Effectiveness of exercise prescription variables to reduce fall risk among older adults: a meta-analysis.

Objective: This meta-analysis explored the relationship between various exercise prescription variables and their effects on fall risk reduction in older adults, enabling the selection of targeted and evidence-based intervention prescription variables tailored to individual risk-assessment results.

Method: Databases including PubMed, Embase, Web of Science, and the Cochrane Library were systematically searched for randomized controlled trials that investigated the impact of exercise intervention on fall prevention. Study quality was assessed using the Cochrane risk-of-bias tool. Meta-analyses, subgroup analyses, sensitivity analyses, and assessments of publication bias were performed using Stata 16.0.

Results: A total of 43 articles comprising 51 studies and involving 2,743 participants were included. The results indicated significant improvements in fall risk assessment indices due to Mind-body Exercise (MBE), Multi-component Physical Activity (MCPA), and Muscle-strengthening Activity(MSA). Subgroup analyses revealed differential optimal type, cycle (week), frequency (day/week), and session time (minutes) across assessment tools, such as the unipedal stance test with eyes open (MCPA, < 8, 3, 45 ≤ Time < 60), functional reach (MCPA, < 8, < 3, ≥ 60), the "get-up and go" test (MSA, ≥ 24, < 3, 30 ≤ Time < 45), Berg balance scale (MBE, 8 ≤ Time < 12, 3, 30 ≤ Time < 45), Five stands sit-to-stand (MCPA, ≥ 24, > 3, 30 ≤ Time < 45), the 30-s chair-stand test (MSA, 12 ≤ Time, < 3, 45 ≤ Time < 60), short physical performance battery (MCPA, 12 ≤ Time < 24, < 3, ≥ 60), and Falls Efficacy Scale-International (MBE, 8 ≤ Time < 12, < 3, 45 ≤ Time < 60).

Conclusion: The findings suggest that prescription variables combining MCPA and MBE, ≥ 8-week programs, and ≥ 30-min sessions, effectively reduce fall risk through concurrent enhancement of balance, strength, and self-efficacy; their integration into community-based protocols with individualized resistance-balance combinations optimizes functional outcomes in older adults.