Summary of findings 5. Summary of findings: 3D (dance) exercise versus control (e.g. usual activities).
| 3D (dance) exercise versus control (e.g. usual activities) for preventing falls in older people in the community | ||||||
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Patient or population: Older people living in the community (trials focusing on people recently discharged from hospital were not included) Settings: Community, either at home or in places of residence that, on the whole, do not provide residential health‐related care Intervention: Exercise, type = 3D (dance) traininga Comparison: Usual care (no change in usual activities) or a control (non‐active) interventionb | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of participants (studies) | Certainty of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Control | Exercise (3D [dance]) | |||||
| Rate of falls (falls per person‐years) Follow‐up: 12 months |
All studies population | Rate ratio 1.34 (0.98 to 1.83) | 522 (1 RCT) |
⊕⊝⊝⊝d very low | The evidence is of very low certainty, hence we are uncertain of the findings of an increase of 34% (95% CI 2% reduction to 83% increase) in the number of falls Guide to the data based on the all‐studies estimate If 1000 people were followed over 1 year, the number of falls may be 1139 (95% CI 833 to 1556) compared with 850 in the group receiving usual care or attention control |
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| 850 per 1000c | 1139 per 1000 (833 to 1556) | |||||
| Specific exercise population | ||||||
| 800 per 1000c | 1072 per 1000 (784 to 1464) | |||||
| Number of people who experienced one or more falls Follow‐up: 12 months |
All studies population | RR 1.35 (0.83 to 2.20) | 522 (1 RCT) |
⊕⊝⊝⊝d very low | The evidence is of very low certainty, hence we are uncertain of the findings of an increase of 35% (95% CI 17% reduction to 120% increase) in the number of people who experienced one or more falls Guide to the data based on the all‐studies estimate If 1000 people were followed over 1 year, the number of people who experienced one or more falls may be 648 (95% CI 399 to 1056) compared with 480 in the group receiving usual care or attention control |
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| 480 per 1000e | 648 per 1000 (399 to 1056) | |||||
| Specific exercise population | ||||||
| 583 per 1000e | 787 per 1000 (484 to 1283) | |||||
| Number of people who experienced one or more fall‐related fractures | Not estimable | Not estimable | See comment | ‐ | This outcome was not reported | |
| Adverse events | See comment | Not estimable | 522 (1 RCT) |
⊕⊝⊝⊝f very low | Adverse events were reported for the intervention group only (275 participants) in the one trial in this analysis. There were no occurrences of adverse events | |
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; RR: risk ratio | ||||||
| GRADE Working Group grades of evidence High certainty: We are very confident that the true effect lies close to that of the estimate of the effect Moderate certainty: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different Low certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect | ||||||
aUsing Prevention of Falls Network Europe (ProFaNE) taxonomy, 3D (dance) training uses dynamic movement qualities, patterns and speeds whilst engaged in constant movement in a fluid, repetitive, controlled manner through three spatial planes. Exercise programmes included in this analysis had 3D (dance) training as the single primary exercise category; these exercise programmes may also include secondary categories of exercise. bA control intervention is one that is not thought to reduce falls, such as general health education, social visits, very gentle exercise, or 'sham' exercise not expected to impact on falls. cThe all‐studies population risk was based on the number of events and the number of participants in the control group for this outcome over the 59 all‐exercise types RCTs. The specific exercise population risk was based on the number of events and the number of participants in the control group for this outcome in the sole RCT. dGraded very low due to serious imprecision (only one cluster‐RCT, with a wide CI due to small sample size). eThe all‐studies population risk was based on the number of events and the number of participants in the control group for this outcome over the 63 all‐exercise types RCTs. The specific exercise population risk was based on the number of events and the number of participants in the control group for this outcome in the sole RCT. fDowngraded by three levels due to limitations in the design of studies, suggesting a high likelihood of bias (the trial measured the number of participants experiencing adverse events in the exercise group).