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Age Ageing. 2016 May;45(3):345-52. doi: 10.1093/ageing/afw036.

Exercise for reducing fear of falling in older people living in the community: Cochrane systematic review and meta-analysis.

Author information

Division of Primary Care, University of Nottingham, Nottingham, UK.
NeuRA, University of New South Wales, New South Wales, Australia.
Department of Health Services Research, Maastricht University and CAPHRI School for Public Health and Primary Care, Maastricht, The Netherlands.
Research Department of Primary Care and Population Health, University College London, London, UK.
Nottingham University Hospitals NHS Trust, Nottingham, UK.
Institute of Allied Health Research, Glasgow Caledonian University, Glasgow, UK.



to determine the effect of exercise interventions on fear of falling in community-living people aged ≥65.


systematic review and meta-analysis. Bibliographic databases, trial registers and other sources were searched for randomised or quasi-randomised trials. Data were independently extracted by pairs of reviewers using a standard form.


thirty trials (2,878 participants) reported 36 interventions (Tai Chi and yoga (n = 9); balance training (n = 19); strength and resistance training (n = 8)). The risk of bias was low in few trials. Most studies were from high-income countries (Australia = 8, USA = 7). Intervention periods (<12 weeks = 22; 13-26 weeks = 7; >26 weeks = 7) and exercise frequency (1-3 times/week = 32; ≥4 times/week = 4) varied between studies. Fear of falling was measured by single-item questions (7) and scales measuring falls efficacy (14), balance confidence (9) and concern or worry about falling (2). Meta-analyses showed a small to moderate effect of exercise interventions on reducing fear of falling immediately post-intervention (standardised mean difference (SMD) 0.37, 95% CI 0.18, 0.56; 24 studies; low-quality evidence). There was a small, but not statistically significant effect in the longer term (<6 months (SMD 0.17, 95% CI -0.05, 0.38 (four studies) and ≥6 months post-intervention SMD 0.20, 95% CI -0.01, 0.41 (three studies)).


exercise interventions probably reduce fear of falling to a small to moderate degree immediately post-intervention in community-living older people. The high risk of bias in most included trials suggests findings should be interpreted with caution. High-quality trials are needed to strengthen the evidence base in this area.


exercise; falls; fear; older people; systematic review

[Indexed for MEDLINE]

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