A fall in an older adult can lead to significant pain and reduced functioning, not to mention enormous health care costs. Although studies show that exercise programs can help prevent falls themselves, there has been limited analysis of the effect of exercise on the prevention of fall-related injuries.

In an attempt to distill what little information there is, researchers evaluated 17 randomized controlled trials of fall-prevention exercise inter-ventions that yielded enough infor-mation on injuries to permit analysis.

Participants were adults ages 60 years and older who lived in the community. A total of 2,195 adults were randomized to receive exercise; the control groups comprised an additional 2,110 participants. The mean age across studies was 77 years, and 77% of the participants were women. Fourteen of the studies involved group exercise (home exercise was also provided in six of the 14). The other three studies involved home-based, individualized exercise interventions.

Although the definition and classification of injurious falls varied among the studies, the pooled data showed that fall-prevention exercise programs did help prevent injuries, offering estimated reductions of 37% in injuries overall, 43% in severe fall-related injuries, and 61% in falls resulting in fractures. Meta-analysis suggested that moderate-intensity exercise both reduced fall risk and increased protective responses during a fall, thus helping to prevent serious injury in older adults. The study authors also noted, however, substantial heterogeneity between the studies, and they recommend that conclusions from the pooled data be drawn with caution.

The authors recommend that providers encourage their elderly patients to take part in exercise programs aimed at fall prevention. They encourage those conducting studies in the future to incorporate systematic reporting of falls and injuries, including standardized measures of injury severity

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