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Randomised controlled trial of the effectiveness of community group and home-based falls prevention exercise programmes on bone health in older people: the ProAct65+ bone study

Duckham, Rachel L.; Masud, Tahir; Taylor, Rachael; Kendrick, Denise; Carpenter, Hannah; Iliffe, Steve; Morris, Richard; Gage, Heather; Skelton, Dawn A.; Dinan-Young, Susie; Brooke-Wavell, Katherine

Authors

Rachel L. Duckham

Tahir Masud

Rachael Taylor

DENISE KENDRICK denise.kendrick@nottingham.ac.uk
Professor of Primary Care Research

Hannah Carpenter

Steve Iliffe

Richard Morris

Heather Gage

Dawn A. Skelton

Susie Dinan-Young

Katherine Brooke-Wavell



Abstract

Background: exercise can reduce osteoporotic fracture risk by strengthening bone or reducing fall risk. Falls prevention exercise programmes can reduce fall incidence, and also include strengthening exercises suggested to load bone, but there is little information as to whether these programmes influence bone mineral density (BMD) and strength.

Objective: to evaluate the skeletal effects of home (Otago Exercise Programme, OEP) and group (Falls Exercise Management, FaME) falls prevention exercise programmes relative to usual care in older people.

Methods: men and women aged over 65 years were recruited through primary care. They were randomised by practice to OEP, FaME or usual care. BMD, bone mineral content (BMC) and structural properties were measured in Nottingham site participants before and after the 24-week intervention.

Results: participants were 319 men and women, aged mean(SD) 72(5) years. Ninety-two percentage of participants completed the trial. The OEP group completed 58(43) min/week of home exercise, while the FaME group completed 39(16) and 30(24) min/week of group and home exercise, respectively. Femoral neck BMD changes did not differ between treatment arms: mean (95% CI) effect sizes in OEP and FaME relative to usual care arm were −0.003(−0.011,0.005) and −0.002(−0.010,0.005) g cm−2, respectively; P = 0.44 and 0.53. There were no significant changes in BMD or BMC at other skeletal sites, or in structural parameters.

Conclusions: falls prevention exercise programmes did not influence BMD in older people. To increase bone strength, programmes may require exercise that exerts higher strains on bone or longer duration.

Journal Article Type Article
Publication Date Jul 1, 2015
Journal Age and Ageing
Electronic ISSN 0002-0729
Publisher Oxford University Press
Peer Reviewed Peer Reviewed
Volume 44
Issue 4
Pages 573-579
APA6 Citation Duckham, R. L., Masud, T., Taylor, R., Kendrick, D., Carpenter, H., Iliffe, S., …Brooke-Wavell, K. (2015). Randomised controlled trial of the effectiveness of community group and home-based falls prevention exercise programmes on bone health in older people: the ProAct65+ bone study. Age and Ageing, 44(4), 573-579. doi:10.1093/ageing/afv055
DOI https://doi.org/10.1093/ageing/afv055
Publisher URL https://academic.oup.com/ageing/article/44/4/573/66782
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