Effects of exercise interventions on fall-related injuries in community-dwelling older adults: an updated systematic review and meta-analysis.

BACKGROUND

Exercise interventions are widely recommended for preventing falls in older adults in the community; however, existing evidence regarding their effectiveness in reducing fall-related injuries remains inconsistent. This updated systematic review and meta-analysis aimed to assess the impact of exercise interventions on fall-related injuries in older adults in the community.

METHODS

PubMed, Embase, Cochrane Library, and CINAHL databases were systematically searched from inception to April 2, 2026. Included studies were randomized controlled trials of exercise interventions for older adults in the community. Outcome measures included all fall-related injuries, injuries requiring medical attention, severe injuries, and fall-related fractures. Pooled risk ratios (RRs) and 95% confidence intervals (CIs) were calculated using a random-effects model. Risk of bias was assessed using the Cochrane RoB 2 tool, and the quality of evidence was assessed using the GRADE method. This review followed the PRISMA 2020 guidelines and was registered in PROSPERO (CRD420261348337).

RESULTS

29 randomized controlled trials involving 6367 participants were included. Exercise intervention significantly reduced the incidence of all fall-related injuries based on 19 studies [RR = 0.87, 95% CI (0.80, 0.95), I2 = 15.7%], injuries requiring medical attention based on 11 studies [RR = 0.71, 95% CI (0.57, 0.89), I2 = 33.3%], severe injuries based on 8 studies [RR = 0.67, 95% CI (0.54, 0.83), I2 = 0.0%], and fall-related fractures based on 11 studies [RR = 0.56, 95% CI (0.37, 0.85), 23.3%]. Heterogeneity among outcome measures was low to moderate.

CONCLUSION

Exercise intervention can effectively reduce the incidence of fall-related injuries and fractures in older adults in the community and may contribute to healthy aging and injury prevention. Keywords: exercise; falls; fractures; older adults; injury prevention; meta-analysis.

SYSTEMATIC REVIEW REGISTRATION: PROSPERO, identifier [CRD420261348337].