Effects of a Multimodal Exercise Program on Physical Function, Falls, and Injuries in Older Women: A 2‐Year Community‐Based, Randomized Controlled Trial

<jats:sec> <jats:title>Objectives</jats:title> <jats:p>To investigate the effects of multimodal supervised exercise on physical functioning, falls, and related injuries in older women.</jats:p> </jats:sec> <jats:sec> <jats:title>Design</jats:title> <jats:p>Two‐year randomized controlled trial.</jats:p> </jats:sec> <jats:sec> <jats:title>Setting</jats:title> <jats:p>Tampere, Finland.</jats:p> </jats:sec> <jats:sec> <jats:title>Participants</jats:title> <jats:p>Women aged 70 to 80 who had fallen in the previous year (n = 409).</jats:p> </jats:sec> <jats:sec> <jats:title>Intervention</jats:title> <jats:p> Participants were randomly assigned to an exercise or control group ( <jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="http://www.Clinicaltrial.gov">ClinicalTrial.gov</jats:ext-link> NCT00986466). Exercisers participated in group exercise classes twice a week for 12 months and once a week for the subsequent 12 months and home exercises. Controls maintained their current physical activity. </jats:p> </jats:sec> <jats:sec> <jats:title>Measurements</jats:title> <jats:p>Physical functioning assessed at baseline and at 6‐month intervals during the intervention. Falls and related injuries monitored with fall diaries.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p> Intention‐to‐treat analyses showed that exercise led to significant improvements in physical functioning. Leg strength differed significantly between the groups (mean change: 14.1%, 95% confidence interval (CI) = 8.0 to 20.2 in exercisers; 1.6%, 95% CI = −4.5 to 7.7 in controls; <jats:italic>P</jats:italic>  < .001). Chair stand time also differed significantly between groups (7.4%, 95% CI 3.8 to 10.8% in exercisers; 2.4%, 95% CI = −1.6 to 6.2) in controls; <jats:italic>P</jats:italic>  = .02). Between‐group differences were significant for fast walking speed ( <jats:italic>P</jats:italic>  = .003) and probability of completing the backward walking test ( <jats:italic>P</jats:italic>  < .001), favoring exercisers. Timed Up‐and‐Go and grip strength did not differ between groups. There was no difference in the total falls incidence rate ratio (IRR = 1.0, 95% CI = 0.79 to 1.26), but exercisers were less likely to have medically attended injurious falls (IRR = 0.45, 95% CI = 0.27 to 0.78; <jats:italic>P</jats:italic>  = .004). </jats:p> </jats:sec> <jats:sec> <jats:title>Conclusion</jats:title> <jats:p>Twenty‐four months of multimodal exercise enhanced physical functioning in women aged 70 to 80 with a history of falls. Although the total number of falls was not lower than in controls, the rate of medically attended injurious falls was more than 50% lower.</jats:p> </jats:sec>