Physical-activity interventions to reduce fear of falling in frail and pre-frail older adults: a systematic review of randomized controlled trials

Abstract Background Frailty in older adults leads to progressive deterioration of their physical condition and makes them prone to develop Fear of Falling (FoF). Physical-activity interventions appear to be effective in managing the components of frailty but there is no clear evidence to determine whether physical-activity may affect FoF in frail and pre-frail older adults. Objective Τhis systematic literature review aims to synthesize evidence on the relationship between the physical interventions to ameliorate balance, strength, and mobility and FoF reduction in frail and pre-frail older adults. Methods Studies assessing physical-activity interventions for frail and pre-frail older adults aged 60 years and older were identified in English through searches in PubMed, ScienceDirect, and Cochrane Central Register of Controlled Trials databases till February 2023. Study quality was assessed, and a qualitative synthesis of results was performed. Results A total of 13 studies published were included. All of them were Randomized Control Trials and the most frequent assessment tool used to assess FoF (10 of 13 studies) was the Fall Efficacy Scale-International (FES-I). Six studies were assessed as having a low risk of bias. Cumulatively, the findings of this review indicate that physical-activity interventions are effective in reducing the FoF of frail and pre-frail older adults. Conclusion The results are encouraging and recapitulate the positive role of physical interventions in FoF reduction. However, future research would benefit from longer follow-up periods, longer intervention duration, and participation of interdisciplinary teams.