- Update of a systematic review with random effects meta-analysis and meta-regression.
- From January 2010 to January 2016, Cochrane Library, CINAHL, MEDLINE, EMBASE, PubMed, PEDro and SafetyLit were searched.
- Inclusion of randomised controlled trials were performed to compare fall rates in older people randomised to receive exercise as a single intervention with fall rates in those randomised to a control group.
- 99 comparisons from 88 trials with 19478 members were available for meta-analysis.
- Exercise lessened the rate of falls in community-dwelling older people by 21% (pooled rate ratio 0.79, 95% CI 0.73 to 0.85, p<0.001, I2 47%, 69 comparisons) with greater impacts observed from exercise programmes that challenged balance and included more than 3 hours/week of exercise.
- These variables explained 76% of the between-trial heterogeneity in association with a 39% reduction in falls (incident rate ratio 0.61, 95% CI 0.53 to 0.72, p<0.001).
- Exercise had a fall prevention impact in community-dwelling people with Parkinson's disease (pooled rate ratio 0.47, 95% CI 0.30 to 0.73, p=0.001, I2 65%, 6 comparisons) or cognitive impairment (pooled rate ratio 0.55, 95% CI 0.37 to 0.83, p=0.004, I221%, 3 comparisons).
- No evidence was suggestive of a fall prevention effect of exercise in residential care settings or among stroke survivors or people recently discharged from hospital.