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139 Preventing falls with motor-cognitive training: a 12-month randomised controlled trial
  1. Daina Sturnieks1,2,
  2. Cameron Hicks1,
  3. Stephen Lord1,2
  1. 1Neuroscience Research Australia, Randwick, Australia
  2. 2University of New South Wales, Sydney, Australia


Background Training programs that target both cognitive and motor functions important for balance control may provide enhanced value for fall prevention.

Aims To examine the effects of a home-based exergame system, delivered either as cognitive-motor or cognitive-only training, on preventing falls in community-dwelling older people.


769 community dwelling older people aged 65+ years were randomised to one of three groups: 1) cognitive-motor training playing exergames while standing and stepping on a wireless mat; 2) cognitive-only training playing the same exergames while seated at a computer; or 3) no intervention control. Intervention participants were asked to undertake two hours of training per week for 12 months. All participants reported falls monthly for 12 months. The protocol was pre-registered (ACTRN12616001325493), statistical analysis plan pre-published (, analyses were intention-to-treat.

Results Compared to control, the motor-cognitive training group had a significantly lower rate of falls (IRR=0.74, 95%CI=0.56–0.98) and proportion of fallers (RR=01.75, 95%CI=0.61–0.92), while cognitive-only group had similar rate of falls (IRR=0.86, 95%CI=0.65–1.12) and proportion of fallers (RR=0.87, 95%CI=0.73–0.05). Pre-planned subgroup analyses of previous fallers showed a significant protective effect of cognitive-only training on rate of falls (IRR=0.63, 95%CI=0.44–0.92), but not motor-cognitive training (IRR=0.69, 95%CI=0.48–1.00).

Conclusion Exergames involving step training can prevent falls in older people living in the community. Exergames played with the hands while seated can prevent recurrent falls as well as the rate of falls in previous fallers.

Learning Outcomes Home-based exergaming can provide safe and efficacious method of preventing falls in older people living in the community.

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