Exercise for reducing fear of falling in older people living in the community: Cochrane systematic review and meta-analysis

Objective: To determine the effect of exercise interventions on fear of falling in community-living people aged ≥65 years. Design: Systematic review and meta-analysis. Bibliographic databases, trial registers and other sources were searched for randomised or quasi-randomised trials. Data were independently extracted by pairs of reviewers using a standard form. Results: Thirty trials (2878 participants) reported 36 interventions (Tai Chi and yoga (n=9); balance training (n=19); strength and resistance training (n=8)). The risk of bias was low in few trials. Most studies were from high income countries (Australia=8, USA=7). Intervention periods (26 weeks=7) and exercise frequency (1-3 times/week=32; ≥4 times/week=4) varied between studies. Fear of falling was measured by single-item questions (7) and scales measuring falls efficacy (14), balance confidence (9) and concern or worry about falling (2). Meta-analyses showed a small to moderate effect of exercise interventions on reducing fear of falling immediately post intervention (standardised mean difference (SMD) 0.37, 95% CI 0.18, 0.56; 24 studies; low quality evidence). There was a small, but not statistically significant effect in the longer term