Sherrington Catherine, Whitney Julie C, Lord Stephen R, Herbert Robert D, Cumming Robert G, Close Jacqueline C T
Musculoskeletal Division, The George Institute for International Health, University of Sydney, Sydney, Australia.
J Am Geriatr Soc. 2008 Dec;56(12):2234-43. doi: 10.1111/j.1532-5415.2008.02014.x.
To determine the effects of exercise on falls prevention in older people and establish whether particular trial characteristics or components of exercise programs are associated with larger reductions in falls.
Systematic review with meta-analysis. Randomized controlled trials that compared fall rates in older people who undertook exercise programs with fall rates in those who did not exercise were included.
Older people.
General community and residential care.
Fall rates.
The pooled estimate of the effect of exercise was that it reduced the rate of falling by 17% (44 trials with 9,603 participants, rate ratio (RR)=0.83, 95% confidence interval (CI)=0.75-0.91, P<.001, I(2)=62%). The greatest relative effects of exercise on fall rates (RR=0.58, 95% CI=0.48-0.69, 68% of between-study variability explained) were seen in programs that included a combination of a higher total dose of exercise (>50 hours over the trial period) and challenging balance exercises (exercises conducted while standing in which people aimed to stand with their feet closer together or on one leg, minimize use of their hands to assist, and practice controlled movements of the center of mass) and did not include a walking program.
Exercise can prevent falls in older people. Greater relative effects are seen in programs that include exercises that challenge balance, use a higher dose of exercise, and do not include a walking program. Service providers can use these findings to design and implement exercise programs for falls prevention.
确定运动对老年人预防跌倒的作用，并确定特定的试验特征或运动计划的组成部分是否与更大幅度地减少跌倒有关。
荟萃分析的系统评价。纳入比较进行运动计划的老年人跌倒率与未运动的老年人跌倒率的随机对照试验。
老年人。
普通社区和机构照料中的老年人。
跌倒率。
运动效果的合并估计值是，运动使跌倒率降低了17%（44项试验，9603名参与者，率比（RR）=0.83，95%置信区间（CI）=0.75-0.91，P<0.001，I²=62%）。在包括较高总运动量（试验期间超过50小时）和具有挑战性的平衡练习（站立时进行的练习，人们旨在双脚更靠近或单腿站立，尽量少用手辅助，并练习重心的控制移动）且不包括步行计划的运动计划中，运动对跌倒率的相对影响最大（RR=0.58，95%CI=0.48-0.69，解释了68%的研究间变异性）。
运动可预防老年人跌倒。在包括具有挑战性的平衡练习、运动量较大且不包括步行计划的运动计划中，相对效果更显著。服务提供者可利用这些研究结果设计和实施预防跌倒的运动计划。
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