| Study characteristics |
| Methods |
RCT |
| Participants |
Setting: Calgary, Canada
N = 163
Sample: high‐risk community‐dwelling men and women (72% women)
Age (years): mean 77.6 (SD 6.8)
Inclusion criteria: aged ≥ 65; fallen in previous 3 months; community‐dwelling; ambulatory (with or without aid); mentally intact (able to give consent)
Exclusion criteria: qualifying fall resulted in lower extremity fracture, resulted from vigorous or high‐risk activities, because of syncope or acute stroke, or while undergoing active treatment in hospital |
| Interventions |
1. One in‐home assessment by a geriatric specialist (doctor, nurse, physiotherapist, or OT) lasting 1 to 2 hours. Intrinsic and environmental risk factors assessed. Multidisciplinary case conference (20 min). Recommendations sent to patients and patients' doctor for implementation. Subjects referred to exercise class if problems with balance or gait and not already attending an exercise programme. Given instructions about exercises to do at home
2. Control: 1 home visit by recreational therapist |
| Outcomes |
1. Rate of falls
2. Number of people falling
3. Number of fractures (not number of people sustaining a fracture) |
| Duration of the study |
1 year |
| Notes |
|
| Risk of bias |
| Bias |
Authors' judgement |
Support for judgement |
| Random sequence generation (selection bias) |
Low risk |
Computer‐generated. Stratified by number of falls in previous year: 1 or > 1. |
| Allocation concealment (selection bias) |
Unclear risk |
Sequence concealed in locked cabinet prior to randomisation |
| Blinding of participants and personnel (performance bias)
All outcomes |
Unclear risk |
Participants and personnel not blind to allocated group but impact of non‐blinding unclear |
| Blinding of outcome assessment (detection bias)
Falls and fallers |
Low risk |
Falls reported by participants who were aware of their group allocation. Quote: "The RA (research assistant) remained blinded throughout the study as to each subject's group assignment." |
| Blinding of outcome assessment (detection bias)
Fractures |
Unclear risk |
No mention of whether fractures reported were confirmed |
| Incomplete outcome data (attrition bias)
Falls |
Unclear risk |
SeeAppendix 3 for method of assessment |
| Incomplete outcome data (attrition bias)
Fallers |
Low risk |
SeeAppendix 3 for method of assessment |
| Risk of bias in recall of falls |
Unclear risk |
Falls recorded on monthly calenders (47.8% returned). Also retrospective recall at 3, 6 months (at visit), and 12 months (by phone). |
