Table 2.
Characteristics of randomised controlled trials
| Author/year | Location | Sample size I:C |
Recruitment | Population | Intervention setting |
Comparator | Relevant outcome/s† | Follow-up |
|---|---|---|---|---|---|---|---|---|
| Arija 2017 [20] | Spain | 260:104 | Primary care | Inclusion: primary care catchment, mean age >65 years Exclusion: episode of ischemic heart disease less than 6 months previously, acute episode of arthritis that would limit the ability to walk, lung or heart disease causing dyspnoea |
Community | Usual care | International Physical Activity Questionnaire, short version | 9 months |
| Arkkukangas 2019 [60] and Tuvemo Johnson 2021 [16]* |
Sweden | 61:58:56 | Patients who requested walking aids/home care from health centres or municipality | Inclusion: ≥75 years, able to walk independently and understand written and oral information in Swedish, mean age >80 years Exclusion: scoring <25 on the Mini Mental State Examination, ongoing regular physiotherapy, terminal care |
Home and healthcare centres | Otago exercise program | Falls Efficacy Scale (Swedish version) The Frandin/Grimby Activity Scale |
12 weeks, 12 months and 24 months |
| Bae 2019 [41] | Japan | 41:42 | The National Centre for Geriatrics and Gerontology Study of Geriatric Syndromes | Inclusion: mild cognitive impairment, normal general cognitive function, no evidence of functional dependency, no dementia, mean age >65 Exclusion: <65 years, certification of needing care from the long-term care insurance, disability in activities of daily living, history of Parkinson’s or Alzheimer’s disease, depression, contraindication of exercise by GP, pacemaker, connection to this research, frequent 1–10 km trips outdoors, currently employed, no mild cognitive impairment, missing data |
Community | Oral care and nutrition education | Time spent in moderate-to-vigorous physical activity Step count Going outdoors, number of times/day |
N/A |
| Boongird 2017 [40] | Thailand | 219:220 | N/A | Inclusion: mild to moderate balance dysfunction, mean age >65 Exclusion: moderate to severe cognitive problems, neurological conditions influencing gait and mobility, acute arthritis, unstable or terminal illness that would preclude the planned exercises, not Thai speaking, participating in regular strengthening exercise |
Primary care clinics | Falls prevention education | Thai fall efficacy scale | 3, 6, 9 and 12 months |
| Clemson 2004 [57] | Australia | 157:153 | Promotional material, health referrals, advertisements, mailing lists, department of veteran’s affairs, football clubs, community organisations | Inclusion: fallen in the previous year, consider themselves at risk of falling, conversational English, mean age >70 years Exclusion: cognitive problems associated with dementia, homebound, unable to independently leave home |
Predetermined community venue | Two social visits from an occupational therapist | Modified Falls-Efficacy Scale Physical Activity Scale for the Elderly |
N/A |
| Croteau 2007 [45] | USA | 95:84 | Health, educational, and social programmes in the community | Inclusion: able to ambulate independently, able to walk at velocity and/or with appropriate gait patterns necessary to permit adequate pedometer readings, wears appropriate clothing, physician approval, mean age >70 years | Community | Wait-list controls instructed to continue with their usual activity | Daily step counts | 12 weeks, 24 weeks |
| Crotty 2002 [48] |
Australia | 34:32 | Acute hospital | Inclusion: hip fracture, medically stable, physical and mental capacity, expected home discharge Exclusion: inadequate social support, no telephone, outside catchment, mean age >80 years |
Home | Routine care | Falls Efficacy Scale | 4 months |
| de Roos 2018 [56] | The Netherlands | 26:26 | Primary general care practices and hospital | Inclusion: Clinically stable COPD (GOLD Stage II COPD—≤50% FEV1 < 80%), score of ≥2 on Medical Research Council Dyspnoea Scale, mean age >70 years Exclusion: Exercise-restricting, non-COPD related complaints (e.g. severe cardiac or MSK issues) |
Primary physiotherapy care centre and home | Usual care | Daily physical activity (minutes per day) 6-min Walk test |
10 weeks |
| Echeverria 2020 [44] | Spain | 27:28 | Internal Medicine and Neurology services of University Hospital of Araba | Inclusion: ≥70 years, scored ≥20 on the Mini Mental State Examination, able to walk at least 4 m independently, mean age >80 years Exclusion: Chronic kidney disease, severe dementia, autoimmune neuromuscular disease, acute myocardial infarction, bone fracture in the last 3 months, refusal to sign informed consent |
Hospital and home | Short-term program | 6-min walk test Time in moderate-vigorous physical activity steps per day |
24 weeks |
| Hauer 2002 [38] |
Germany | 15:13 | Inpatient rehabilitation | Inclusion: hip fracture, ≥75 years, female, mean age >80 years Exclusion: severe cognitive/cardiovascular/musculoskeletal disease, acute neurological impairment, unstable chronic/terminal illness, major depression |
