TY - JOUR
PY - 2021//
TI - Effects of gait adaptability training on falls and fall-related fractures in older adults: a systematic review and meta-analysis
JO - Age and ageing
A1 - Nørgaard, Jens Eg
A1 - Jorgensen, Martin Gronbech
A1 - Ryg, Jesper
A1 - Andreasen, Jane
A1 - Danielsen, Mathias Brix
A1 - Steiner, Daniel Kjærgaard
A1 - Andersen, Stig
SP - ePub
EP - ePub
VL - ePub
IS - ePub
N2 - OBJECTIVE: falls among older adults are common and can have devastating consequences. A novel task-specific exercise modality, gait adaptability training (GAT), has shown promising preventive effects. This systematic review and meta-analysis synthesise the evidence regarding GATs effect on falls and fall-related fractures in community-dwelling older adults.
METHODS: electronic databases (PubMed, EMBASE, CINAHL, CENTRAL) were systematically searched from inception to 18 June 2020. Additional sources include searches of trial registrations, manual screening of reference lists and requests to experts. We included randomised controlled trials (RCTs) evaluating the effect of GAT on falls with at least 6-month follow-up among community-dwelling people aged 60+ years. Two reviewers independently screened studies against eligibility criteria, extracted relevant information and appraised studies for bias. Random-effects meta-analytic models were employed to pool effect estimates.
RESULTS: eleven studies with 1,131 participants were included. A meta-analysis in which an outlier study was excluded showed that GAT reduces fall rates by 42% (incidence rate ratio 0.58, 95% confidence interval [CI] 0.39-0.81, I2 = 0.00%; moderate certainty; seven RCTs). Moreover, proportion with fall-related fractures and proportion of fallers was reduced by 81% (risk ratio [RR] 0.19, 95% CI 0.06-0.56, I2 = 0.00%; very low certainty; two RCTs) and 43% (RR 0.57, 95% CI 0.4-to 0.8, I2 = 47.08%; low certainty; 11 RCTs), respectively.
CONCLUSIONS: our results show that GAT significantly reduces the number of falls and prevents fall-related fractures in older community dwellers. GAT is a promising and feasible exercise modality; however, studies of high quality should be conducted to support a robust conclusion. PROTOCOL REGISTRATION: PROSPERO; CRD42020191051.
Language: en
LA - en SN - 0002-0729 UR - http://dx.doi.org/10.1093/ageing/afab105 ID - ref1 ER -