Falls prevention over 2 years: a randomized controlled trial in women 80 years and older

Background: after 1 year, a home-based programme of strength and balance re training exercises was effective in reducing falls and injuries in women ag ed 80 years and older. The exercise programme had been individually prescri bed by a physiotherapist during the first 2 months of a randomized controle d trial. Objective: we aimed to assess the effectiveness of the programme over 2 yea rs. Setting: 17 general practices in Dunedin, New Zealand. Subjects: women from both the control group and the exercise group completi ng a 1-year trial (213 out of the original 233) were invited to continue fo r a further year. Methods: falls and compliance to the exercise programme were monitored for 2 years. Results: 81 (74%) in the control group and 71 (69%) in the exercise group a greed to continue in the study. After 2 years, the rate of falls remained s ignificantly lower in the exercise group than in the control group. The rel ative hazard for all falls for the exercise group was 0.69 (95% confidence interval 0.49-0.97). The relative hazard for a fall resulting in a moderate or severe injury was 0.63 (95% confidence interval 0.42-0.95). Those compl ying with the exercise programme at 2 years had a higher level of physical activity at baseline, were more likely to have reported falling in the year before the study and had remained more confident in the first year about n ot falling compared with the rest of the exercise group. Conclusions: falls and injuries can be reduced by an individually tailored exercise programme in the home. For those who keep exercising, the benefit continues over a 2-year period.