RANDOMIZED CONTROLLED TRIAL OF A GENERAL-PRACTICE PROGRAM OF HOME-BASED EXERCISE TO PREVENT FALLS IN ELDERLY WOMEN

Objective: To assess the effectiveness of a home exercise programme of strength and balance retraining exercises in reducing falls and injur ies in elderly women. Design: Randomised controlled trial of an indivi dually tailored programme of physical therapy in the home (exercise gr oup, n=116) compared with the usual care and an equal number of social visits (control group, n=117). Setting 17 general practices in Dunedi n, New Zealand. Subjects: Women aged 80 years and older living in the community and registered with a general practice in Dunedin. Main outc ome measures: Number of falls and injuries related to falls and time b etween falls during one year of follow up; changes in muscle strength and balance measures after six months. Results: After one year there w ere 152 falls in the control group and 88 falls in the exercise group. The mean (SD) rate of falls was lower in the exercise than the contro l group (0.87 (1.29) v 1.34 (1.93) falls per year respectively; differ ence 0.47; 95% confidence interval 0.04 to 0.90). The relative hazard for the first four falls in the exercise group compared with the contr ol group was 0.68 (0.52 to 0.90). The relative hazard for a first fall with injury in the exercise group compared with the control group was 0.61 (0.39 to 0.97). After six months, balance had improved in the ex ercise group (difference between groups in change in balance score 0.4 3 (0.21 to 0.65). Conclusions: An individual programme of strength and balance retraining exercises improved physical function and was effec tive in reducing falls and injuries in women 80 years and older.