Outpatient geriatric rehabilitation unit | Seated activities | Physical activity questionnaire for elderly people | 3 months |
| Hughes 2004 [59] Hughes 2006 [62]* |
USA | 80:70 | Newsletter, announcements in the local media, presentations to local senior groups | Inclusion: clinical presence of lower extremity joint osteoarthritis, mean age >70 years Exclusion: <60 years, participating in an aerobic exercise programme, have had uncomplicated hip or knee surgery within the previous 6 months or complicated surgery within the past year, have received steroid injections in either knee or hip within the previous 3 months; a diagnosis of rheumatoid arthritis, moderate to severe cognitive impairment; severe, limiting cardiovascular disease, active thrombophlebitis, recent pulmonary embolus, acute systemic illness, poorly controlled diabetes, people with other health conditions precluding exercise. |
Senior centres, senior housing residences | ‘The Arthritis Helpbook’, a list of community exercise programmes, self-care materials and handouts | 6-min walk test Maintenance of Physical Activity (minutes per week) |
2, 6, 9, and 12 months |
| Iliffe 2014 [39] | UK | 411:387:458 | General practices, mailed invitations, telephone contact | Inclusion: commitment to participate for the duration of the study, availability of suitable community venue, ≥65 years, able to walk independently indoors and outdoors, physically able to take part in a group exercise class, eligible to participate in the trial, mean age >70 years Exclusion: significant cognitive impairment, three or more self-reported falls in the previous year, resting blood pressure >180/100 mmHg, tachycardia >100 bpm, uncontrolled hypertension as considered by GP, drop in blood pressure during exercise, psychiatric conditions preventing participation in an exercise class, uncontrolled medical problems, conditions requiring a specialist exercise program, unable to maintain a seated upright position, unable to move independently indoors, not living independently, receiving long-term physiotherapy, already in an exercise program. |
Home | Free to participate in any other exercise as they normally would | Proportion meeting target of ≥150 min of moderate-vigorous physical activity per week (Community Health Activities Model Program for Seniors scale) Physical Activity Scale for the Elderly Falls-related self-efficacy |
6, 12, 18 and 24 months |
| Karlsson 2016 [47] | Sweden | 107:98 | Geriatric ward | Inclusion: hip fracture, ≥70 years, living in the municipality of Umeå, lives in ordinary housing or residential care facilities, dementia and cognitive impairments were included, mean age >80 years Exclusion: pathological fractures and those whose hip fracture occurred in hospital |
Home | Conventional geriatric care and rehabilitation | Walking ability indoors and outdoors | 3 and 12 months |
| Kerr 2018 [17] and Crist 2021 [61]* | USA | 151:156 and 150:155 |
Flyers, presentations, participant testimonials from previous sites, encouragement from site staff and peers | Inclusion: >65 years, timed up and go <30 s, able to walk 20 m without assistance, no falls in previous 12 months that resulted in hospitalisation, able to talk over the phone, no plans to move in the next 12 months, completion of post-consent comprehension test, mean age >80 years Exclusion: dementia or cognitive impairment |
Continuing Care Retirement Communities | Education on successful ageing and four general health calls |
Physical activity (minutes of moderate-vigorous per day) Time spent in four mutually exclusive domains further from home (GPS) |
3, 6, 9 and 12 months |
| Kerse 2010 [43] | New Zealand | 97:96 | Invitation from primary care practitioner | Inclusion: ≥75 years, community dwelling, able to communicate in English, complete assessments, no severe dementia or unstable medical conditions preventing participation in physical activity, mean age >80 years Exclusion: dementia/cognitive impairment, living in residential care, terminal illness, unable to communicate in English, unstable medical condition |
Home | Social visits | Auckland Heart Study Physical Activity Questionnaire | 6 and 12 months |
| Lee 2007 [19] | Taiwan | 102:100 | Eligible individuals identified and contacted from healthcare database | Inclusion: resident in local township, mild to moderate hypertension (resting systolic blood pressure between 140 mmHg and 179 mmHg), mean age >70 years Exclusion: Unable to walk regularly, high blood pressure |
Community, home and/or telephone | Usual care | Self-Efficacy for Exercise Scale | 6 months |
| Logan 2004 [54] | UK | 86:82 | GP registers | Inclusion: clinical diagnosis of stroke in the last 36 months, mean age >70 years | Home | Routine care and transport leaflets | Outdoor mobility satisfaction Number of journeys made outside the house |
4 and 10 months |
| Logan 2014 [18] | UK | 287:281 | General practices, primary care therapy teams, community stroke teams, outpatient clinics | Inclusion: stroke at least 6 weeks previously, wished to get out of the house more often, mean age >70 years Exclusion: not able to comply with the protocol and therapy programme, being in active rehabilitation |
