Follow-up efficacy of physical exercise interventions on fall incidence and fall risk in healthy older adults: a systematic review and meta-analysis

Hamed, Azza; Bohm, Sebastian; Mersmann, Falk; Arampatzis, Adamantios

doi:10.1186/s40798-018-0170-z

Sports Medicine - Open

Table 3 Methodological quality of the included studies

From: Follow-up efficacy of physical exercise interventions on fall incidence and fall risk in healthy older adults: a systematic review and meta-analysis

Study	Methodological quality
	Internal validity
	1.1^a	1.2^a	1.3^a	1.4^a	1.5^a	2.1A^b	2.1B^b	2.1 C^b	2.1D^b	2.2A^b	2.2B^b	2.2C^b	2.2D^b	2.2E^b	2.2F^b	2.2G^b	2.2H^b	3A^b	3B^b	3C^b	3D^b	Score (%)
Ballard et al. [90]	+	+	+	+	+	–	–	–	–	+	+	/	/	+	+	+	–	+	–	+	–	79
Beyer et al. [50]	–	+	+	+	+	+	+	–	–	+	+	/	/	+	+	+	+	+	+	+	+	81
Fitzharris et al. [73]	+	+	+	+	+	+	+	–	–	+	+	/	/	+	–	+	–	–	–	–	–	77
Freiberger et al. [82]a,b	+	+	+	+	+	+	+	+	–	+	+	/	/	+	+	+	+	+	–	+	–	91
Halvarsson et al. [94]	+	+	+	+	+	+	–	–	–	+	+	/	/	+	+	+	–	+	–	+	+	82
Iliffe et al. [83]a,b	+	–	+	+	+	–	+	–	–	+	+	+	+	+	+	+	+	+	–	+	+	75
Kamide et al. [95]	+	+	+	+	+	+	–	–	–	+	/	–	–	+	+	+	+	+	–	+	–	81
Karinkanta et al. [51]a,b,c	+	+	+	+	+	–	–	–	–	+	+	/	/	+	+	+	–	–	–	+	–	76
Li et al. [89]	+	+	+	+	+	+	+	–	–	+	+	/	/	+	+	+	–	–	+	+	–	85
Liu-Ambrose et al. [96]	+	+	+	+	+	+	+	+	–	+	/	+	+	+	+	+	+	+	–	+	+	94
Logan et al. [129]	+	+	+	+	+	+	+	–	–	+	+	+	/	+	+	+	–	+	–	–	–	82
Logghe et al. [97]	+	+	+	+	+	–	+	–	–	+	+	/	/	+	+	+	–	–	–	–	–	76
Lord et al. [101]	+	+	+	+	+	+	+	–	–	+	+	/	/	+	+	+	–	–	–	+	–	82
Means et al. [86]	+	–	+	+	+	+	+	–	–	+	+	/	/	+	+	+	–	+	–	+	–	73
Means et al. [98]	+	+	+	+	+	+	+	–	–	+	+	/	/	+	+	+	–	–	–	+	–	83
Morgan et al. [84]	–	+	+	+	+	–	+	–	–	+	+	/	/	+	+	+	+	+	–	+	–	72
Salminen et al. [130]	+	+	+	+	+	+	+	–	–	+	+	+	+	+	–	+	–	+	–	–	–	83
Suzuki et al. [99]	+	+	+	+	+	–	+	–	–	+	+	+	–	+	–	+	+	+	+	–	–	83
Taylor et al. [76]a,b	+	+	+	+	+	+	+	+	–	+	+	/	/	+	+	+	+	+	–	–	+	91
Trombetti et al. [88]	+	+	+	+	+	+	+	–	–	+	+	/	/	+	–	+	–	+	–	+	–	83
Uusi-Rasi et al. [87]	+	–	+	+	+	+	+	–	–	+	+	/	/	+	+	+	–	–	–	+	+	73
Weerdesteyn et al. [100]	+	+	+	+	+	+	+	+	–	+	+	/	/	+	+	+	–	+	–	–	–	85
Whitehead et al. [85]	–	+	+	+	+	+	+	–	–	+	–	+	+	+	+	+	–	+	–	–	+	68
Yamada et al. [78]	+	+	+	+	+	+	+	–	–	+	+	/	/	+	–	+	–	–	–	–	+	80
Yamada et al. [79]	+	+	+	+	+	+	+	–	–	+	+	/	/	+	–	+	–	+	–	+	+	86
Yamada et al. [77]	+	+	+	+	+	+	+	–	–	+	+	/	/	+	+	+	–	+	–	+	+	89
Mean ± SD																						81 ± 6
Study	Methodological quality
	Statistical validity			External validity														Total score (%)
	4^a	5^a	Score (%)	6.1^a	6.2^a	7.1^b	7.2^b	7.3^b	8A^b	8B^b	8C^b	8D^b	8E^b	8F^b	8G^b	8H^b	Score (%)	Total score (%)
Ballard et al. [90]	+	+	100	+	+	+	+	+	+	+	–	+	+	+	–	+	94	91
Beyer et al. [50]	+	+	100	+	+	+	+	+	+	+	+	+	+	+	+	+	100	94
Fitzharris et al. [73]	+	+	100	–	+	+	+	+	–	–	–	–	–	–	–	+	53	77
Freiberger et al. [82]a,b	+	–	50	–	+	+	–	+	+	+	–	–	+	+	–	+	57	66
Halvarsson et al. [94]	+	+	100	+	+	+	+	+	+	+	–	+	+	+	+	+	72	85
Iliffe et al. [83]a,b	+	+	100	+	+	+	+	+	+	+	–	+	+	+	+	+	72	82
Kamide et al. 2009 [95]	+	–	50	–	+	+	+	+	+	+	+	+	+	+	–	+	72	68
Karinkanta et al. [51]a,b,c	+	–	50	+	+	+	+	+	+	+	+	+	+	+	–	–	69	65
Li et al. [89]	+	–	50	–	+	+	+	+	+	+	–	–	+	+	–	–	63	66
Liu-Ambrose et al. [96]	+	+	100	+	+	+	+	+	+	+	+	+	+	+	+	+	75	90
Logan et al. [129]	+	+	100	+	+	+	–	+	+	+	–	–	+	–	–	+	79	87
Logghe et al. [97]	+	–	50	–	+	+	–	+	+	+	–	–	–	–	–	–	48	58
Lord et al. [101]	+	–	50	–	+	+	+	+	+	+	–	–	+	+	–	–	63	65
Means et al. et al. [86]	+	–	50	–	+	+	+	+	+	+	–	–	+	+	–	+	66	63
Means et al. [98]	+	+	100	+	+	+	+	+	+	–	–	–	+	+	–	–	84	89
Morgan et al. [84]	+	–	50	–	+	+	+	+	+	+	–	–	–	+	–	+	63	61
Salminen et al. [130]	+	–	50	+	+	+	+	+	+	+	–	–	–	–	–	+	84	72
Suzuki et al. [99]	+	–	50	–	+	+	+	+	+	+	–	–	+	–	–	+	63	65
Taylor et al. 2012a,b [76]	+	–	50	+	+	+	–	+	+	+	–	–	–	–	+	+	79	73
Trombetti et al. [88]a,b	+	–	50	+	+	+	+	+	+	+	–	+	+	+	–	+	94	76
Uusi-Rasi et al. [87]	+	–	50	+	+	+	+	+	+	+	+	+	+	–	+	–	94	72
Weerdesteyn et al. [100]	+	–	50	–	+	+	+	+	+	+	–	–	–	–	–	+	59	65
Whitehead et al. [85]	+	–	50	–	+	–	–	+	+	+	–	–	–	–	+	+	46	55
Yamada et al. [78]	+	–	50	–	+	+	+	+	+	–	–	–	–	–	+	–	56	62
Yamada et al. [79]	+	–	50	–	+	+	+	+	+	+	+	+	–	+	+	+	72	69
Yamada et al. [77]	+	+	100	+	+	+	+	+	+	+	+	–	–	+	+	+	94	94
Mean ± SD			67 ± 23														71 ± 14	73 ± 11

