Buchner 1997a.
| Methods | Type of study: RCT. | |
| Participants | Number of participants randomised: 105.
Losses: 5 of 105. Age: mean 75, range 68 to 85 Sex: 51% women. Health status as defined by authors: Frail with history of falls Residential status of participants: enrolled from health maintenance organisation Setting: USA. Inclusion: 68 to 85 years unable to do 8 step tandem gait with no errors, below 50th centile for knee extensor strength for height and weight. Exclusion: cardiovascular, pulmonary, vestibular and bone disease, dependency terminal illness, unable to speak English, positive cardiac stress test, body weight greater than 180% of ideal. |
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| Interventions | EXERCISE GROUP (STRENGTH): weight machines (n = 25)
EXERCISE GROUP: endurance training (n = 25) EXERCISE GROUP: strength and endurance training (n = 25) CONTROL GROUP: usual activities (n = 30). Duration and intensity: intervention groups ‐ 1 hour x 3 days a week (24 to 26 weeks). Supervisor: not stated. Supervision: group. Setting: gym/ clinic. |
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| Outcomes | Ability to walk on wide and narrow beams.
Balance in parallel, semi tandem and tandem stance (s).
Single legged stance (s)
Gait speed (m/min).
Tilt board AP and OMNI directional (s) Compliance/adherence : Adherence: 14 of 75 randomised to exercise dropped out (described and reasons given), 1 drop out from control group Adverse events: not reported |
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| Notes | Trial had 4 arms. Part of FICSIT study see Buchner 1993. Only strength and control groups included in our analysis | |
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Low risk | Random permuted blocks |
| Allocation concealment (selection bias) | Unclear risk | Not clear who carried out above |
| Incomplete outcome data (attrition bias) All outcomes | Low risk | Intention‐to‐treat analysis |
| Selective reporting (reporting bias) | Low risk | Protocols and outcomes all available |
| Other bias | Low risk | The study appears to be free of other sources of bias |
| Blinding (participant) | High risk | Not possible |
| Blinding (assessor) | Low risk | Assessors blinded |
| Were the treatment and control group comparable at entry? | High risk | Home care visits greater in control group, inpatient costs greater in exercise group, self reported health lower in exercise group, formal education higher in exercise group. |
| Was the surveillance active, and of clinically appropriate duration (i.e. at least 3 months post intervention)? | Low risk | Measured at 6 and 9 months follow‐up |