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Meta-Analysis
. 2023 Jul 14:14:1187325.
doi: 10.3389/fendo.2023.1187325. eCollection 2023.

Exercise for prevention of falls and fall-related injuries in neurodegenerative diseases and aging-related risk conditions: a meta-analysis

Feifei Feng  1   2 , Haocheng Xu  1 , Yu Sun  1 , Xin Zhang  1 , Nan Li  1 , Xun Sun  1 , Xin Tian  1 , Renqing Zhao  1
Affiliations
Meta-Analysis

Exercise for prevention of falls and fall-related injuries in neurodegenerative diseases and aging-related risk conditions: a meta-analysis

Feifei Feng et al. Front Endocrinol (Lausanne). .

Abstract

Introduction: Neurodegenerative diseases often cause motor and cognitive deterioration that leads to postural instability and motor impairment, while aging-associated frailty frequently results in reduced muscle mass, balance, and mobility. These conditions increase the risk of falls and injuries in these populations. This study aimed to determine the effects of exercise on falls and consequent injuries among individuals with neurodegenerative diseases and frail aging people.

Methods: Electronic database searches were conducted in PubMed, Cochrane Library, SportDiscus, and Web of Science up to 1 January 2023. Randomized controlled trials that reported the effects of exercise on falls and fall-related injuries in neurodegenerative disease and frail aging people were eligible for inclusion. The intervention effects for falls, fractures, and injuries were evaluated by calculating the rate ratio (RaR) or risk ratio (RR) with 95% confidence interval (CI).

Results: Sixty-four studies with 13,241 participants met the inclusion criteria. Exercise is effective in reducing falls for frail aging people (RaR, 0.75; 95% CI, 0.68-0.82) and participants with ND (0.53, 0.43-0.65) [dementia (0.64, 0.51-0.82), Parkinson's disease (0.49, 0.39-0.69), and stroke survivors (0.40, 0.27-0.57)]. Exercise also reduced fall-related injuries in ND patients (RR, 0.66; 95% CI, 0.48-0.90) and decreased fractures (0.63, 0.41-0.95) and fall-related injuries (0.89, 0.84-0.95) among frail aging people. For fall prevention, balance and combined exercise protocols are both effective, and either short-, moderate-, or long-term intervention duration is beneficial. More importantly, exercise only induced a very low injury rate per participant year (0.007%; 95% CI, 0-0.016) and show relatively good compliance with exercise (74.8; 95% CI, 69.7%-79.9%).

Discussion: Exercise is effective in reducing neurodegenerative disease- and aging-associated falls and consequent injuries, suggesting that exercise is an effective and feasible strategy for the prevention of falls.

Keywords: aging; exercise; fall-related injuries; falls; neurodegenerative diseases.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Summary estimates of exercise for prevention of falls in participants with neurodegenerative diseases and frail aging people. (A) Participants with neurodegenerative diseases; (B) frail aging people. RaR, rate ratio; CI, confidence interval; N, number.
Figure 2
Figure 2
Effects of exercise on the risk of fall-related injuries. (A) Participants with neurodegenerative diseases; (B) frail aging people. RR, risk ratio; CI, confidence interval; N, number.
Figure 3
Figure 3
Effects of exercise on the risk of fractures. (A) Participants with neurodegenerative diseases; (B) frail aging people. RR, risk ratio; CI, confidence interval; N, number.
Figure 4
Figure 4
Effects of exercise on fall rates categorized by exercise types. (A) Participants with neurodegenerative diseases; (B) frail aging people. RaR, rate ratio; CI, confidence interval; N, number.
Figure 5
Figure 5
Effects of exercise on fall rates categorized by exercise durations. (A) Participants with neurodegenerative diseases; (B) frail aging people. RaR, rate ratio; CI, confidence interval; N, number.
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