A study in the British Medical Journal found that exercise is superior
to home hazard modifications and vision correction when it comes to reducing
the number of at-home falls among the elderly.
Researchers at the Accident Research Center in Victoria, Australia, conducted
the study among 442 people 70 years and older and living in their own home
or apartment. The subjects were randomly assigned to receive at least one of
three interventions: a weekly hour-long exercise class, supplemented with daily
home exercises; home hazards modification done by the participants or the city's
home maintenance program; or vision improvement treatment.
Some subjects received two interventions, one group received all three, and
a control group had no interventions. In all, eight groups were studied over
an 18-month period. All participants submitted a monthly postcard, on which
they recorded their falls.
Exercise was the most effective
The study found that among individual interventions, exercise had the greatest
impact on reducing falls. Patients who had their homes modified or their
vision corrected had a minimal reduction in their annual fall rate of 3.1%
and 4.4%, respectively, compared with the exercise group, which had a significant
6.9% reduction. The group who had all three interventions fared the best,
with an estimated reduction in annual falls of 14%.
Exercise improves balance
Patients who took the exercise class were able to reduce their rate of falling
primarily by improving their balance, the authors said. The other two interventions
may have been less effective because they were not as intense as they needed
The findings lend further support to the importance of exercise in helping
elderly people maintain physical function. A study in the American Journal
of Preventive Medicine reported that inactive elderly adults showed improvement
in physical function after taking an hour-long tai chi class twice a week for
6 months. The improvement was most pronounced among the previously least active
According to the authors of the British Medical Journal study, this
research together suggests that exercise programs involving balance improvement
might benefit elderly people. More research on the cost effectiveness of such
programs are needed to determine whether such programs are worthwhile in helping
to prevent falls among the elderly.
Day L, Fildes B, Gordon I, et al. Randomised factorial trial of falls prevention
among older people living in their own homes. BMJ. 2002;325:128-133.
Li F, Fisher KJ, Harmer P, McAuley E. Delineating the impact of Tai Chi training
on physical function among the elderly. Am J Prev Med. 2002;23(2S):92-97.
Review Date: 3/12/2007
Reviewed By: Benjamin W. Van Voorhees, MD, MPH, Assistant Professor of Medicine and Pediatrics, The University of Chicago, Chicago, IL. Review provided by VeriMed Healthcare Network.
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