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 Workouts that focus on improving balance, coordination, mobility and
flexibility all may help reduce the risk of falls more than getting
no exercise at all, the study found. And getting a variety of
different types of exercise may have the greatest effect, regardless
of whether individuals start out with a low or high risk for falls.
"All older adults should be regularly undertaking exercises that
safely challenge their balance to prevent falls," said Cathie
Sherrington of the University of Sydney in Australia, the study's
lead author.
"Frailer people should see a health professional for such exercise
to be prescribed but fitter people can attend a local gym or
community exercise class," Sherrington said by email. "The trick is
to find an exercise regimen that you enjoy and will stick too as it
fits with your other priorities and commitments."
The current study, published in the British Journal of Sports
Medicine, updates findings Sherrington and colleagues reported
earlier this year in the Cochrane Library journal, which analyzed
results from randomized controlled trials through May 2018.
The new study includes findings from 25 countries, including results
that weren't available when the original came out, and provides more
certainty about the effect of exercise on older adults, Sherrington
said.
For the current analysis, researchers examined data from 59 trials
with a total of almost 13,000 participants. They found with "high
certainty" that exercise reduces the rate of falls by 23% among
adults aged 60 and up.
The risk reduction with exercise was similar when researchers only
looked at adults 75 and older, as well as when researchers looked
only at people with a high risk for falls.
Balance and functional exercises - workouts designed to make people
safer during daily activities like dressing and bathing - were
associated with a 24% lower risk of falls, the study found.
And when people did multiple types of exercises - typically a mix of
balance and functional workouts as well as resistance training to
improve muscle strength - they had a 34% lower risk of falls than
people who didn't exercise.
Tai chi, a Chinese meditation practice that combines deep breathing
and slow, fluid movements, was associated with a 19% lower risk of
falling.
Workouts supervised by physical therapists or other health
professionals appeared more effective at reducing the risk of falls
than unsupervised exercise.
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Researchers didn't have enough data to determine whether workouts
that only involve resistance exercises, walking or dancing might
reduce falls.
Most of the smaller studies in the analysis didn't report the risk
of fracture, hospitalization, medical attention or other adverse
events associated with falls, the authors note.
The analysis also wasn't designed to determine what exact exercises
to do or how intensely or frequently people need to exercise for
maximum fall-prevention benefits.
While exercise can help prevent falls, many other precautions also
matter, said Dr. Eric Larson of the Kaiser Permanente Washington
Health Research Institute in Seattle.
"Exercise, if you don't already do so, is really valuable," Lawson,
who wasn't involved in the study, said by email. "Aim for at least
30 minutes a day on most days - more might be better if it's not too
exhausting."
Fall-proofing at home is also key, he said.
"Check for loose rugs, cords, and other items that you could trip
on," Lawson advised. "Get good lighting and, for nighttime, get
motion lights near your bed, especially if you often go to the
bathroom at night."
Footwear matters, too.
"Avoid walking around barefooted or in stocking feet - a good tennis
shoe is often safest of all shoes," Larson added. "Don't be too
proud to use a cane or walker if your balance is poor and especially
if you are prone to falling, and use the cane or walker to stay as
physically active as possible."
SOURCE: https://bit.ly/34D1aa3 British Journal of Sports Medicine,
online December 2, 2019.
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