Liu‐Ambrose 2008.
Methods | Type of study: RCT | |
Participants | Number of participants randomised: 74 Losses:14/38 from control and 8/36 from exp group Age: aged 70 and older Sex: 22 women and 9 men in experimental and 19 women and 9 men in control Health status as defined by authors: At risk of falls Residential status of participants:community dwellers Setting: Vancover, Canada Inclusion:aged 70 or older; referred to and attended a dedicated falls clinic; had fallen and at risk of further falls; had one of the following criteria 1. one additional nonsyncopal fall in the previous year for those whose index fall was suspected to have been due to carotid sinus syndrome 2. A TUG test time of greater than 15 seconds 3. A Physiological Profile assessment (PPA) z‐score of 1 or greater; able to walk at least 3 metres. Exclusion:progressive neurological condition; life expectancy of less than 12 months; MMSE score less than 24 |
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Interventions | EXERCISE GROUP (MULTIPLE): (N=36) Home based Otago Exercise programme CONTROL GROUP: (N=38) usual care through clinics. Assumed no exercise. Duration and intensity: 30 mins OEP exercise 3 times a week and walk twice per week, over 6 months Supervisor: 2 physiotherapists Supervision: initial home visit then 3 additional visits (every other week) then final visit at 6 months Setting: Participants homes | |
Outcomes | Timed‐Up and Go test (s) Postural Sway (mm) Compliance/Adherence: Twenty‐five percent (7/28) of all participants completed the exercise program three or more, 57% (16/28) two or more times per week, and 68% (19/28) at least once per week. From data extracted from geriatricians notes at 6 months and 1 year, no participants in control group took up recommendations to exercise. Adverse Events:Two participants in the OEP group reported low back pain associated with the exercises. One resumed exercising, and the other discontinued the exercises. |
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Notes | ||
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Low risk | Computer generated three strata (sex; falls which necessitated visit to emergency dept; falls clinic physician) in blocks of 6 |
Allocation concealment (selection bias) | Low risk | Allocation held externally and remotely |
Incomplete outcome data (attrition bias) All outcomes | Low risk | All analyses were 'full analysis set' |
Selective reporting (reporting bias) | Low risk | All outcomes reported |
Other bias | Low risk | Well reported paper |
Blinding (participant) | High risk | Not possible |
Blinding (assessor) | Low risk | All assessments and telephone interviews |
Were the treatment and control group comparable at entry? | High risk | Baseline characteristics of groups were significantly different for postural sway and TUG. |
Was the surveillance active, and of clinically appropriate duration (i.e. at least 3 months post intervention)? | High risk | Only immediately post intervention data, no follow‐up data reported. |