![using a .pem royal ts using a .pem royal ts](https://content.royalapps.com/Help/RoyalTS/V3/yourfirstconnection02.png)
Types of exercise interventions include balance training, strength and resistance training and three‐dimensional (3D) exercises, such as dance or Tai Chi. We wanted to find out whether exercise, in the form of a planned, structured, repetitive physical activity aimed at improving physical fitness, helps to reduce fear of falling.
![using a .pem royal ts using a .pem royal ts](https://i.stack.imgur.com/KASjs.png)
Fear of falling can have a serious impact on an older person's health and life as it often reduces their physical and social activities. Many older people are afraid of falling, more so after experiencing a fall. It is important to remember that our included studies do not represent the totality of the evidence of the effect of exercise interventions on falls, depression, anxiety or physical activity as our review only includes studies that reported fear of falling.Įxercise for reducing fear of falling in older people living in the community No studies reported the effects of exercise interventions on activity avoidance or costs.
![using a .pem royal ts using a .pem royal ts](https://www.puttygen.com/images/terminal-emulator.jpg)
The only study reporting the effects of exercise interventions on anxiety found no difference between groups. Very low quality evidence from four studies indicated that exercise interventions did not appear to reduce symptoms of depression or increase physical activity. Very low quality evidence suggests exercise interventions in these studies that also reported on fear of falling reduced the risk of falling measured either as participants incurring at least one fall during follow‐up or the number of falls during follow‐up. There was very low quality evidence that exercise interventions may be associated with a small reduction in fear of falling up to six months post intervention (SMD 0.17, 95% CI ‐0.05 to 0.38 four studies, 356 participants) and more than six months post intervention (SMD 0.20, 95% CI ‐0.01 to 0.41 three studies, 386 participants). However, there was some weak evidence of a smaller effect, which included no reduction, of exercise when compared with an alternative control. None of our subgroup analyses provided robust evidence of differences in effect in terms of either the study primary aim (reduction of fear of falling or other aim), the study population (recruitment on the basis of increased falls risk or not), the characteristics of the study exercise intervention or the study control intervention (no treatment or alternative intervention). Although none of the sensitivity analyses changed the direction of effect, the greatest reduction in the size of the effect was on removal of an extreme outlier study with 73 participants (SMD 0.24 favouring exercise, 95% CI 0.12 to 0.36). Pooled effect sizes did not differ significantly between the different scales used to measure fear of falling. Using GRADE criteria, we judged the quality of evidence to be 'low' for fear of falling immediately post intervention and 'very low' for fear of falling at short or long‐term follow‐up and all other outcomes.Įxercise interventions were associated with a small to moderate reduction in fear of falling immediately post intervention (SMD 0.37 favouring exercise, 95% confidence interval (CI) 0.18 to 0.56 24 studies 1692 participants, low quality evidence). Twelve studies were at high risk of attrition bias. All of the studies were at high risk of performance and detection biases as there was no blinding of participants and outcome assessors and the outcomes were self reported. Poor reporting of the allocation methods in the trials made it difficult to assess the risk of selection bias in most studies. Twelve studies recruited participants at increased risk of falls three of these recruited participants who also had fear of falling. Most studies included more women than men, with four studies recruiting women only. The studies included a total of 2878 participants with a mean age ranging from 68 to 85 years. Two of these were cluster‐randomised trials, two were cross‐over trials and one was quasi‐randomised. We included 30 studies, which evaluated 3D exercise (Tai Chi and yoga), balance training or strength and resistance training.