Trail-walking exercise and fall risk factors in community-dwelling older adults: preliminary results of a randomized controlled trial.

Objectives: To evaluate the effects of a trail-walking exercise (TWE) program on the rate of falls in community-dwelling older adults.
Design: Pilot randomized controlled trial (RCT).
Setting: This trial was conducted in Japan and involved community-dwelling older adults as participants.
Participants: Sixty participants randomized into a TWE group (n=30) and a walking (W) group (n=30).
Intervention: Exercise class combined with multicomponent trail walking program, versus exercise class combined with simple indoor walking program.
Measurement: Measurement was based on the difference in fall rates between the TWE and W groups.
Results: Six months after the intervention, the incidence rate ratio (IRR) of falls for the TWE group compared with the W group was 0.20 (95% confidence interval (CI)=0.04-0.91); 12 months after the intervention, the IRR of falls for the TWE group compared with the W group was 0.45 (95% CI=0.16-1.77).
Conclusion: The results of this pilot RCT suggest that the TWE program was more effective in improving locomotion and cognitive performance under trail-walking task conditions than walking. In addition, participants who took part in the TWE demonstrated a decrease in the incidence rate of falls 6 months after trial completion. Further confirmation is needed, but this preliminary result may promote a new understanding of accidental falls in older adults.
(© 2010, Copyright the Authors. Journal compilation © 2010, The American Geriatrics Society.)