Studies employed a number of different...

Studies employed a number of different designs including: quasi-experimental (two studies), RCT (six studies) and cluster-RCT (one study). Table 1 summarises the key characteristics of the included studies. Additional details are available in Appendix 2. Studies were conducted in Australia, the USA, Canada, Spain, the UK and Ireland (Table 1). Seven trials were conducted in the community and in participants’ homes [12, 13, 26–29, 32]; two trials took place in care homes [30, 31].

Table 1.

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Summary of key characteristics of included studies

Study 1. First author 2. Year 3. Study design 4. Country	Participants and setting Study population (N) Total number Age (x(SD), years) Gender (F/M) Falls risk at study entry	Intervention (I)^a 1. Name of intervention 2. Regimen 3. Duration of intervention	Comparison (C)	Primary outcomes^b
SINGLE COMPONENT PODIATRY INTERVENTIONS
Menz [32] 2015 RCT Australia	Community dwelling (ambulatory older adults with disabling foot pain) 120 Whole group: 82 (8) 48/72 NR	1. Podiatry treatment plus off-the-shelf extra depth footwear 2. NR 3. 16 weeks	Podiatry treatment only	Foot Pain and Function (Foot Health Status—Pain Questionnaire)
Perry [26] 2008 Quasi-RCT Canada	Community dwelling (older adults, moderate loss foot sole sensation) 40 I: 69 (3.6); C: 69 (3.1) 19/21 NR	Balance enhancing facilitatory insole NR 12 weeks	Conventional insole	Lateral stability (gait perubation protocol)
MULTIFACETED PODIATRY INTERVENTIONS
Cockayne [12] 2014 RCT The UK; Ireland	Community dwelling (aged >65+) 1,010 (996 analysis) I: 78.1 (7.2); C:77.7 (7.0) 610/400 ≥1 fall in previous 12 months: 657 (65%)	‘Multifaceted Podiatry intervention’ 2 podiatry appointments; Foot and ankle exercise 30 min/day, three x/week 12 months	Routine podiatry care incl. treatment of pathological nails and skin lesions	Falls Rate (Falls Calendar)
Spink [13] 2008 RCT Australia	Community dwelling (older adults with disabling foot-pain) 305 Whole group: 73.9 (5.9) 211/94 ≥2 falls in previous 12 months: I: 48; C: 45	Routine podiatry plus multifaceted podiatry intervention Home-based exercise Programme: 30 minutes 3x per week 6 months	Routine podiatry care incl. treatment of pathological nails and skin lesions	Proportion of fallers/ Multiple fallers; Falls rate; Time to first fall (Falls Calendar)
Wylie [31] 2017 RCT The UK	Care home residents 43 I: 86.9 (6.2); C: 85.9 (7.8) 35/8 NR	Multifaceted podiatry intervention Ankle exercises: 30 repetitions 3x per week; toe exercise: 20 repetitions each foot 3x per week 3 months	Routine podiatry care incl. treatment of pathological nails and skin lesions	No. of falls; Time to first fall (Accident Records); Feasibility (Recruitment, retention, adherence and missing data)
MULTIFACTORIAL INTERVENTIONS
Dyer [30] 2004 Cluster RCT The UK	Residential care (aged 60 years+) 196 (20 Residential homes) I: 87.2 (SD: 6.9); C: 87.4 (SD: 6.9) 153/43 Tinetti gait and balance score: I: 15.43 (SD: 6.8); C: 16 (SD: 6.9)	‘Multifactorial Risk Factor Modification Programme’ Group exercise 40 min, 3x/week for 12–14 weeks. Individual home visits and/ or assessments within 12–14 weeks: Optician assessment; Podiatry assessment (foot condition a concern at baseline assessment); one OT visit. 3 months	None	Falls Rate/Recurrent Falls Rate (Falls Calendar)
Mahoney [29] 2007 RCT The USA	Community dwelling (older adults) 349 I: 79.6 (7.2); C: 80.3 (7.7) 274/75 Mean no. falls in previous 12 months: I: 2.4 (SD: 2.6); C: 2.4 (SD: 2.6)	Intermediate-intensity, individual multifactorial intervention Assessment visit 2x first three weeks after enrollment then 11 monthly TC; Review of recommendations with primary physician within one month. Longer term exercise—walking ≥4–5 days/week; Standing balance exercises 2–3 days/week 12 months	In-home assessment	Falls Rate (Falls diary/calendar)
Pujiula Blanch [28] 2000 Quasi-RCT Spain	Community dwelling (older adults aged >70 years) 3,727 (707 analysis) NR 418/283 NR	Program for the prevention of falls in the elderly NR 2 years	Routine healthcare	Falls Rate; Mean no. falls/year; No. multiple fallers
Russell [27] 2010 RCT Australia	Community dwelling (older adults) 712 (698 analysis) I: 74.9 (7.9); C: 75.8 (8.6) 500/112 Median no. falls/person/12 months: 2 (IQR 1–3)	Standard care plus targeted multifactorial falls prevention programme NR 12 months	Standard care as organised by ED staff	Falls Rate; Falls Injuries (Falls Calendar)

