| Content Provider |
World Health Organization (WHO)-Global Index Medicus |
| Author |
Buford, Thomas W. Walkup, Michael P. Strotmeyer, Elsa S. Guralnik, Jack M. Demons, Jamehl L. King, Abby C. Gill, Thomas M. Mcdermott, Mary M. Miller, Michael E. Nelson, Miriam E. Pahor, Marco Sink, Kaycee M. Kashaf, Susan S. |
| Spatial Coverage |
United States |
| Description |
Author Affiliation: Gill TM ( Department of Medicine, Yale School of Medicine, Adler Geriatric Center, 874 Howard Avenue, New Haven, CT 06510, USA thomas.gill@yale.edu.); Pahor M ( Department of Aging and Geriatric Research, University of Florida, Gainesville, FL, USA.); Guralnik JM ( Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA.); McDermott MM ( Departments of Medicine and Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.); King AC ( Departments of Health Research & Policy and Medicine, Stanford School of Medicine, Stanford, CA, USA.); Buford TW ( Department of Aging and Geriatric Research, University of Florida, Gainesville, FL, USA.); Strotmeyer ES ( Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, PA, USA.); Nelson ME ( Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA.); Sink KM ( Department of Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA.); Demons JL ( Department of Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA.); Kashaf SS ( Department of Medicine, Yale School of Medicine, Adler Geriatric Center, 874 Howard Avenue, New Haven, CT 06510, USA.); Walkup MP ( Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA.); Miller ME ( Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA.); |
| Abstract |
Objective To test whether a long term, structured physical activity program compared with a health education program reduces the risk of serious fall injuries among sedentary older people with functional limitations. Design Multicenter, single blinded randomized trial (Lifestyle Interventions and Independence for Elders (LIFE) study). Setting Eight centers across the United States, February 2010 to December 2011. Participants 1635 sedentary adults aged 70-89 years with functional limitations, defined as a short physical performance battery score ≤9, but who were able to walk 400 m. Interventions A permuted block algorithm stratified by field center and sex was used to allocate interventions. Participants were randomized to a structured, moderate intensity physical activity program (n=818) conducted in a center (twice a week) and at home (3-4 times a week) that included aerobic, strength, flexibility, and balance training activities, or to a health education program (n=817) consisting of workshops on topics relevant to older people and upper extremity stretching exercises. Main outcome measures Serious fall injuries, defined as a fall that resulted in a clinical, non-vertebral fracture or that led to a hospital admission for another serious injury, was a prespecified secondary outcome in the LIFE Study. Outcomes were assessed every six months for up to 42 months by staff masked to intervention assignment. All participants were included in the analysis. Results Over a median follow-up of 2.6 years, a serious fall injury was experienced by 75 (9.2%) participants in the physical activity group and 84 (10.3%) in the health education group (hazard ratio 0.90, 95% confidence interval 0.66 to 1.23; P=0.52). These results were consistent across several subgroups, including sex. However, in analyses that were not prespecified, sex specific differences were observed for rates of all serious fall injuries (rate ratio 0.54, 95% confidence interval 0.31 to 0.95 in men; 1.07, 0.75 to 1.53 in women; P=0.043 for interaction), fall related fractures (0.47, 0.25 to 0.86 in men; 1.12, 0.77 to 1.64 in women; P=0.017 for interaction), and fall related hospital admissions (0.41, 0.19 to 0.89 in men; 1.10, 0.65 to 1.88 in women; P=0.039 for interaction). Conclusions In this trial, which was underpowered to detect small, but possibly important reductions in serious fall injuries, a structured physical activity program compared with a health education program did not reduce the risk of serious fall injuries among sedentary older people with functional limitations. These null results were accompanied by suggestive evidence that the physical activity program may reduce the rate of fall related fractures and hospital admissions in men. Trial registration ClinicalsTrials.gov {"type":"clinical-trial","attrs":{"text":"NCT01072500","term_id":"NCT01072500"}}NCT01072500. |
| ISSN |
09598138 |
| e-ISSN |
17561833 |
| Journal |
BMJ (British Medical Journal) |
| Volume Number |
352 |
| Language |
English |
| Publisher |
British Medical Journal Publishing Group |
| Publisher Date |
2016-02-01 |
| Publisher Place |
Great Britain (UK) |
| Access Restriction |
Open |
| Subject Keyword |
Accidental Falls Prevention & Control Exercise Therapy Gait Physiology Health Education Lower Extremity Muscle Strength Postural Balance Sedentary Lifestyle Sex Factors Single-Blind Method Multicenter Study Randomized Controlled Trial Research Support, N.I.H., Extramural Medicine |
| Content Type |
Text |
| Resource Type |
Article |
