The results of a randomized controlled trial published in Age and Ageing show that a self-directed walking program designed for sedentary older people did not reduce incidence of falls, although it did increase mobility levels.
The Easy Steps trial investigated the impact of a 48-week walking program in older people. The study randomized 386 physically inactive, community-dwelling people 65 years or older from the greater Sydney area of Australia into an intervention or control group. The intervention group received a self-directed, 48-week walking program that involved three mailed printed manuals and telephone coaching. At the same time, the control group received health information that was unrelated to falls. Monthly fall calendars were used to monitor falls during a 48-week period. Secondary outcomes were self-reported, including information on quality of life, exercise levels and walking levels.
“These results show that walking is unlikely to have an effect on falls,” Alexander Voukelatos, PhD, lead author of the study and injury prevention program manager for Sydney Local Health District, stated in a press release. Therefore, we need to reconsider how walking is incorporated into falls prevention guidelines given that it is currently considered by a majority of older people to be a good way to prevent falls.”
Additionally, a sub-sample of 178 participants took part in a home visit scheme that measured mobility levels, choice step reaction time and knee extension strength. Among those participants, there was no evidence of the walking program having an impact on choice step reaction time or knee extension strength, although mobility scores were significantly improved. There was a non-significant increase in self-reported quality of life for the walking group.
There was also some evidence that effects were modified by age: a non-significant trend indicated that the effect of walking in participants from 65 years to 74 years was different to that observed in people 75 years and older. People older than 75 years are more likely to be frailer and at higher risk of falls. This may explain why in participants 75 years and older there was a non-significant increase in fall rates in the intervention group compared to the control group.
“The finding that the walking program also had no impact on balance may explain why the program was ineffective with respect to falls,” Voukelatos stated. “However, walking may be a useful adjunct to increase physical activity for older people, particularly for those under the age of 75 [years].”
Voukelatos A. Age Ageing. 2015;doi: 10.1093/ageing/afu186.
Disclosure: The authors have no relevant financial disclosures.