Table 1.
The baseline characteristics of included studies and participants
| Study | Country | Sample size | Age (years) | Percent male (%) | BMI (kg/m2) | Number of fractures | Exercise regimen | Control | Supplements | Follow-up duration | Study quality |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Preisinger 1996 [32] | Australia | 58 (27/31) | 60.7 (62.6/59.0) | 0.0 | NM | 7 (5/2) | Postural stability, functional movement, coordination and muscle strength, 3 times per week, for 4 years; home-based | Retained usual lifestyle | No supplements | 4.0 years | 3 |
| McMurdo 1997 [33] | UK | 92 (44/48) | 64.5 | 0.0 | NM | 2 (0/2) | Weight-bearing exercise, 3 times a week, 10 weeks a year for 2 years; centre-based | Retained usual lifestyle | Daily calcium (1000 mg) supplements | 7.0 years | 2 |
| Ebrahim 1997 [34] | UK | 97 (49/48) | 67.2 (66.4/68.1) | 0.0 | NM | 10 (6/4) | Brisk walking for 40 min, 3 times a week, for 2 years; home-based | Received usual care | No supplements | 2.0 years | 5 |
| Robertson 2001 [35] | New Zealand | 240 (121/119) | 81.0 (80.8/81.1) | 32.5 | NM | 9 (2/7) | Muscle strengthening and balance exercise, 3 times a week, plus a walking programme, 2 times a week, training for 12 mos and following-up for 18 months; home-based | Usual care | No supplements | 1.0 year | 5 |
| Chan 2004 [36] | China | 108 (54/54) | 54.0 (54.4/53.6) | 0.0 | 23.8 | 3 (1/2) | 50 min of Yang Style Tai Chi exercise in each training day, 5 days a week, for 12 months; centre-based | Retained sedentary lifestyle | No supplements | 1.0 year | 2 |
| Ashburn 2007 [37] | UK | 134 (67/67) | 72.2 (72.7/71.6) | 61.0 | NM | 8 (2/6) | Daily muscle strengthening, movement, balance training and walking for 6 months; home-based | Received usual care | No supplements | 6.0 months | 5 |
| Karinkanta 2007 [38] | Finland | 144 (108/36) | 72.6 (72.8/72.0) | 0.0 | 28.5 | 4 (2/2) | Resistance training, balance-jumping or combining those exercises together, 3 times a week, for 12 months; centre-based | Asked to maintain Usual physical activity | No supplements | 1.0 year | 5 |
| Swanenburg 2007 [39] | Switzerland | 20 (10/10) | 71.2 (71.8/70.7) | 0.0 | 23.3 | 1 (1/0) | A group programme of muscular strength, co-ordination, balance and endurance training, 3 sessions a week for 3 months, following-up for 12 months; centre-based | Retained routine activities | Daily calcium (500–1000 mg) and Vit D (400–800 IU) supplements | 1.0 year | 5 |
| Haines 2009 [40] | Australia | 53 (19/34) | 80.6 (80.9/80.5) | 39.6 | NM | 3 (1/2) | A progressive exercise programme combining lower limb strength and balance exercises, lasting for 6 months; home-based | Retained usual lifestyle | No supplements | 6.0 months | 5 |
| Zeng 2009 [41] | China | 124 (63/61) | 50.0–69.0 | NA | NM | 7 (2/5) | Tai Chi exercise, 3 times a week, training for 2 months and following-up for 2 years; centre-based | Asked to keep usual lifestyle | Daily calcium (600 mg) supplements | 2.0 years | 3 |
| Bischoff-Ferrari 2010 [42] | Switzerland | 173 (87/86) | 84.2 (83.4/85.1) | 20.8 | 24.3 | 22 (7/15) | An additional daily 30-min exercise including balance and strength training, plus functional mobility during acute care, continuing the programme each day after discharge, lasting for 12 months; home-based | Received usual care | No supplements | 1.0 year | 5 |
| Kemmler 2010 [43] | Germany | 227 (115/112) | 69.0 (68.9/69.2) | 0.0 | NM | 18 (6/12) | Two times of supervised balance training, strength training and upper body exercises, plus 2 times of home training including strength and flexibility exercises, 4 times a week for 18 months; centre/ home-based | Retained usual lifestyle and exercise habits | Daily calcium (1500 mg) and Vit D (500 IU) supplements | 1.5 years | 5 |
