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Minimally supervised multimodal exercise to reduce falls risk in economically and educationally disadvantaged older adults
Almeida TL, Alexander NB, Nyquist LV, Montagnini ML, Santos ACS, Rodrigues GHP, Negrao CE, Trombetta IC, Wajngarten M
Journal of Aging and Physical Activity 2013 Jul;21(3):241-259
clinical trial
4/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

Few studies have evaluated the benefit of providing exercise to underprivileged older adults at risk for falls. Economically and educationally disadvantaged older adults with previous falls (mean age 79.06, SD 4.55) were randomized to 4 mo of multimodal exercise provided as fully supervised center-based (FS, n = 45), minimally supervised home-based (MS, n = 42), or to nonexercise controls (C, n = 32). Comparing groups on the mean change in fall-relevant mobility task performance between baseline and 4 mo and compared with the change in C, both FS and MS had significantly greater reduction in timed up-and-go, F[2,73] = 5.82, p = 0.004, n2p = 0.14, and increase in tandem-walk speed, F[2,73] = 7.71, p < 0.001 n2p = 0.17. Change in performance did not statistically differ between FS and MS. In community-dwelling economically and educationally disadvantaged older adults with a history of falls, minimally supervised home-based and fully supervised center-based exercise programs may be equally effective in improving fall-relevant functional mobility.

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