Effects of a Fall Prevention Intervention on Chinese Rural Older Adults with Various Physical Activity Levels
Abstract
ABSTRACT
Introduction
Falls and fall-induced injury are major public health concerns. In Chinese rural older adults, physical activity (PA) levels correlate with falls, but with varying effects. This study examined the effects of a fall prevention intervention, primarily consisted of balance and functional exercises, on falls and fall-induced injury among rural Chinese older adults with various PA levels.
Methods
This post-hoc analysis was based on the FAMILY cluster randomized trial in 128 rural Chinese villages. The intervention group received balance and functional exercises with community-engaged health education; controls received usual care. PA levels were classified using the International Physical Activity Questionnaire Short Form. Main outcomes were self-reported falls and fall-induced injuries. Multivariate logistic regression model was used to quantify the effects, with adjustment of covariates (sex, age, educational attainment, history of falls, comorbidity status, fall risk, and fear of falling).
Results
A total of 2,616 participants were recruited, with 2,606 included in the analysis (6 died before randomization and 4 lost to follow-up). The proportion of fallers in the intervention group was lower in moderate-PA (n=608, OR = 0.59; 95% CI: 0.41 - 0.85; P < 0.005) and high-PA (n=1,604, OR = 0.68; 95% CI: 0.41 - 0.85; P < 0.001), but not low-PA (n=394, OR = 0.69; 95% CI: 0.44 - 1.09; P = 0.11). In all subgroups, the proportion of fall-induced injuries was significantly lower in the intervention groups.
Conclusion
In Chinese rural older adults, the balance and functional exercises and community-engaged health education effectively reduced the risk of falls in moderate- and high-PA subgroups and fall-induced injuries in all PA levels. These interventions may achieve greater benefits among older adults with higher PA levels. Future interventions shall focus on individuals with low PAs.
Comments
PA stratification
What were the cut-points for the PA stratification (low, moderate, high)?
cut-points for the PA
Thank you for your question.
The physical activity levels were classified according to the IPAQ scoring protocol. Participants were categorized as having high physical activity if they reported vigorous-intensity physical activity on ≥3 days/week with a total physical activity level of ≥1500 MET-min/week, or any combination of walking, moderate-intensity, and vigorous-intensity activities on ≥7 days/week with a total physical activity level of ≥3000 MET-min/week. Participants were categorized as having moderate physical activity if they met any of the following criteria: vigorous-intensity physical activity for ≥20 min/day on ≥3 days/week; moderate-intensity activity and/or walking for ≥30 min/day on ≥5 days/week; or any combination of walking, moderate-intensity, and vigorous-intensity activities on ≥5 days/week with a total physical activity level of ≥600 MET-min/week. Participants who did not meet these criteria or did not report physical activity were classified as having low physical activity.