By Joene Hendry

NEW YORK (Reuters Health) - Combined findings from multiple studies indicate that exercise programs, especially those that include balance training, do reduce falls among elderly people.

Examples of successful falls prevention programs include "Tai Chi and home-based or group-based exercise prescribed by a health professional," Dr. Catherine Sherrington told Reuters Health.

On the other hand, walking programs did not appear to have much effect in preventing falls, Sherrington and her colleagues report in the Journal of the American Geriatrics Society.

Sherrington, at The George Institute for International Health, in Sydney, Australia, and colleagues assessed the reduction of falls with exercise programs in 44 trials. A total of 9,603 mostly community-living men and women, 65 percent of whom were 75 years of age or older, participated in the trials.

Pooled data from these trials showed that exercise programs were associated with a 17 percent reduction in the occurrence of falls.

The greatest effect in preventing falls were seen with exercises that highly challenged balance, such as standing with legs closer together or on one leg, and programs that included a higher total "dose" of exercise, for example at least 2 days a week for more than 25 weeks.

Fall prevention was also better when programs "did not include a walking program," Sherrington's team reports, and strength training also lacked benefit in this regard.

The researchers surmise that walking may expose older people to a greater risk of falling or, in time-limited programs, may take the place of time spent on more effective balance training. Strength training alone may not effectively reduce falls, the investigators note, since "impaired balance is a stronger risk factor for falls than poor muscle strength."

Sherrington's group calls for further research to investigate whether well-designed walking programs can prevent falls.

They further suggest research into methods to entice larger numbers of older people to engage in falls prevention exercises.

SOURCE: Journal of the American Geriatrics Society, December 2008

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