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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

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posted on 24.06.2015 by Rachel Duckham, Tahir Masud, Rachael Taylor, Denise Kendrick, Hannah Carpenter, Steve Iliffe, Richard Morris, Heather Gage, Dawn A. Skelton, Susie Dinan-Young, Katherine Brooke-Wavell
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.

Funding

The main ProAct65+ trial was supported by the National Institute of Health Research Health Technology Assessment Programme (grant number: 06/36/04). The ProAct65+ bone study was supported by an additional award from the National Osteoporosis Society (grant number NOS-2008-23).

History

School

  • Sport, Exercise and Health Sciences

Published in

Age and ageing

Citation

DUCKHAM, R. ... et al, 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), pp.573-579.

Publisher

Oxford University Press on behalf of the British Geriatrics Society / © The Authors

Version

AM (Accepted Manuscript)

Publisher statement

This work is made available according to the conditions of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) licence. Full details of this licence are available at: https://creativecommons.org/licenses/by-nc-nd/4.0/

Publication date

2015

Notes

This paper was published in the journal Age and Ageing [Oxford University Press on behalf of the British Geriatrics Society / © The Authors] and the definitive version is available at: http://dx.doi.org/10.1093/ageing/afv055

ISSN

0002-0729

eISSN

1468-2834

Language

en

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