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Falls prevention: Individual exercise programs for osteoporosis/osteopenia

Healthcare: Falls Prevention for Older Adults
  Literature review updated January 2018.

Individual exercise programs for individuals with osteoporosis or osteopenia aim to prevent falls and fractures by providing supervised exercises that improve balance and postural control. In the included study, a physiotherapist supervised a one-year exercise program, consisting of three 30-minute outpatient sessions weekly. For the rest of each week, participants were assigned home-based exercises for one hour daily. Participants were women with osteoporosis.

This meta-analysis includes only interventions delivered to community-dwelling older adults with osteoporosis or osteopenia. It excludes exercise interventions that had both group class and individual components. We analyze these interventions for community-dwelling older adults with osteoporosis or osteopenia separately.
 
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‡The effect size for this outcome indicates an incidence rate ratio (IRR), not a standardized mean difference effect size. An IRR less than one indicates a lower rate of the outcome in the treatment group relative to the comparison group; an IRR greater than one indicates a higher rate of the outcome. The treatment n for this outcome represents person-years.

Meta-analysis is a statistical method to combine the results from separate studies on a program, policy, or topic to estimate its effect on an outcome. WSIPP systematically evaluates all credible evaluations we can locate on each topic. The outcomes measured are the program impacts measured in the research literature (for example, impacts on crime or educational attainment). Treatment N represents the total number of individuals or units in the treatment group across the included studies.

An effect size (ES) is a standard metric that summarizes the degree to which a program or policy affects a measured outcome. If the effect size is positive, the outcome increases. If the effect size is negative, the outcome decreases. See Estimating Program Effects Using Effect Sizes for additional information on how we estimate effect sizes.

The effect size may be adjusted from the unadjusted effect size estimated in the meta-analysis. Historically, WSIPP adjusted effect sizes to some programs based on the methodological characteristics of the study. For programs reviewed in 2024 or later, we do not make additional adjustments, and we use the unadjusted effect size whenever we run a benefit-cost analysis.

Research shows the magnitude of effects may change over time. For those effect sizes, we estimate outcome-based adjustments, which we apply between the first time ES is estimated and the second time ES is estimated. More details about these adjustments can be found in our Technical Documentation.

Meta-Analysis of Program Effects
Outcomes measured No. of effect sizes Treatment N Effect sizes (ES) and standard errors (SE) Unadjusted effect size (random effects model)
ES SE Age ES p-value
Falls‡
An event which results in a person coming to rest inadvertently on the ground or floor or other lower level.
 69 1 49 0.432 0.222 69 0.432 0.064

Citations Used in the Meta-Analysis

Mikó, I., Szerb, I., Szerb, A., & Poor, G. (2017). Effectiveness of balance training programme in reducing the frequency of falling in established osteoporotic women: A randomized controlled trial. Clinical rehabilitation, 31(2), 217-224.