Kwok 2016.
| Methods | Study design: RCT Number of study arms: 2 Length of follow‐up: 12 months |
|
| Participants | Setting: Singapore Number of participants: 80 Number analysed: 80 Number lost to follow‐up: 0 Sample: community‐dwelling Age (years): mean 80 Sex: 85% female Inclusion criteria: not participating in any routine exercise programme, participants with MFES scores ≤ 9 and could comprehend English, Mandarin or a local dialect Exclusion criteria: people with neurological disorders |
|
| Interventions | 1. Group‐based balance, strength and aerobic training plus home practice: gym equipment used for cardiovascular training, strength training prescribed at 10 or 15 repetitive maximum; 1‐hour sessions, weekly for 12 weeks, 20 minutes of home balance and strength exercises from week 13 on non‐intervention days 2. Balance, strength and aerobic training using the Nintendo WiiActive: supervision provided for gaming exercises with the Wii balance board, calisthenics and resistance band and calisthenics used for cadiovascular training, resistance band used for strengthening; 20 minutes, weekly for 12 weeks, 20 minutes of home exercises from week 13 |
|
| Outcomes | 1. Rate of falls 2. Number of people who experienced 1 or more falls (risk of falling) |
|
| Duration of the study | 52 weeks | |
| Adherence | Adherence measured as session attendance and home exercise compliance 1. Group‐based balance, strength and aerobic training plus home‐practice group: mean exercise session attendance 9.4 (SD 3.2); mean home exercise compliance 2.1 days a week (SD 1.2) 2. Balance, strength and aerobic training using the Nintendo WiiActive group: mean exercise session attendance 9.5 (SD 2.5); mean home exercise compliance 2.4 days per week (SD 1.4) |
|
| Notes | Source of funding: The SingHealth Foundation, Singapore Physiotherapy Association Economic information: not reported |
|
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Unclear risk | Quote: "Generated the random allocation sequence". Insufficient information about the sequence generation process to permit judgement |
| Allocation concealment (selection bias) | Unclear risk | Consecutively‐numbered, sealed envelope. Opaque not stated |
| Blinding of participants and personnel (performance bias) All outcomes | Unclear risk | Participants and personnel unblinded but impact of unblinding unknown |
| Blinding of outcome assessment (detection bias) Falls | Low risk | Quote: "Baseline and follow‐up measurements were performed by trained and blinded research assistants". Assume this includes monthly telephone follow‐up of fall‐tracking |
| 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) | Unclear risk | Not applicable |
| Incomplete outcome data (attrition bias) Falls and fallers | Low risk | No missing fall data |
| Selective reporting (reporting bias) | High risk | Falls were measured, but number of falls was not reported |
| Method of ascertaining falls (recall bias) | Low risk | Participants tracked monthly fall incidence on a recording sheet and were contacted monthly through telephone or mobile phone short messages to minimise recall bias |