Exercise and vitamin D in fall prevention among older women: a randomized clinical trial
Uusi-Rasi K, Patil R, Karinkanta S, Kannus P, Tokola K, Lamberg-Allardt C, Sievänen H
JAMA internal medicine · 178 citas
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Financiación no declaradaDatos neutrales que nuestra revisión registró sobre cómo se hizo este estudio. Describen el método, nunca si nos gusta el resultado.
Cómo se estudió
- Diseño
- Ensayo controlado aleatorizado (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Eventos clínicos como enfermedad o muerte
Quién lo pagó
- Financiación
- Financiación no declarada
Publicación
- Publicado
- 2015-03-23 · JAMA Intern Med · vol. 175 · número 5 · pág. 703
- Editorial
- American Medical Association
- Citado
- 263 citas · más que el 100% de estudios similares · 91.2× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 32 trabajos
- Acceso
- De pago
- Áreas de investigación
- Balance, Gait, and Falls Prevention · Vitamin D Research Studies · Bone health and osteoporosis research
- Palabras clave
- fall prevention, vitamin D supplementation, exercise training, older women, injurious falls, resistance training, balance training, bone mineral density, physical function, muscle strength, community-dwelling older adults, vitamin D metabolism, trabecular bone density, femoral neck bone mineral density, fall rates, community-dwelling older women
- MeSH
- humans, wounds and injuries, vitamins, vitamin d, treatment outcome, exercise therapy, trauma severity indices, accidental falls, bone density, aged, aged, 80 and over, female, muscle strength, postural balance, independent living
7 autores
- Kirsti Uusi‐Rasi🇫🇮Tampere University Hospital; Urho Kaleva Kekkonen Institute
- Radhika Patil🇫🇮Urho Kaleva Kekkonen Institute
- Saija Karinkanta🇫🇮Urho Kaleva Kekkonen Institute
- Pekka Kannus🇫🇮Tampere University; Tampere University Hospital; University of Tampere
- Kari Tokola🇫🇮Urho Kaleva Kekkonen Institute
- Christel J. E. Lamberg-Allardt🇫🇮University of Helsinki
- Harri T. Sievänen🇫🇮Urho Kaleva Kekkonen Institute
Resumen
El texto original del estudio, en el idioma en que se publicó.
Importance
While vitamin D supplementation and exercise are recommended for prevention of falls for older people, results regarding these 2 factors are contradictory.
Objective
To determine the effectiveness of targeted exercise training and vitamin D supplementation in reducing falls and injurious falls among older women.
Design, setting, and participants
A 2-year randomized, double-blind, placebo-controlled vitamin D and open exercise trial conducted between April 2010 and March 2013 in Tampere, Finland. Participants were 409 home-dwelling women 70 to 80 years old. The main inclusion criteria were at least 1 fall during the previous year, no use of vitamin D supplements, and no contraindication to exercise.
Interventions
Four study groups, including placebo without exercise, vitamin D (800 IU/d) without exercise, placebo and exercise, and vitamin D (800 IU/d) and exercise.
Main outcomes and measures
The primary outcome was monthly reported falls. Injurious falls and the number of fallers and injured fallers were reported as secondary outcomes. In addition, bone density, physical functioning (muscle strength, balance, and mobility), and vitamin D metabolism were assessed.
Results
Intent-to-treat analyses showed that neither vitamin D nor exercise reduced falls. Fall rates per 100 person-years were 118.2, 132.1, 120.7, and 113.1 in the placebo without exercise, vitamin D without exercise, placebo and exercise, and vitamin D and exercise study groups, respectively; however, injurious fall rates were 13.2, 12.9, 6.5, and 5.0, respectively. Hazard ratios for injured fallers were significantly lower among exercisers with vitamin D (0.38; 95% CI, 0.17-0.83) and without vitamin D (0.47; 95% CI, 0.23-0.99). Vitamin D maintained femoral neck bone mineral density and increased tibial trabecular density slightly. However, only exercise improved muscle strength and balance. Vitamin D did not enhance exercise effects on physical functioning.
Conclusions and relevance
The rate of injurious falls and injured fallers more than halved with strength and balance training in home-dwelling older women, while neither exercise nor vitamin D affected the rate of falls. Exercise improved physical functioning. Future research is needed to determine the role of vitamin D in the enhancement of strength, balance, and mobility.
Trial registration
clinicaltrials.gov Identifier: NCT00986466.
Resumen vía Europe PMC. Los derechos de autor siguen siendo de los autores o la editorial.
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