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Effects of a Multimodal Exercise Program on Physical Function, Falls, and Injuries in Older Women: A 2‐Year Community‐Based, Randomized Controlled Trial
Author(s) -
Patil Radhika,
UusiRasi Kirsti,
Tokola Kari,
Karinkanta Saija,
Kannus Pekka,
Sievänen Harri
Publication year - 2015
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/jgs.13489
Subject(s) - medicine , randomized controlled trial , confidence interval , physical therapy , grip strength , rate ratio , injury prevention , poison control , surgery , environmental health
Objectives To investigate the effects of multimodal supervised exercise on physical functioning, falls, and related injuries in older women. Design Two‐year randomized controlled trial. Setting Tampere, Finland. Participants Women aged 70 to 80 who had fallen in the previous year (n = 409). Intervention Participants were randomly assigned to an exercise or control group ( ClinicalTrial.gov NCT00986466). Exercisers participated in group exercise classes twice a week for 12 months and once a week for the subsequent 12 months and home exercises. Controls maintained their current physical activity. Measurements Physical functioning assessed at baseline and at 6‐month intervals during the intervention. Falls and related injuries monitored with fall diaries. Results Intention‐to‐treat analyses showed that exercise led to significant improvements in physical functioning. Leg strength differed significantly between the groups (mean change: 14.1%, 95% confidence interval (CI) = 8.0 to 20.2 in exercisers; 1.6%, 95% CI = −4.5 to 7.7 in controls; P < .001). Chair stand time also differed significantly between groups (7.4%, 95% CI 3.8 to 10.8% in exercisers; 2.4%, 95% CI = −1.6 to 6.2) in controls; P = .02). Between‐group differences were significant for fast walking speed ( P = .003) and probability of completing the backward walking test ( P < .001), favoring exercisers. Timed Up‐and‐Go and grip strength did not differ between groups. There was no difference in the total falls incidence rate ratio (IRR = 1.0, 95% CI = 0.79 to 1.26), but exercisers were less likely to have medically attended injurious falls (IRR = 0.45, 95% CI = 0.27 to 0.78; P = .004). Conclusion Twenty‐four months of multimodal exercise enhanced physical functioning in women aged 70 to 80 with a history of falls. Although the total number of falls was not lower than in controls, the rate of medically attended injurious falls was more than 50% lower.