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.

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.

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.

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).

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.

跌倒是老年人的常见和严重的问题之一，跌倒效能是跌倒的重要影响因素，提高老年人跌倒效能的运动方式多样但各种运动干预效果的优劣尚无定论。

分析比较不同运动方式对老年人跌倒效能的影响，旨在为患者选择最佳运动方式提供参考。

计算机检索中国知网、万方数据知识服务平台、维普网、SinoMed、PubMed、CINAHL、Web of Science、Embase、Cochrane Library、FMRS等数据库中关于运动提高老年人跌倒效能的相关文献，检索时限为建库至2025-08-15。结局指标为国际版跌倒效能量表（FES-I）、Berg平衡量表（BBS）、计时起立-行走测试（TUGT）。采用Cochrane偏倚评估工具进行文献质量评价，采用Stata 18.0软件进行网状Meta分析，采用累积概率排名曲线下面积（SUCRA）对不同方案的效果进行排名。

共纳入35项研究，包括2 627例研究对象、13种运动方式。在跌倒效能方面，奥塔戈（MD=8.94，95%CI=3.51~14.38）、太极拳（MD=9.24，95%CI=4.96~13.51）、方步运动（MD=8.60，95%CI=2.56~14.64）、普拉提（MD=6.86，95%CI=1.19~12.53）的效果优于常规护理组（P<0.05），太极拳成为最佳干预措施的可能性最大（SUCRA=81.2）。在平衡功能方面，奥塔戈（MD=3.87，95%CI=2.71~5.02）、太极拳（MD=3.87，95%CI=1.71~6.03）、抗阻+平衡训练（MD=3.26，95%CI=0.53~6.00）的效果优于常规护理组（P<0.05），奥塔戈成为最佳干预措施的可能性最大（SUCRA=68.1）。在移动能力方面，奥塔戈（MD=3.90，95%CI=2.77~5.04）、太极拳（MD=4.44，95%CI=3.50~5.39）、八段锦（MD=2.25，95%CI=1.47~3.02）、八卦掌（MD=2.35，95%CI=1.26~3.43）、步态平衡操（MD=3.60，95%CI=2.15~5.05）的效果优于常规护理组（P<0.05），太极拳成为最佳干预措施的可能性最大（SUCRA=95.0）。

太极拳、奥塔戈运动在改善老年人跌倒效能、平衡功能、移动能力方面效果较好。临床医护人员应结合老年人健康状况及需求，合理选择运动方式，以提高老年人跌倒效能，有效预防跌倒，促进患者健康。未来仍需进一步开展更多高质量的研究以验证此结论。