The impact of falls prevention on participation in daily occupations of older adults following discharge: a systematic review and meta-analysis

Purpose: To investigate the impact of falls intervention programmes on participation of older adults returning home to live, following discharge from hospital. Method: A systematic review of peer-reviewed articles and grey literature was completed. Limits were set for articles published in English, dated 1990-2012. Inclusion criteria included randomised control trials with older adults (>= 65 years) that used an effective falls intervention and a participation measure, following discharge from hospital or emergency department. Two independent researchers assessed the studies for eligibility. Research risk of bias was evaluated using the PEDro scale (range 1-10). A meta-analysis of the selected articles was completed. Results: Five studies fulfilled the inclusion criteria and measured participation outcomes short-term (<six months post-discharge, n = 488) and long-term (6-12 months post-discharge, n = 571). The results indicated that falls interventions provided a positive improvement in patients' participation level (p = 0.042, p = 0.026). However, the effect size was small at 0.20 and 0.21. Conclusions: The meta-analysis findings indicate that there is a causal association between falls interventions and participation in daily occupations with older adults post-discharge. Although the effect size was small, practice implications of this study suggest that participation needs to be considered in future falls prevention research.