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In a supplementary analysis, the recently updated Cochrane review of interventions for preventing falls in older adults living at home examined the effect of exercise on fractures specifically.7 This analysis, which was based on six trials, showed that fall prevention exercise programmes are associated with a significantly lower risk of fractures.To our knowledge, no review or meta-analysis has examined the effect of fall prevention exercise programmes on other injurious falls outcomes that are common and that can also have important medical, psychological, and economic consequences.After reviewing the case definitions used in the selected studies, we sought to group definitions of injurious falls into more homogeneous categories to allow results to be compared across studies and the data to be pooled.The Pro Fa NE group recently proposed a standardised classification of injurious falls to be used in future randomised controlled trials.10 As a foundation for developing a retrospective classification of the definitions of injurious falls found in the studies selected for this review, we used the Pro Fa NE classification along with the standardised classification of Campbell and Robertson,13 which is the classification most often used in published trials of these interventions.14 We also recorded any reports of adverse effects associated with interventions.A pooled rate ratio was estimated for each category of injurious falls based on random effects models.Results 17 trials involving 4305 participants were eligible for meta-analysis.

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Data sources Electronic databases (Pub Med, the Cochrane Library, Embase, and CINAHL) and reference lists of included studies and relevant reviews from inception to July 2013.The taxonomy for fall prevention interventions developed by the Prevention of Falls Network Europe (Pro Fa NE)12 was used to describe the characteristics of the interventions provided (for example, participants’ selection criteria, type of exercises, and intervention procedures).This tool uses internationally agreed criteria to evaluate systematically the content and format of fall prevention interventions.Two authors (FEK, PDM) independently assessed the risks of bias and extracted data.Disagreement was resolved by consensus or adjudication by a third party.

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