Tailored group exercise (Falls Management Exercise -- FaME) reduces falls in community-dwelling older frequent fallers (an RCT).

Frequent or recurrent fallers are more likely to have chronic medical conditions and physiological impairments, exhibit functional decline and have poor outcomes, than single fallers [1]. Fractures are also more common in recurrent fallers than single fallers [2]. Modern surgery for hip fracture can no longer improve on its outcomes [3] and therefore, effective prevention of falls [4, 5] is the key to preventing disability and death. There is still no published evidence that a single intervention (tailored group exercise) can prevent falls or injuries in a high risk group of frequent fallers. This randomised controlled trial (RCT) aimed to investigate the impact of a 36 week individualised and tailored group and home exercise intervention, compared with a control intervention, in reducing falls and injuries in communitydwelling, independent-living, frequent falling women aged 65 years and over. Preliminary results have been published in abstract form [6]. The primary outcome was falls and fallrelated injuries. The secondary outcome was the number of frequent fallers who had died, had moved into residential care or were in hospital compared with the group they were in.

[1]  P. Shekelle,et al.  Interventions for the prevention of falls in older adults: systematic review and meta-analysis of randomised clinical trials , 2004, BMJ : British Medical Journal.

[2]  R. Cumming,et al.  Interventions for preventing falls in elderly people. , 2003, The Cochrane database of systematic reviews.

[3]  S. Lord,et al.  Physiological factors associated with injurious falls in older people living in the community. , 1992, Gerontology.

[4]  D. Skelton,et al.  FaME (Falls Management Exercise): An RCT on the effects of a 9-month group exercise programme in frequently falling community dwelling women age 65 and over. , 2004 .

[5]  Dawn A. Skelton,et al.  Exercise for falls management: Rationale for an exercise programme aimed at reducing postural instability , 1999 .

[6]  Stephen E Roberts,et al.  Time trends and demography of mortality after fractured neck of femur in an English population, 1968–98: database study , 2003, BMJ : British Medical Journal.

[7]  S. Lord,et al.  Physiological Factors Associated with Falls in Older Community‐Dwelling Women , 1994, Journal of the American Geriatrics Society.

[8]  Dawn A Skelton,et al.  Explosive power and asymmetry in leg muscle function in frequent fallers and non-fallers aged over 65. , 2002, Age and ageing.

[9]  Nancy Devlin,et al.  Effectiveness and economic evaluation of a nurse delivered home exercise programme to prevent falls. 1: Randomised controlled trial , 2001, BMJ : British Medical Journal.

[10]  C. Cryer,et al.  Falls, fragility and fractures. National Service Framework for Older People: The case for and strategies to implement a joint health improvement and modernisation plan for falls and osteoporosis , 2001 .

[11]  L. Bouter,et al.  Fall-risk screening test: a prospective study on predictors for falls in community-dwelling elderly. , 2001, Journal of clinical epidemiology.

[12]  D. Rodell,et al.  Psychosocial effects of an exercise program in older persons who fall. , 2003, Journal of rehabilitation research and development.