Home | Verbal advice, packs of local travel information | Number of journeys made outside the house Satisfaction with outdoor mobility |
6 months, 12 months |
| Magaziner 2019 [49] | USA | 105:105 | Clinic/health centres | Inclusion: hip fracture, community dwelling, ambulatory prefracture, <300 m in 6-min walk test at randomisation, mean age >80 years Exclusion: medically unstable, pathological fracture, low potential to benefit, practical impediments to participation |
Home | Seated activities and TENS | 6-min walk test | 4 months |
| Mangione 2005 [50] | USA | 13:17:11 | Physiotherapy practice | Inclusion: hip fracture, ≥65 years, living at home, discharged from physiotherapy, able to travel for assessment, mean age >75 years Exclusion: MMSE<20, unstable angina, uncompensated congestive heart failure, metabolic conditions that limit training, residual hemiplegia, Parkinsons Disease, life expectancy of <6 months, nursing home dwelling |
Home | Routine care and written materials | 6-min walk test | 3 months |
| Orwig 2011 [53] |
USA | 91:89 | Acute hospital | Inclusion: hip fracture, ≥65 years, female, community dwelling, ambulatory unaided prefracture, mean age >80 years Exclusion: <20 MMSE, pathological fracture, cardiovascular/neurologic/respiratory diseases/conditions which increased risk of falls limiting exercising home alone, bone disease, metastatic cancer, cirrhosis, end-stage renal disease, hardware in contralateral hip |
Home | Routine care | Yale Physical Activity Scale | 2,6, and 12 months |
| Pfeiffer 2020 [21] |
Germany | 57:58 | Inpatient rehabilitation | Inclusion: hip fracture, community-dwelling, positively screened for fear of falling, mean age >80 years Exclusion: cognitive impairment, severe communication deficiencies |
Inpatient rehabilitation and home | Routine care | Short Falls Efficacy Scale Daily walking duration |
3 months |
| Pol 2019 [51] |
Netherlands | 87:76:77 | Nursing and community care facilities | Inclusion: hip fracture, ≥65 years, living alone, MMSE ≥15 Exclusion: MMSE <15, terminal illness, awaiting nursing home placement, mean age >80 years |
Home, nursing and community care facilities | Routine care | Falls Efficacy Scale International | 1, 4 and 6 months |
| Resnick 2007 [52] |
USA | 51:54:52:51 | Acute hospital | Inclusion: hip fracture, ≥65 years, female, community dwelling, clearance from surgeon, mean age ≥80 years Exclusion: MMSE <20, medical problems that increase falls risk when exercising home alone, walking unaided prefracture, pathological fracture |
Home | Routine care | Self-efficacy for walking/exercise scale The Yale Physical Activity Survey |
2, 6 and 12 months |
| VanderWalde 2021 [58] | USA | 27:27 | Dept of Radiation Oncology at the West Cancer Center and Research Institute | Inclusion: ≥65 years, English speaking, stage 0–3 breast cancer, exercise less than 120 min per week, scheduled to receive either whole breast or regional radiotherapy with curative intent, mean age >65 years Exclusion: those who exercise ≥120 min per week, too unhealthy to walk safely |
Home | Standard fractionated radiotherapy | 1 month | |
| Varas 2018 [55] | Spain | 21:19 | Hospital at Universidad Autonoma de Madrid | Inclusion: COPD diagnosis, no exacerbation 4 weeks prior to the study, exertional dyspnoea, habitual low physical activity level (<30 min of moderate intensity exercise per day) mean age >65 years Exclusion: difficulty walking, CVD (except high BP), participated in a PR programme in the 12 months prior |
Community | Exercise education, pedometer with general recommendations to walk more every day | Exercise capacity—Endurance Shuttle test Physical activity (average number of steps/day) |
10 weeks, 3 and. 12 months |
| Voukelatos 2015 [42] and Merom 2015 [63]* | Australia | 191:194 145:170 |
Newspaper advertisements, personal and professional referrals, sampling from Australian electoral roll | Inclusion: ≥65 years, inactive (<120 min exercise per week), able to walk at least 50 m, able to communicate in English, walk unaided or with manual assistance for 50 m, mean age >70 years Exclusion: neurological conditions limiting participation or cognitive impairment |
Home | Health education | Falls Efficacy Scale-International Incidental and Planned Exercise Questionnaire |
2 months and 12 months |
| Ziden 2008 [46] and Ziden 2010 [64]* | Sweden | 48:54 | Community-dwelling patients with hip fracture in the central or western parts of Goteborg | Inclusion: hip fracture, ≥65 years, able to speak and understand Swedish, mean age >80 years Exclusion: severe medical illness with expected survival of <1 year, severe drug or alcohol abuse, mental illness, or severe cognitive impairment |
Home | Conventional Care | Falls efficacy Scale, Swedish version | 1, 6 and 12 months |
I: Intervention C: Control COPD: Chronic Pulmonary Disease
*Two articles for one RCT
†Relevant to current systematic review