Efficacy of Exercise on Fall in Old Adults: A Network Meta-analysis / 中国康复理论与实践

ABSTRACT

Objective:To evaluate the efficacy of exercise on preventing falls in the elderly. Methods:Literatures of randomized controlled trials about exercises for prevention of falls in the elderly were retrieved from Web of Science, PubMed, Cochrane Library and CNKI from 1980 to July, 2020. The qualities were evaluated with Review Manager 5.3, and the data were analyzed with R-Studio and Addis 1.16.6. Results:A total of 172 randomized controlled trials were finally included, with nine kinds of exercise intervention. The cognition and movement multitask training was the most effective to decrease fall rate (OR = 0.26, 95%CI 0.14 to 0.49, P < 0.05). The combined physical and whole body vibration training was the most effective to improve the score of Berg Balance Scale (d = 6.3, 95%CI 3.5 to 9.2, P < 0.05) and the time of Timed 'Up & Go' Test (d = -4.5, 95%CI -6.8 to -2.1, P < 0.05). The blood flow restriction training was the most effective to increase the lower limb muscle strength (d = 12, 95%CI 7.4 to 16, P < 0.05). Conclusion:The cognition and movement multitask training is the first recommended exercise to prevent falls in the elderly, followed by Taiji Quan and multimodal training. Gait practice or resistance training are the least effective. A variety of new intervention methods (blood flow restriction training, combined physical and whole body vibration training, Wit Fit training, etc.) may improve the physical function of the elderly, and need further researches.