Motivational Interviewing and Exercise for Falls Prevention in Older Adults: A Systematic Review

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Olayinka Akinrolie 1,2 , Oseremen R. Oriarewo 3 , Francis O. Kolawole 2,3 , Henrietha C. Adandom 2,4 , Eseose Animhiaga 3 , Osaosemwen Uyi 3 , Sarah I. Ashama3 , Ekundayo Fatai 2,5 , Tolulope Adeniji 2,6,7, Henrietta O. Fawole2,3,8

1 University of Calgary. 2 ERPAAN. 3 University of Benin. 4 University of Lethbridge. 5 .University of Nigeria Enugu Campus. 6 Canterbury Christ Church University. 7 University of KwaZulu-Natal. 8 Coventry University.

Scientific Research

SP - Falls

Falls

View DOI

Abstract

Introduction:

Exercise-based programmes reduce falls in older adults, yet adherence is often suboptimal. There is evidence to support the use of motivational interviewing (MI) for strengthening motivation for behaviour change; but its additive benefit with exercise for falls prevention remains unclear. This systematic review examined whether exercise and MI improve falls-related outcomes among older adults.

Method:

CENTRAL, MEDLINE, CINAHL, PsycINFO, Web of Science and EMBASE were searched from inception to September 2025. Randomised and non-randomised controlled trials were eligible if MI was delivered as an adjunct to an exercise programme intended to prevent falls in adults aged ≥60 years. Comparators were exercise alone or usual care. The primary outcome was number or rate of falls; secondary outcomes included balance, fall-efficacy and physical performance. Risk of bias was assessed using RoB 2.0 for randomised trials and the RoBINS-I for non-randomised trials. Due to heterogeneity, findings were synthesised narratively using SWiM, and certainty assessed using GRADE.

Results:

From 402 records, three trials (five publications) enrolling 206 participants were included. Two trials combined MI with the Otago Exercise Programme, and one embedded MI within a multicomponent falls’ prevention programme. Only one trial was judged low risk of bias. Certainty of evidence for falls outcomes was low to very low. Across outcomes and follow- up periods, MI plus exercise did not demonstrate significant reduction in falls compared to control conditions, although one extended follow-up publication reported fewer falls at two years. Similarly, there was no significant improvement in balance, fall-efficacy, and physical performance.

Conclusion(s):

Currently, there is no evidence to support the additive effect of MI on exercise for falls prevention in older adults aged 60 years and older. There is a need for more and high-quality trials with follow-up and clear demonstration of MI integration to exercise programs.

Keywords: older adults, falls, exercise, motivational interviewing