Methodological quality: 1 Study design | 1.1 Number of falls | 1.2 Number of fallers | 1.3 Healthy older adults | 1.4 Follow-up ≥ 6 months | 1.5 Control group | 2 Methods | 2.1 Fall Incidence | 2.1 A fall definition | 2.1B Monthly diary |2.1C Reminder Calls| 2.1D Objective fall measure | 2.2 Intervention | 2.2A Physical exercises | 2.2B Group training under therapist supervision | 2.2C Exercise material for home training | 2.2D Controlling home visits by therapists | 2.2E Intervention duration ≥ 4 weeks | 2.2F At least twice weekly | 2.2G Session duration ≥ 15 min | 2.2H Reporting compliance | 3 Cofactors | 3A Previous fall history | 3B Reporting no exercise continuation during follow-up period | 3C Health status | 3D Cognitive status | 4 Appropriate statistical tests used | 5 Power analysis | 6 Eligibility | 6.1 Appropriate and representative participant sample | 6.2 Appropriate representation of the outcome variables | 7 Description experimental protocol | 7.1 Type of physical Intervention | 7.2 Exercise description | 7.3 Intervention duration in weeks, days and session time | 8 Description of the participant sample | 8A Age | 8B Sex | 8C Body height | 8D Body mass| 8E Activity level | 8F Health status | 8G Cognitive status | 8H Fall history. The single criteria were rated (“+” = point, “−” = no point, “/” = not included) and used to calculate the quality score for each category (i.e., internal, statistical, and external validity). The average of the three scores gives the total score. ^aA full point was assigned to each sub-category for the calculation of the score in the respective validity section ((assigned points/possible points)*100). ^bThe subcategories of the respective block were pooled to a single point (assigned points/possible points). The studies followed by the letters a or b or c mean that they include different intervention groups, and each letter resembles one intervention group

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