Skip to main content
. 2019 Jan 31;2019(1):CD012424. doi: 10.1002/14651858.CD012424.pub2

Sherrington 2014.

Methods Study design: RCT
Number of study arms: 2
Length of follow‐up: 12 months
Participants Setting: Sydney, Australia
Number of participants: 340
Number analysed: 340
Number lost to follow‐up: 0
 Sample: community‐dwelling
 Age (years): mean 81.2 (SD 8.0)
Sex: 74% female
 Inclusion criteria: aged 60 years and over and had been admitted to and subsequently discharged from 9 aged care, rehabilitation and orthopaedic wards at 4 public hospitals in Sydney, Australia
 Exclusion criteria: resided in a high‐care residential facility (nursing home); had cognitive impairment (a MMSE score < 24); had insufficient English language to understand procedures; were unable to walk more than 1 m even with an assistive device or the help of 1 person; or had a medical condition precluding a 12‐month home exercise program (e.g. unstable cardiac disease or progressive neurological disease)
Interventions 1. Home‐based strength and balance programme: Weight‐bearing Exercise for Better Balance exercise programme + 32‐page education booklet about fall prevention, home programme of lower limb balance and strengthening exercises for 20 ‐ 30‐minute sessions, up to 6 a week for 12 months; home visits: 10 over 12 months
 2. Control group: Usual care from health and community services + 32‐page education booklet about fall prevention
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 Participants who actually exercised
 1. Weight‐bearing Exercise group: 1 month: 90%, 3 months: 81%, 8 months: 66%, 12 months: 60%
Notes Source of funding: Australian National Health and Medical Research Council, Australian National Health and Medical Research Council Research Fellowships
Economic information: Mean cost per person (intervention): WEBB AUD 751. Healthcare service costs: WEBB AUD 12,029, usual care AUD 10,327. Incremental costs per fall prevented/per QALY gained: AUD 77,403 per
 QALY gained
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Low risk Computer‐generated random‐number schedule with randomly‐ordered blocks of 2, 4, and 6
Allocation concealment (selection bias) Low risk Quote: “Ensure concealed randomisation to groups, the randomisation schedule was generated in advance by and only accessible to the first author who was not involved in participant recruitment, interviews or assessments”
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 Same method used to ascertain falls in both groups. Blinded research assistants recorded and confirmed falls
Blinding of outcome assessment (detection bias) 
 Fractures Unclear risk Method of ascertaining fractures not specified
Blinding of outcome assessment (detection bias) 
 Hospital admission, medical attention and adverse events Low risk Adverse events were monitored using the exercise diaries and recorded by blinded assessors
Blinding of outcome assessment (detection bias) 
 Health related quality of life (self report) High risk Participants were not blinded to group allocation
Incomplete outcome data (attrition bias) 
 Falls and fallers Low risk No missing fall data
Selective reporting (reporting bias) Low risk Falls, risk of falls and adverse events are reported and the trial protocol paper prespecifies the same fall outcomes as those in the trial report
Method of ascertaining falls (recall bias) Low risk Monthly falls calendar. Participants who did not return calendars or who reported a fall were telphoned by blinded research assistants