Study 1. First author 2. Year 3. Study design 4. Country	Participants and setting Study population (N) Total number Age (x(SD), years) Gender (F/M) Falls risk at study entry	Intervention (I)^a 1. Name of intervention 2. Regimen 3. Duration of intervention	Comparison (C)	Primary outcomes^b
SINGLE COMPONENT PODIATRY INTERVENTIONS
Menz [32] 2015 RCT Australia	Community dwelling (ambulatory older adults with disabling foot pain) 120 Whole group: 82 (8) 48/72 NR	1. Podiatry treatment plus off-the-shelf extra depth footwear 2. NR 3. 16 weeks	Podiatry treatment only	Foot Pain and Function (Foot Health Status—Pain Questionnaire)
Perry [26] 2008 Quasi-RCT Canada	Community dwelling (older adults, moderate loss foot sole sensation) 40 I: 69 (3.6); C: 69 (3.1) 19/21 NR	Balance enhancing facilitatory insole NR 12 weeks	Conventional insole	Lateral stability (gait perubation protocol)
MULTIFACETED PODIATRY INTERVENTIONS
Cockayne [12] 2014 RCT The UK; Ireland	Community dwelling (aged >65+) 1,010 (996 analysis) I: 78.1 (7.2); C:77.7 (7.0) 610/400 ≥1 fall in previous 12 months: 657 (65%)	‘Multifaceted Podiatry intervention’ 2 podiatry appointments; Foot and ankle exercise 30 min/day, three x/week 12 months	Routine podiatry care incl. treatment of pathological nails and skin lesions	Falls Rate (Falls Calendar)
Spink [13] 2008 RCT Australia	Community dwelling (older adults with disabling foot-pain) 305 Whole group: 73.9 (5.9) 211/94 ≥2 falls in previous 12 months: I: 48; C: 45	Routine podiatry plus multifaceted podiatry intervention Home-based exercise Programme: 30 minutes 3x per week 6 months	Routine podiatry care incl. treatment of pathological nails and skin lesions	Proportion of fallers/ Multiple fallers; Falls rate; Time to first fall (Falls Calendar)
Wylie [31] 2017 RCT The UK	Care home residents 43 I: 86.9 (6.2); C: 85.9 (7.8) 35/8 NR	Multifaceted podiatry intervention Ankle exercises: 30 repetitions 3x per week; toe exercise: 20 repetitions each foot 3x per week 3 months	Routine podiatry care incl. treatment of pathological nails and skin lesions	No. of falls; Time to first fall (Accident Records); Feasibility (Recruitment, retention, adherence and missing data)
MULTIFACTORIAL INTERVENTIONS
Dyer [30] 2004 Cluster RCT The UK	Residential care (aged 60 years+) 196 (20 Residential homes) I: 87.2 (SD: 6.9); C: 87.4 (SD: 6.9) 153/43 Tinetti gait and balance score: I: 15.43 (SD: 6.8); C: 16 (SD: 6.9)	‘Multifactorial Risk Factor Modification Programme’ Group exercise 40 min, 3x/week for 12–14 weeks. Individual home visits and/ or assessments within 12–14 weeks: Optician assessment; Podiatry assessment (foot condition a concern at baseline assessment); one OT visit. 3 months	None	Falls Rate/Recurrent Falls Rate (Falls Calendar)
Mahoney [29] 2007 RCT The USA	Community dwelling (older adults) 349 I: 79.6 (7.2); C: 80.3 (7.7) 274/75 Mean no. falls in previous 12 months: I: 2.4 (SD: 2.6); C: 2.4 (SD: 2.6)	Intermediate-intensity, individual multifactorial intervention Assessment visit 2x first three weeks after enrollment then 11 monthly TC; Review of recommendations with primary physician within one month. Longer term exercise—walking ≥4–5 days/week; Standing balance exercises 2–3 days/week 12 months	In-home assessment	Falls Rate (Falls diary/calendar)
Pujiula Blanch [28] 2000 Quasi-RCT Spain	Community dwelling (older adults aged >70 years) 3,727 (707 analysis) NR 418/283 NR	Program for the prevention of falls in the elderly NR 2 years	Routine healthcare	Falls Rate; Mean no. falls/year; No. multiple fallers
Russell [27] 2010 RCT Australia	Community dwelling (older adults) 712 (698 analysis) I: 74.9 (7.9); C: 75.8 (8.6) 500/112 Median no. falls/person/12 months: 2 (IQR 1–3)	Standard care plus targeted multifactorial falls prevention programme NR 12 months	Standard care as organised by ED staff	Falls Rate; Falls Injuries (Falls Calendar)

