonexercise components, such as behavioral components, medication changes, education, functional activity, or nutritional supplements. —Time to each fall (fall-related injury) by self-report and/or medical records. —Using the Andersen-Gill extension of the Cox model that allows multiple fall outcomes per patient, the adjusted fall incidence ratio for treatment arms including general exercise was 0.90 (95% confidence limits [CL], 0.81, 0.99) and for those including balance was 0.83 (95% CL, 0.70,0.98). No exercise component was significant for injurious falls, but power was low to detect this outcome. —Treatments including exercise for elderly adults reduce the risk of falls.

Original languageEnglish (US)
Pages (from-to)1341-1347
Number of pages7
JournalJAMA: The Journal of the American Medical Association
Volume273
Issue number17
DOIs
StatePublished - Jan 1 1995

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Meta-Analysis
Exercise
Wounds and Injuries
Arm
Accidental Falls
Tai Ji
Independent Living
Health Maintenance Organizations
Activities of Daily Living
Nursing Homes
Proportional Hazards Models
Self Report
Medical Records
Lower Extremity
Therapeutics
Randomized Controlled Trials
Education
Incidence

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Province, M. A., Hadley, E. C., Hornbrook, M. C., Lipsitz, L. A., Miller, J. P., Mulrow, C. D., ... Wolf, S. L. (1995). The Effects of Exercise on Falls in Elderly Patients: A Preplanned Meta-analysis of the FICSIT Trials. JAMA: The Journal of the American Medical Association, 273(17), 1341-1347. https://doi.org/10.1001/jama.1995.03520410035023

The Effects of Exercise on Falls in Elderly Patients : A Preplanned Meta-analysis of the FICSIT Trials. / Province, Michael A.; Hadley, Evan C.; Hornbrook, Mark C.; Lipsitz, Lewis A.; Miller, J. Philip; Mulrow, Cynthia D.; Ory, Marcia G.; Sattin, Richard Warren; Tinetti, Mary E.; Wolf, Steven L.

In: JAMA: The Journal of the American Medical Association, Vol. 273, No. 17, 01.01.1995, p. 1341-1347.

Research output: Contribution to journalArticle

Province, MA, Hadley, EC, Hornbrook, MC, Lipsitz, LA, Miller, JP, Mulrow, CD, Ory, MG, Sattin, RW, Tinetti, ME & Wolf, SL 1995, 'The Effects of Exercise on Falls in Elderly Patients: A Preplanned Meta-analysis of the FICSIT Trials', JAMA: The Journal of the American Medical Association, vol. 273, no. 17, pp. 1341-1347. https://doi.org/10.1001/jama.1995.03520410035023
Province, Michael A. ; Hadley, Evan C. ; Hornbrook, Mark C. ; Lipsitz, Lewis A. ; Miller, J. Philip ; Mulrow, Cynthia D. ; Ory, Marcia G. ; Sattin, Richard Warren ; Tinetti, Mary E. ; Wolf, Steven L. / The Effects of Exercise on Falls in Elderly Patients : A Preplanned Meta-analysis of the FICSIT Trials. In: JAMA: The Journal of the American Medical Association. 1995 ; Vol. 273, No. 17. pp. 1341-1347.
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