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. 2019 Jan 31;2019(1):CD012424. doi: 10.1002/14651858.CD012424.pub2

Kerse 2010.

Methods Study design: RCT
Number of study arms: 2
Length of follow‐up: 12 months
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
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
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
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
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
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