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Article pour les cliniciens

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L'exercice pour prévenir les chutes chez les personnes âgées: mise à jour d'une revue systématique et méta-analyse.

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• Sherrington C
• Michaleff ZA
• Fairhall N
• Paul SS
• Tiedemann A
• Whitney J, et al.

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Commentaires cliniques (en anglais)

Family Medicine (FM)/General Practice (GP)

This is not a conclusive but useful review. My own unreliable observation is that exercise benefits the elderly more than the young. I like studies which agree with me but have tried to be dispassionate in reading this. If this is correct, the reduction in fractures and falls and gains in cardiovascular performance and mental health are worth more study.

General Internal Medicine-Primary Care(US)

This review of the impact of exercise on fall risk clarifies several aspects of specific requirements to achieve benefits. The benefits seem limited to community dwelling elderly and is not clearly of value in those in residence facilities. As clinicians, we often suggest that simply walking is of benefit. However even in community dwelling elderly, that simple form of exercise alone was not useful in reducing falls. Indeed, there was a trend towards harm. Supporting that conclusion was the finding that there was greater fall reduction with more extensive (> 3 hours per week) programs that included specific exercises which required balance challenging components. The authors rightly point out that there may be value to any exercise in all these groups, but to specifically reduce risk of falling requires a more regimented approach as they found in this review.

Internal Medicine

It is well known that exercise prevents falls in older people. What this study adds is that it works well in patients with Parkinson disease and cognitive impairment, and it is not so clear in stroke survivors. The updated recommendation for exercise practices to prevent falls given by authors is a good starting point.

Public Health

This meta analysis confirms with including the results of newer study the benefit of exercise in preventing falls in the elderly: Therefore, there is no new news but reinforcement and strengthening of previous findings.