Background: Falls can lead to fatal injuries and increased rate of hospitalizations in the elderly, and exercises are one of the important strategies to prevent falling. However, no comparisons of different types of exercises for fall prevention have been conducted previously.
Objectives: To compare different types of exercises for fall prevention in older people living in the community.
Methods: We searched MEDLINE, Embase, CINAHL, PEDro, and the Cochrane Central Register of Controlled Trials (CENTRAL) to identify clinical studies comparing different types of exercises for fall prevention in older people. Two review authors conducted selection of studies, data extraction, and assessment of risk of bias independently. A random-effects model was used to conduct the pairwise meta-analysis and the Bayesian network meta-analysis.
Results: Overall, 40 studies were included in the systematic review. Among the different exercise types, balance combined with strength training was the best treatment strategy for rate of falls (median HR versus control 0.24, 95% credible interval (CrI) 0.24 to 0.29). Balance combined with strength, flexibility, and Tai chi training was the best treatment strategy for risk of falls (median risk ratio versus control 0.18, 95% CrI 0.03 to 0.70). Rankogram was plotted (x-axis for risk of falls and y-axis for rate of falls) and balance combined with strength, flexibility, and Tai chi training was the best treatment strategy in consideration of the two outcomes. No reporting bias was noted in the study. The quality of these studies was good.
Conclusions: According to our analyses, balance combined with strength, flexibility, and Tai chi training was the most effective treatment among these different exercise types for fall prevention.