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Randomized Controlled Trial
. 2014 Sep 2;9(9):e104412.
doi: 10.1371/journal.pone.0104412. eCollection 2014.

A post-hospital home exercise program improved mobility but increased falls in older people: a randomised controlled trial

Catherine Sherrington  1 , Stephen R Lord  2 , Constance M Vogler  3 , Jacqueline C T Close  4 , Kirsten Howard  5 , Catherine M Dean  6 , Gillian Z Heller  7 , Lindy Clemson  8 , Sandra D O'Rourke  2 , Elisabeth Ramsay  2 , Elizabeth Barraclough  2 , Robert D Herbert  2 , Robert G Cumming  5
Affiliations
Randomized Controlled Trial

A post-hospital home exercise program improved mobility but increased falls in older people: a randomised controlled trial

Catherine Sherrington et al. PLoS One. .

Abstract

Background: Home exercise can prevent falls in the general older community but its impact in people recently discharged from hospital is not known. The study aimed to investigate the effects of a home-based exercise program on falls and mobility among people recently discharged from hospital.

Methods and findings: This randomised controlled trial (ACTRN12607000563460) was conducted among 340 older people. Intervention group participants (n = 171) were asked to exercise at home for 15-20 minutes up to 6 times weekly for 12 months. The control group (n = 169) received usual care. Primary outcomes were rate of falls (assessed over 12 months using monthly calendars), performance-based mobility (Lower Extremity Summary Performance Score, range 0-3, at baseline and 12 months, assessor unaware of group allocation) and self-reported ease of mobility task performance (range 0-40, assessed with 12 monthly questionaries). Participants had an average age of 81.2 years (SD 8.0) and 70% had fallen in the past year. Complete primary outcome data were obtained for at least 92% of randomised participants. Participants in the intervention group reported more falls than the control group (177 falls versus 123 falls) during the 12-month study period and this difference was statistically significant (incidence rate ratio 1.43, 95% CI 1.07 to 1.93, p = 0.017). At 12-months, performance-based mobility had improved significantly more in the intervention group than in the control group (between-group difference adjusted for baseline performance 0.13, 95% CI 0.04 to 0.21, p = 0.004). Self-reported ease in undertaking mobility tasks over the 12-month period was not significantly different between the groups (0.49, 95% CI -0.91 to 1.90, p = 0.488).

Conclusions: An individualised home exercise prescription significantly improved performance-based mobility but significantly increased the rate of falls in older people recently discharged from hospital.

Trial registration: Australian New Zealand Clinical Trials Registry ACTRN12607000563460.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Participant flow.
Figure 2
Figure 2. Number of falls in the 12-month study period by baseline walking velocity and group.
The lines shown are locally weighted regression lines using Stata's “lowess” command.
See this image and copyright information in PMC

References

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    1. Sherrington C, Lord SR, Close JC, Barraclough E, Taylor M, et al. (2011) A simple tool predicted probability of falling after aged care inpatient rehabilitation. J Clin Epidemiol 64: 779–786. - PubMed
    1. Gillespie LD, Robertson MC, Gillespie WJ, Sherrington C, Gates S, et al. (2012) Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev 9: Cd007146. - PMC - PubMed

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