Intervention Characteristics Associated With a Reduction in Fear of Falling Among Community-Dwelling Older People: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Fear of falling (FoF) is a common and serious problem for older people. Multi-component interventions usually show only moderate effects. Disentangling the effective components may help in the optimisation of interventions. Randomised controlled trials in older community-dwelling people were identified in a systematic review of five scientific databases. Two reviewers extracted information about outcomes and content of interventions. Intervention content was coded with a coding scheme of 68 intervention components. Sixty-two studies, reporting on 79 interventions, were included in the systematic review. The components occurring most often were a warm-up, balance exercises, repetition, strength training, motivating the participants, an increase in difficulty and tailoring. We compared all studies with a component to those without using univariate meta-regressions. Few components were associated with intervention effects at the first available follow up after the intervention, but interventions with meditation, holistic exercises (such as Tai Chi or Pilates) or body awareness were significantly more effective than interventions without these components. Interventions with self-monitoring, balance exercises, tailoring or motivation by the supervisor were less effective compared to those without these components. The identified components may be important for the design and optimisation of FoF interventions