@article{ref1,
title="Step training improves reaction time, gait and balance and reduces falls in older people: a systematic review and meta-analysis",
journal="British journal of sports medicine",
year="2016",
author="Okubo, Yoshiro and Schoene, Daniel and Lord, Stephen R.",
volume="51",
number="7",
pages="586-593",
abstract="OBJECTIVE: To examine the effects of stepping interventions on fall risk factors and fall incidence in older people. DATA SOURCE: Electronic databases (PubMed, EMBASE, CINAHL, Cochrane, CENTRAL) and reference lists of included articles from inception to March 2015. STUDY SELECTION: Randomised (RCT) or clinical controlled trials (CCT) of volitional and reactive stepping interventions that included older (minimum age 60) people providing data on falls or fall risk factors. <br><br>RESULTS: Meta-analyses of seven RCTs (n=660) showed that the stepping interventions significantly reduced the rate of falls (rate ratio=0.48, 95% CI 0.36 to 0.65, p<0.0001, I(2)=0%) and the proportion of fallers (risk ratio=0.51, 95% CI 0.38 to 0.68, p<0.0001, I(2)=0%). Subgroup analyses stratified by reactive and volitional stepping interventions revealed a similar efficacy for rate of falls and proportion of fallers. A meta-analysis of two RCTs (n=62) showed that stepping interventions significantly reduced laboratory-induced falls, and meta-analysis findings of up to five RCTs and CCTs (n=36-416) revealed that stepping interventions significantly improved simple and choice stepping reaction time, single leg stance, timed up and go performance (p<0.05), but not measures of strength. <br><br>CONCLUSIONS: The findings indicate that both reactive and volitional stepping interventions reduce falls among older adults by approximately 50%. This clinically significant reduction may be due to improvements in reaction time, gait, balance and balance recovery but not in strength. Further high-quality studies aimed at maximising the effectiveness and feasibility of stepping interventions are required. SYSTEMATIC REVIEWS REGISTRATION NUMBER: CRD42015017357.<p /> <p>Language: en</p>",
language="en",
issn="0306-3674",
doi="10.1136/bjsports-2015-095452",
url="http://dx.doi.org/10.1136/bjsports-2015-095452"
}