LaStayo 2017.

Methods	Study design: RCT Number of study arms: 2 Length of follow‐up: 12 months
Participants	Setting: Utah, USA Number of participants: 134 Number analysed: 112 Number lost to follow‐up: 22 Sample: community‐dwelling Age (years): mean 76.1 (SD 7.18) Sex: 65% female Inclusion criteria: at least 65 years of age or older; had experienced at least 1 fall in the previous 12 months; community‐dwelling; ambulatory with a gait speed ranging from of 0.42 to 1.3 m/s; able to recall all 3 items (or 1 to 2 items with a normal clock drawing test) on the Mini‐CogTM instrument for dementia screening; managing 2 or more co‐morbid conditions, though cleared by their physician to participate in a 60‐minute (with rests) multicomponent exercise fall reduction programme (MCEFRP) Exclusion criteria: progressive diagnosed neurologic disease (e.g. Parkinson’s, multiple sclerosis, Guillain‐Barre, Alzheimers); any dystrophies or rheumatologic conditions that primarily affects muscle (e.g. muscular dystrophy, polymyalgia rheumatica); already participated in a MCEFRP or if they were currently performing (or had performed) regular (3 times a week) aerobic (defined as hiking, fast‐walking, jogging, running swimming or cycling) or resistance (defined as weight training with bands, cable, free‐weights or weight‐machines) exercise over the past 12 months; any of the absolute contraindications for a MRI scan
Interventions	Participants trained for 60 minutes per session, 3 times a week for 3 months as part of the multicomponent exercise fall reduction program that included aerobic training (recumbent trainer, cycle erg or treadmill), flexibility exercise, 15 ‐ 20‐minute individualised balance exercises, upper‐limb resistance training and lower‐limb resistance training The 2 lower‐limb resistance training programmes were: 1) Traditional (TRAD) resistance exercise: 3 sets of 15 repetitions of a seated bilateral leg‐press exercise at 70% 1 RM. Also, standing multidirectional straight‐leg exercises with a weighted cuff placed just proximal to the ankle. The training loads for this exercise were increased as tolerated every 2 weeks, provided the participants could complete 3 sets of 15 repetitions with appropriate form 2) Resistance exercise by negative, eccentrically‐induced, work (RENEW): progressive resistive eccentric exercise of the knee and hip extensor muscles using a recumbent stepper‐ergometer. The duration of each resistance training session was progressively increased to a maximum 15‐minute duration during weeks 5 – 12
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	All participants completed the prespecified requisite minimum 18 MCEFRP sessions and ≥ 90% adhered to at least 29 of the 36 exercise sessions
Notes	Source of funding: National Institute of Aging of the National Institutes of Health Economic information: not reported Email communication regarding fall data, response received, data not included in review
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Quote: "A randomisation process with blocks of ten insured equivalency in the number of subjects adn the same proportion of men and women were assigned into each of the groups"
Allocation concealment (selection bias)	Unclear risk	Allocation not specified
Blinding of participants and personnel (performance bias) All outcomes	Unclear risk	Blinding not specified. Assume participants and presonnel not blinded. Impact of non‐blinding is unknown
Blinding of outcome assessment (detection bias) Falls	High risk	Assessors were not blinded to group
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	Unclear risk	Less than 20% of fall outcome data are missing (16%). Missing data were not balanced between the RENEW (n = 14) and traditional (n = 8) groups, with more participants dropping out in the first 3 months in the RENEW group (9 dropouts compared with 4 dropouts). The reasons for the dropouts are not clear
Selective reporting (reporting bias)	Unclear risk	Minimum set of expected outcomes not reported (adverse events not reported)
Method of ascertaining falls (recall bias)	Low risk	From 0 ‐ 3 months intervention personnel asked about falls at weekly intervention sessions. 4 ‐ 12 months falls were recorded by monthly stamped postcards, with telephone contact if a fall was reported or postcards were not returned