Kerse 2010.
Methods | Study design: RCT Number of study arms: 2 Length of follow‐up: 12 months |
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Participants | Setting: Auckland, New Zealand Number of participants: 193 Number analysed: 193 Number lost to follow‐up: 0 Sample: community‐dwelling Age (years): mean 81.1 (SD 4.4) Sex: 58% female Inclusion criteria: aged 75 years or older, were community‐dwelling, were able to communicate in English to complete assessments, positive depression screen (answered yes to 2 of the 3 depression screen questions) and that they had no severe dementia or unstable medical conditions precluding participation in a physical activity programme Exclusion criteria: see inclusion criteria |
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Interventions | 1. Individual Otago Exercise Programme: home‐based programme which comprised moderate‐intensity balance retraining, 'progressive resistance' lower limb‐strengthening exercises, upper limb strengthening, walking, goal setting, and social enrichment; leg and arm weights used (1, 2, 3 kg); ≥ 30 minutes, 3 a week for 6 months; total of 8 x 1‐hour visits to discuss, adjust the programme and motivate 2. Control group: 8 social visits with standardised conversation for a similar amount of time to the intervention participants |
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Outcomes | 1. Rate of falls 2. Number of people who experienced 1 or more falls (risk of falling) 3. Health‐related quality of life 4. Number of people who died |
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Duration of the study | 52 weeks | |
Adherence | Adherence measured as number of visits received, frequency of exercises 1. Individual Otago Exercise Programme: 81/97 participants (84%) received all the intervention visits, 6/97 had < 6 visits; During the first 6 months: 29% exercised ≥ 3 a week and 37% walked ≥ 3 a week 65% exercised ≥ 2 a week and 63% walked ≥ 2 a week At 12 months: 25% exercised ≥ 3 a week and 37% walked ≥ 3 a week 55% exercised ≥ 2 a week and 59% walked ≥ 2 a week 7 participants performed the programme almost daily 2. Control group: 86% completed all visits |
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Notes | Source of funding: New Zealand Health Research Council, University of Auckland Research Committee Economic information: not reported Email communication to obtain fall data, response received, data included in review |
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Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Low risk | Computer‐generated random numbers |
Allocation concealment (selection bias) | Unclear risk | Method of concealment is not described |
Blinding of participants and personnel (performance bias) All outcomes | High risk | Participants and personnel unblinded but impact of unblinding unknown |
Blinding of outcome assessment (detection bias) Falls | Low risk | Assessment of falls was the same in both groups Quote: "The research nurses conducting follow‐up assessments were blinded to the participants’ group allocation. To maintain this blinding, immediately before the follow‐up visits, participants were reminded by a telephone call from a researcher not to talk to the assessment nurses about the physical activity program or who had been visiting them." |
Blinding of outcome assessment (detection bias) Fractures | Unclear risk | Not applicable |
Blinding of outcome assessment (detection bias) Hospital admission, medical attention and adverse events | Unclear risk | Not applicable |
Blinding of outcome assessment (detection bias) Health related quality of life (self report) | High risk | Participants not blinded to group allocation |
Incomplete outcome data (attrition bias) Falls and fallers | Low risk | No missing falls data |
Selective reporting (reporting bias) | Unclear risk | Minimum set of expected outcomes not reported (adverse events not reported) |
Method of ascertaining falls (recall bias) | High risk | Interval recall. Falls were ascertained by self‐report at 6 months and 12 months |