Abbreviations: C—Control/ Comparator; ED—Emergency Department; F—female; I—Intervention; M—male; NR—not reported; SD—Standard Deviation; TC—telephone contact.

Key:^aFurther intervention details profiled using TiDIER reporting guidelines [23] are shown in Supplementary Table S3, available at Age and Ageing online; ^bAdditional outcomes reported in Supplementary Table S2, available at Age and Ageing online. Explanation of falls outcomes: Number of fallers—Number of participants sustaining a fall; Falls incidence—number of falls; Falls rate—expressed as either the number of falls per person or with an additional time denominator; Time to first fall—falls free survival time.

Table 1.

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Summary of key characteristics of included studies

Study 1. First author 2. Year 3. Study design 4. Country	Participants and setting Study population (N) Total number Age (x(SD), years) Gender (F/M) Falls risk at study entry	Intervention (I)^a 1. Name of intervention 2. Regimen 3. Duration of intervention	Comparison (C)	Primary outcomes^b
SINGLE COMPONENT PODIATRY INTERVENTIONS
Menz [32] 2015 RCT Australia	Community dwelling (ambulatory older adults with disabling foot pain) 120 Whole group: 82 (8) 48/72 NR	1. Podiatry treatment plus off-the-shelf extra depth footwear 2. NR 3. 16 weeks	Podiatry treatment only	Foot Pain and Function (Foot Health Status—Pain Questionnaire)
Perry [26] 2008 Quasi-RCT Canada	Community dwelling (older adults, moderate loss foot sole sensation) 40 I: 69 (3.6); C: 69 (3.1) 19/21 NR	Balance enhancing facilitatory insole NR 12 weeks	Conventional insole	Lateral stability (gait perubation protocol)
MULTIFACETED PODIATRY INTERVENTIONS
Cockayne [12] 2014 RCT The UK; Ireland	Community dwelling (aged >65+) 1,010 (996 analysis) I: 78.1 (7.2); C:77.7 (7.0) 610/400 ≥1 fall in previous 12 months: 657 (65%)	‘Multifaceted Podiatry intervention’ 2 podiatry appointments; Foot and ankle exercise 30 min/day, three x/week 12 months	Routine podiatry care incl. treatment of pathological nails and skin lesions	Falls Rate (Falls Calendar)
Spink [13] 2008 RCT Australia	Community dwelling (older adults with disabling foot-pain) 305 Whole group: 73.9 (5.9) 211/94 ≥2 falls in previous 12 months: I: 48; C: 45	Routine podiatry plus multifaceted podiatry intervention Home-based exercise Programme: 30 minutes 3x per week 6 months	Routine podiatry care incl. treatment of pathological nails and skin lesions	Proportion of fallers/ Multiple fallers; Falls rate; Time to first fall (Falls Calendar)
