Abstract
Aim: To summarize the literature regarding the cost-effectiveness of exercise-based programs for falls prevention among the older people, and discuss the implications of the review’s findings for clinical practice and future research on the dosage for cost-effective exercise-based falls prevention program for the older people.
Design: Systematic review.
Method: CINAHL, Scopus, Pubmed, NHS Economic Evaluation Database, ISI Web of Science, Science Citation Index and PsycINFO for pertinent studies from their inception until February 2019. Randomized controlled trials with an economic evaluation of exercise-based falls prevention programs for the older people aged 60 years and above measuring the cost-effectiveness using the incremental cost-effectiveness ratios, cost per quality-adjusted life year, the incremental cost per fall or benefit to cost ratio were included. Methodological quality was assessed using the Physiotherapy Evidence Database (PEDro) scale and the quality of economic evaluation using the Quality of Health Economic Studies (QHES).
Result: Twelve studies including 3668 older people were reviewed. Interventions for falls prevention were either exercise only or multifactorial programs. Five studies of high economic quality and two studies of high methodological quality provided evidence supporting exercise only programs as cost-effective for preventing falls. Exercise-only programs were more cost-effective than multifactorial falls prevention programs.
Conclusion: There is evidence to support exercise-based intervention as a cost-effective treatment for preventing falls among older people. Further research is needed to more fully establish the cost-effectiveness of such programs, especially in both developing and underdeveloped countries.
Key practice points:
• Moderate intensity of strengthening exercise done twice per week lasting for 60 minutes each session for 6 months or over is likely to be cost-effective in preventing falls among the older people.
• Strengthening exercise for the lower limb and balance training needs to be included in the falls prevention exercise program. Scheduled walking, upper limb exercises and functional exercises may provide additional benefits.
• Ongoing exercises are needed for sustained benefits.
Design: Systematic review.
Method: CINAHL, Scopus, Pubmed, NHS Economic Evaluation Database, ISI Web of Science, Science Citation Index and PsycINFO for pertinent studies from their inception until February 2019. Randomized controlled trials with an economic evaluation of exercise-based falls prevention programs for the older people aged 60 years and above measuring the cost-effectiveness using the incremental cost-effectiveness ratios, cost per quality-adjusted life year, the incremental cost per fall or benefit to cost ratio were included. Methodological quality was assessed using the Physiotherapy Evidence Database (PEDro) scale and the quality of economic evaluation using the Quality of Health Economic Studies (QHES).
Result: Twelve studies including 3668 older people were reviewed. Interventions for falls prevention were either exercise only or multifactorial programs. Five studies of high economic quality and two studies of high methodological quality provided evidence supporting exercise only programs as cost-effective for preventing falls. Exercise-only programs were more cost-effective than multifactorial falls prevention programs.
Conclusion: There is evidence to support exercise-based intervention as a cost-effective treatment for preventing falls among older people. Further research is needed to more fully establish the cost-effectiveness of such programs, especially in both developing and underdeveloped countries.
Key practice points:
• Moderate intensity of strengthening exercise done twice per week lasting for 60 minutes each session for 6 months or over is likely to be cost-effective in preventing falls among the older people.
• Strengthening exercise for the lower limb and balance training needs to be included in the falls prevention exercise program. Scheduled walking, upper limb exercises and functional exercises may provide additional benefits.
• Ongoing exercises are needed for sustained benefits.
| Original language | English |
|---|---|
| Publication status | Published - 18 Oct 2019 |
| Event | Transform 2019 Physiotherapy conference - Adelaide, Australia Duration: 17 Oct 2019 → 19 Oct 2019 |
Conference
| Conference | Transform 2019 Physiotherapy conference |
|---|---|
| Country/Territory | Australia |
| City | Adelaide |
| Period | 17/10/19 → 19/10/19 |
