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Efficacy of a short multidisciplinary falls prevention program for elderly persons with osteoporosis and a fall
Ellen Smulders1, Vivian Weerdesteyn, Brenda E Groen
1Department of Rheumatology, Sint Maartenskliniek, Nijmegen, The Netherlands. e.smulders@maartenskliniek.nl
Objective:
To evaluate the efficacy of the Nijmegen Falls Prevention Program (NFPP) for persons with osteoporosis and a fall history in a randomized controlled trial. Persons with osteoporosis are at risk for fall-related fractures because of decreased bone strength. A decrease in the number of falls therefore is expected to be particularly beneficial for these persons.
Design:
Randomized controlled trial.
Setting:
Hospital.
Participants:
Persons with osteoporosis and a fall history (N=96; mean ± SD age, 71.0±4.7y; 90 women).
Intervention:
After baseline assessment, participants were randomly assigned to the exercise (n=50; participated in the NFPP for persons with osteoporosis [5.5wk]) or control group (n=46; usual care).
Main Outcome Measures:
Primary outcome measure was fall rate, measured by using monthly fall calendars for 1 year. Secondary outcomes were balance confidence (Activity-specific Balance Confidence Scale), quality of life (QOL; Quality of Life Questionnaire of the European Foundation for Osteoporosis), and activity level (LASA Physical Activity Questionnaire, pedometer), assessed posttreatment subsequent to the program and after 1 year of follow-up.
Results:
The fall rate in the exercise group was 39% lower than for the control group (.72 vs 1.18 falls/person-year; risk ratio, .61; 95% confidence interval, .40-.94). Balance confidence in the exercise group increased by 13.9% (P=.001). No group differences were observed in QOL and activity levels.
Conclusion:
The NFPP for persons with osteoporosis was effective in decreasing the number of falls and improving balance confidence. Therefore, it is a valuable new tool to improve mobility and independence of persons with osteoporosis.
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