Wylie [31] 2017 RCT The UK	Care home residents 43 I: 86.9 (6.2); C: 85.9 (7.8) 35/8 NR	Multifaceted podiatry intervention Ankle exercises: 30 repetitions 3x per week; toe exercise: 20 repetitions each foot 3x per week 3 months	Routine podiatry care incl. treatment of pathological nails and skin lesions	No. of falls; Time to first fall (Accident Records); Feasibility (Recruitment, retention, adherence and missing data)
MULTIFACTORIAL INTERVENTIONS
Dyer [30] 2004 Cluster RCT The UK	Residential care (aged 60 years+) 196 (20 Residential homes) I: 87.2 (SD: 6.9); C: 87.4 (SD: 6.9) 153/43 Tinetti gait and balance score: I: 15.43 (SD: 6.8); C: 16 (SD: 6.9)	‘Multifactorial Risk Factor Modification Programme’ Group exercise 40 min, 3x/week for 12–14 weeks. Individual home visits and/ or assessments within 12–14 weeks: Optician assessment; Podiatry assessment (foot condition a concern at baseline assessment); one OT visit. 3 months	None	Falls Rate/Recurrent Falls Rate (Falls Calendar)
Mahoney [29] 2007 RCT The USA	Community dwelling (older adults) 349 I: 79.6 (7.2); C: 80.3 (7.7) 274/75 Mean no. falls in previous 12 months: I: 2.4 (SD: 2.6); C: 2.4 (SD: 2.6)	Intermediate-intensity, individual multifactorial intervention Assessment visit 2x first three weeks after enrollment then 11 monthly TC; Review of recommendations with primary physician within one month. Longer term exercise—walking ≥4–5 days/week; Standing balance exercises 2–3 days/week 12 months	In-home assessment	Falls Rate (Falls diary/calendar)
Pujiula Blanch [28] 2000 Quasi-RCT Spain	Community dwelling (older adults aged >70 years) 3,727 (707 analysis) NR 418/283 NR	Program for the prevention of falls in the elderly NR 2 years	Routine healthcare	Falls Rate; Mean no. falls/year; No. multiple fallers
Russell [27] 2010 RCT Australia	Community dwelling (older adults) 712 (698 analysis) I: 74.9 (7.9); C: 75.8 (8.6) 500/112 Median no. falls/person/12 months: 2 (IQR 1–3)	Standard care plus targeted multifactorial falls prevention programme NR 12 months	Standard care as organised by ED staff	Falls Rate; Falls Injuries (Falls Calendar)

