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1 Houston Center for Quality of Care and Utilization Studies, Houston VA Medical Center, Texas.
2 Baylor College of Medicine, Houston, Texas.
3 Division of Health Services Research and Policy, School of Public Health, University of Minnesota, Minneapolis.
4 The Miami VA Medical Center Health Services Research and Development Center, Florida.
5 Department of Exercise and Sport Sciences, School of Education, University of Miami, Coral Gables, Florida.
6 Departments of Industrial Engineering, College of Engineering, University of Miami, Coral Gables; Department of Neurological Surgery, School of Medicine, University of Miami; and Comprehensive Pain and Rehabilitation Center, University of Miami, at South Shore Hospital and Medical Center, Miami Beach, Florida.
7 The Department of Psychiatry and the Behavioral Sciences, School of Medicine, University of Miami, Florida.
Address correspondence to Robert O. Morgan, PhD, Houston Center for Quality of Care and Utilization Studies, VA Medical Center (152), 2002 Holcombe Boulevard, Houston, TX 77030. E-mail: rmorgan{at}bcm.tmc.edu
Background. Among elderly persons, falls account for 87% of all fractures and are contributing factors in many nursing home admissions. This study evaluated the effect of an easily implemented, low-intensity exercise program on the incidence of falls and the time to first fall among a clinically defined population of elderly men and women.
Methods. This community-based, randomized trial compared the exercise intervention with a no-intervention control. The participants were 294 men and women, aged 60 years or older, who had either a hospital admission or bed rest for 2 days or more within the previous month. Exercise participants were scheduled to attend exercise sessions lasting 45 minutes, including warm-up and cool-down, 3 times a week for 8 weeks (24 sessions). Assessments included gait and balance measures, self-reported physical function, the number of medications being taking at baseline, participant age, sex, and history of falling. Falls were tracked for 1 year after each participant's baseline assessment.
Results. 29% of the study participants reported a fall during the study period. The effect of exercise in preventing falls varied significantly by baseline physical function level (p 
.002). The risk for falls decreased for exercise participants with low baseline physical functioning (hazard ratio,.51) but increased for exercise participants with high baseline physical functioning (hazard ratio, 3.51).
Conclusions. This easily implemented, low-intensity exercise program appears to reduce the risk for falls among elderly men and women recovering from recent hospitalizations, bed rest, or both who have low levels of physical functioning.
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