This systematic review update includes
54 randomised controlled trials and confirms that
exercise as a single intervention can prevent falls
(pooled rate ratio 0.84, 95% CI 0.77–0.91). Metaregression
revealed programs that included balance
training, contained a higher dose of exercise
and did not include walking training to have the
greatest effect on reducing falls. We therefore
recommend that exercise for falls prevention
should provide a moderate or high challenge to
balance and be undertaken for at least 2 hours
per week on an ongoing basis. Additionally, we
recommend that: falls prevention exercise should
target both the general community and those at
high risk for falls; exercise may be undertaken in a
group or home-based setting; strength and walking
training may be included in addition to balance
training but high risk individuals should not be
prescribed brisk walking programs; and other
health-related risk factors should also be
addressed.