Randomised controlled trial of a general practice programme of home based exercise to prevent falls in elderly women

RE: Community – based group exercise improves balance and reduces
falls in at-risk older people: a randomised controlled trial.(1)

I read with interest the article “Community – based group exercise
improves balance and reduces falls in at-risk older people: a randomized
controlled trial” in the 2003 July – August issue of Age and Aging.
Barnett and colleagues have shown that an easily accessible, affordable
and user-friendly group exercise programme can improve balance and reduce
falls in elderly people at risk.

However the study did not clearly show that the group setting was the
main contributing factor to the success of the program, especially since
participants also engaged in ancillary exercise at home. I did not see a
comparison between elderly who exercised in a group setting vs. those who
exercised at home or other individual setting, which seems the logical
comparison to determine if the group setting is the determinant for
reduced falls and increased balance.

The method of teaching the exercise groups practical strategies for
avoiding falls was also not clear because control subjects were provided
with the same written information about fall prevention, but no
alternative ‘non-exercise’ activity.

Finally, the authors referenced the successful interventions by
Campbell et al.(2) This was a trial conducted with only women. Barnett’s
trial was mixed (35 males/ 58 females in the intervention group and 29
males/51 females in the control group), but there is no discussion of the
male component in the trial. In the USA, women are three times more likely
to be hospitalised from a fall, but older (> 65) adult men are 22% more
likely than women to die as a result of a fall.(3)

Much work remains in defining the precise components of intervention
that are most effective in preventing falls.

Suzanne Ripley RN
President, CEO
Network Logic International, LLC
4711 W. Evans Drive
Glendale, AZ 85306

1.Barnett et al. Vol. 2003 vol. 32 no. 4 407 – 414

2.Campbell, AJ. Robertson, M. Gardner M. Norton R. Tilyard
Randomised controlled trial of a general practice programme of home based
exercise to prevent falls in elderly women BMJ 1997;315:1065-1069 (25
October)

3.http://www.cdc.gov/ncipc/fact_book/15_Falls_Among_Older_Adults.htm

Competing interests:  
None declared