| Korpelainen 2010 [44] | Finland | 160 (84/76) | 72.7 (72.7/72.6) | 0.0 | 25.6 | 38 (16/22) | A weekly supervised balance, leg strength and impact training programme, 6 months each year, followed by a daily home exercise including a similar programme as supervised training, 6 months a year, training for 2 years and following-up for 6 years; centre/home-based | Asked to continue daily routine activities | No supplements | 7.0 years | 5 |
| Smulders 2010 [45] | Netherlands | 92 (47/45) | 71.0 (70.5/71.6) | 6.3 | NM | 2 (0/2) | Weight-bearing and walking exercises, and gait correction and fall prevention training programmes, training for 5.5 weeks and following-up for 12 months; centre-based | Usual lifestyle | No supplements | 1.0 year | 5 |
| Iliffe 2014 [46] | UK | 1256 (387/411/458) | 73.0 | 37.6 | 26.7 | 9 (3/6) | Centre-based exercise: 1 h of upper body and lower body strength training, plus 2 times of walking per week; home- based exercise: 3 times per week of muscle strengthening and balance exercises plus 2 times of walking; training for 6 months and following-up 1 year; centre/home-based | Retained usual lifestyle | No supplements | 2.0 years | 5 |
| Gill 2016 [47] | USA | 1635 (818/817) | 78.9 (78.7/79.1) | 32.8 | NM | 142 (66/76) | The intervention included two center based visits a week and home based activity 3–4 times a week. The physical activity sessions were individualized and progressed toward a goal of 30 min of walking at moderate intensity, 3–5 min of large muscle group flexibility exercises, 10 min of primarily lower extremity strength training by means of ankle weights (two sets of 10 repetitions), and 10 min of balance training; centre/home-based | Health education to continue daily routine activities | No supplements | 2.6 years | 5 |
| Uusi-Rasi 2017 [48] | Finland | 409 (205/204) | 74.2 (74.5/74.0) | 0.0 | NM | 15 (8/7) | Static balance, 4 m normal walking speed and five-time chair stand tests, and by the Timed up and go (TUG) test; centre-based | Usual lifestyle | Daily calcium (1098 mg) and Vit D (10.4 μg) supplements | 2.0 years | 4 |
| Cockayne 2017 [49] | UK | 1010 (493/517) | 77.9 (78.1/77.7) | 39.6 | 27.7 | 31 (17/14) | Routine podiatry care as determined by the podiatrist and a falls prevention leaflet in addition to: footwear advice and provision if current footwear was judged to be inappropriate; foot orthoses; and a 30 min a day, three times a week home-based foot and ankle exercise programme supplemented with a DVD and explanatory booklet; centre/home-based | Routine care | No supplements | 1.0 year | 4 |
| Harris 2019 [50] | UK | 1001/297 | 45.0–75.0/60.0–75.0 | 36.0/46.0 | NM | 70 (34/36) | Postal, who received the 12-week PACE-UP walking programme (pedometer, handbook, and PA diary) by post, and nurse- supported, who received the same materials at the first of three practice nurse PA consultations; 12-week PACE-Lift walking programme (pedometer, handbook, PA diary, and feedback on their accelerometry measures) at the first of four practice nurse PA consultations; centre/home-based/centre-based | Routine care | No supplements | 3.0 years | 4 |
| Liu-Ambrose 2019 [51] | Canada | 374 (172/172) | 81.6 (81.2/81.9) | 33.4 | 27.0 | 27 (15/12) | 5 strengthening exercises: knee extensor, knee flexor, hip abductor, ankle plantar flexors, and ankle dorsiflexors; 11 balance retraining exercises: knee bends, backward walking, walking and turning around, sideways walking, tandem stands, tandem walking, 1-leg stand, heel walking, toe walking, heel-toe walking backward, and sit to stand; home-based | Usual care | No supplements | 1.0 year | 5 |
*BMI body mass index, NM not mentioned