Preventing falls in physically active community-dwelling older people: a comparison of two intervention techniques.

BACKGROUND Falls are common in physically active older people; however, most intervention studies have been targeted at frail older people. OBJECTIVE To evaluate the effectiveness of two intervention techniques for preventing falls in physically active community-dwelling older people. METHODS Two hundred and seventeen people (120 men and 97 women) aged between 70 and 90 years recruited from a health insurance company membership database were randomly allocated to receive either a psychomotor intervention focusing on body awareness, body experience and coordination, a fitness intervention focusing on functional skills, strength, endurance and flexibility, or no intervention (control group). The outcome measures were prospective falls (number of fallers, number of multiple fallers, number of falls and falls rate) and measures of physical performance (Timed Up and Go Test, maximal step length, sit-to-stand time, normal and fast walking speed). RESULTS At the 4-month follow-up, significant improvements in the Timed Up and Go Test and sit-to-stand times were observed for both the psychomotor and fitness intervention groups. During the 12-month follow-up period, 39% of the participants fell at least once, and 19% fell on multiple occasions. The proportion of fallers in the fitness intervention group was 23% less than in the control group (RR = 0.77, 95% CI 0.60-0.97), but no significant reduction in falls was observed in the psychomotor intervention group. CONCLUSION A fitness training program improves some aspects of physical performance and reduces falls by 23% in physically active older people.