Study 1. First author 2. Year 3. Study design 4. Country	Participants and setting Study population (N) Total number Age (x(SD), years) Gender (F/M) Falls risk at study entry	Intervention (I)^a 1. Name of intervention 2. Regimen 3. Duration of intervention	Comparison (C)	Primary outcomes^b
SINGLE COMPONENT PODIATRY INTERVENTIONS
Menz [32] 2015 RCT Australia	Community dwelling (ambulatory older adults with disabling foot pain) 120 Whole group: 82 (8) 48/72 NR	1. Podiatry treatment plus off-the-shelf extra depth footwear 2. NR 3. 16 weeks	Podiatry treatment only	Foot Pain and Function (Foot Health Status—Pain Questionnaire)
Perry [26] 2008 Quasi-RCT Canada	Community dwelling (older adults, moderate loss foot sole sensation) 40 I: 69 (3.6); C: 69 (3.1) 19/21 NR	Balance enhancing facilitatory insole NR 12 weeks	Conventional insole	Lateral stability (gait perubation protocol)
MULTIFACETED PODIATRY INTERVENTIONS
Cockayne [12] 2014 RCT The UK; Ireland	Community dwelling (aged >65+) 1,010 (996 analysis) I: 78.1 (7.2); C:77.7 (7.0) 610/400 ≥1 fall in previous 12 months: 657 (65%)	‘Multifaceted Podiatry intervention’ 2 podiatry appointments; Foot and ankle exercise 30 min/day, three x/week 12 months	Routine podiatry care incl. treatment of pathological nails and skin lesions	Falls Rate (Falls Calendar)
Spink [13] 2008 RCT Australia	Community dwelling (older adults with disabling foot-pain) 305 Whole group: 73.9 (5.9) 211/94 ≥2 falls in previous 12 months: I: 48; C: 45	Routine podiatry plus multifaceted podiatry intervention Home-based exercise Programme: 30 minutes 3x per week 6 months	Routine podiatry care incl. treatment of pathological nails and skin lesions	Proportion of fallers/ Multiple fallers; Falls rate; Time to first fall (Falls Calendar)
Wylie [31] 2017 RCT The UK	Care home residents 43 I: 86.9 (6.2); C: 85.9 (7.8) 35/8 NR	Multifaceted podiatry intervention Ankle exercises: 30 repetitions 3x per week; toe exercise: 20 repetitions each foot 3x per week 3 months	Routine podiatry care incl. treatment of pathological nails and skin lesions	No. of falls; Time to first fall (Accident Records); Feasibility (Recruitment, retention, adherence and missing data)
MULTIFACTORIAL INTERVENTIONS
Dyer [30] 2004 Cluster RCT The UK	Residential care (aged 60 years+) 196 (20 Residential homes) I: 87.2 (SD: 6.9); C: 87.4 (SD: 6.9) 153/43 Tinetti gait and balance score: I: 15.43 (SD: 6.8); C: 16 (SD: 6.9)	‘Multifactorial Risk Factor Modification Programme’ Group exercise 40 min, 3x/week for 12–14 weeks. Individual home visits and/ or assessments within 12–14 weeks: Optician assessment; Podiatry assessment (foot condition a concern at baseline assessment); one OT visit. 3 months	None	Falls Rate/Recurrent Falls Rate (Falls Calendar)
Mahoney [29] 2007 RCT The USA	Community dwelling (older adults) 349 I: 79.6 (7.2); C: 80.3 (7.7) 274/75 Mean no. falls in previous 12 months: I: 2.4 (SD: 2.6); C: 2.4 (SD: 2.6)	Intermediate-intensity, individual multifactorial intervention Assessment visit 2x first three weeks after enrollment then 11 monthly TC; Review of recommendations with primary physician within one month. Longer term exercise—walking ≥4–5 days/week; Standing balance exercises 2–3 days/week 12 months	In-home assessment	Falls Rate (Falls diary/calendar)
Pujiula Blanch [28] 2000 Quasi-RCT Spain	Community dwelling (older adults aged >70 years) 3,727 (707 analysis) NR 418/283 NR	Program for the prevention of falls in the elderly NR 2 years	Routine healthcare	Falls Rate; Mean no. falls/year; No. multiple fallers
Russell [27] 2010 RCT Australia	Community dwelling (older adults) 712 (698 analysis) I: 74.9 (7.9); C: 75.8 (8.6) 500/112 Median no. falls/person/12 months: 2 (IQR 1–3)	Standard care plus targeted multifactorial falls prevention programme NR 12 months	Standard care as organised by ED staff	Falls Rate; Falls Injuries (Falls Calendar)

Abbreviations: C—Control/ Comparator; ED—Emergency Department; F—female; I—Intervention; M—male; NR—not reported; SD—Standard Deviation; TC—telephone contact.

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