关键词: 跌倒, 老年人, 运动, 跌倒效能, 奥塔戈, 太极拳, 网络Meta分析

Abstract: Background Fall is one of the most common and serious problems in the elderly，and fall efficiency is an important influencing factor. There are various exercise ways to improve fall efficiency in the elderly，and the merits and demerits of various exercise intervention effects are still uncertain. Objective To compare the effects of different exercise modes on fall efficacy in the older people，aiming to provide a reference for patients to choose the best exercise mode. Methods A literature search was conducted in databases such as China National Knowledge Infrastructure（CNKI），Wanfang Data，VIP，SinoMed，PubMed，CINAHL，Web of Science，Embase，Cochrane Library，and FMRS to identify relevant studies on the effectiveness of exercise in reducing falls among the elderly. The search period was from the establishment of the databases to August 15，2025. The outcome measures were the Falls Efficacy Scale-International（FES-I），Berg Balance Scale（BBS），and Timed Up and Go Test（TUGT）. The Cochrane bias assessment tool was used to evaluate the quality of the literature. Stata 18 software was used to perform a network meta-analysis，and the surface under the cumulative ranking curve（SUCRA） was used to rank the effectiveness of different treatment regimens. Results A total of 35 studies were included in this study，involving 2，627 subjects and 13 types of exercise. In terms of fall efficacy，Otago（MD=8.94，95%CI=3.51-14.38），Tai Chi（MD=9.24，95%CI=4.96-13.51），step marching exercise（MD=8.60，95%CI=2.56~14.64）and pilates（MD=6.86，95%CI=1.19~12.53）were more effective than the usual care group（P<0.05），with Tai Chi having the highest likelihood of being the most effective intervention（SUCRA=81.2）. In terms of balance function，Otago（MD=3.87，95%CI=2.71-5.02），Tai Chi（MD=3.87，95%CI=1.71-6.03），and resisted + balance training（MD=3.26，95%CI=0.53-6.00）were more effective than the usual care group（P<0.05），with Otago having the highest likelihood of being the most effective intervention （SUCRA=68.1）. In terms of mobility，Otago（MD=3.90，95%CI=2.77-5.04），Tai Chi（MD=4.44，95%CI=3.50-5.39），Baduanjin（MD=2.25，95%CI=1.47-3.02），Baguazhang（MD=2.35，95%CI=1.26-3.43），Gait balancing enercises（MD=3.60，95%CI=2.15-5.05）were more effective than the usual care group（P<0.05），with Tai Chi having the highest likelihood of being the most effective intervention（SUCRA=95.0）. Conclusion This study indicates that Tai Chi and Otago exercises are effective in improving fall efficacy，balance function，and mobility in older adults. Clinical healthcare professionals should select appropriate exercise methods based on the health status and needs of older adults to enhance fall efficacy，effectively prevent falls，and promote patient health. Meanwhile，further high-quality researches are needed to validate these findings.

Key words: Falls, Aged, Exercise, Fall efficacy, Otago, Tai Chi, Network meta-analysis