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Reducing risk of falling in older people discharged from hospital: a randomized controlled trial comparing seated exercises, weight-bearing exercises, and social visits
Vogler CM, Sherrington C, Ogle SJ, Lord SR
Archives of Physical Medicine and Rehabilitation 2009 Aug;90(8):1317-1324
clinical trial
8/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: To compare the efficacy of seated exercises and weight-bearing (WB) exercises with social visits on fall risk factors in older people recently discharged from hospital. DESIGN: Twelve-week randomized, controlled trial. SETTING: Home-based exercises. PARTICIPANTS: Subjects (n = 180) aged 65 and older, recently discharged from hospital. INTERVENTIONS: Seated exercises (n = 60), WB exercises (n = 60), and social visits (n = 60). MAIN OUTCOME MEASURES: Primary outcome factors were Physiological Profile Assessment (PPA) fall risk score, and balance while standing (Coordinated Stability and Maximal Balance Range tests). Secondary outcomes included the component parts of the PPA and other physical and psychosocial measures. RESULTS: Subjects were tested at baseline and at completion of the intervention period. After 12 weeks of interventions, subjects in the WB exercise group had significantly better performance than the social visit group on the following: PPA score (p = 0.048), Coordinated Stability (p < 0.001), Maximal Balance Range (p = 0.019); body sway on floor with eyes closed (p = 0.017); and finger-press reaction time (p = 0.007) tests. The seated exercise group performed better than the social visit group in PPA score (p = 0.019) but for no other outcome factor. The seated exercise group had the highest rate of musculoskeletal soreness. CONCLUSIONS: In older people recently discharged from the hospital, both exercise programs reduced fall risk score in older people. The WB exercises led to additional beneficial impacts for controlled leaning, reaction time, and caused less musculoskeletal soreness than the seated exercises.

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