Best-Practice Exercise Interventions to Prevent Falls in Older Adults (original) (raw)
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Preventing falls among older adults: no "one size suits all" intervention strategy
Journal of rehabilitation research and development, 2008
Physical activity (exercise) serves primary, secondary, and tertiary roles in the prevention of falls among older adults. In its primary role, physical activity can prevent the onset of pathology and system impairments that lead to disability and increased risk for falls. Slowing the progression of disease and system impairments is its secondary role, while its tertiary role lies in the restoration of function to a level that allows for more autonomy in the performance of essential activities of daily living. Whether used as a stand-alone strategy or a core component of a multifactorial intervention approach, exercise constitutes an effective means by which to reduce fall risk and/or fall incidence rates. At low levels of risk, many exercise choices are available to older adults. As the level of risk increases, however, more tailored and progressive exercise programs that target the physical risk factors associated with falls are more effective in lowering fall risk. Adopting a mult...
Dementia and Geriatric Cognitive Disorders, 2021
Introduction: A growing trend in medicine is older adults and increased need for geriatric services. Falls contribute heavily to hospitalizations and worsening of overall health in this frail demographic. There are numerous biological and physical culprits which, if targeted, can prevent falls. The objective was to review benefits of different types of exercises for fall prevention for older persons who are communitydwelling or living in long-term care facilities. Methods: A systematic review was conducted to determine the different types of exercises for fall prevention. Data extraction via a standardized protocol was performed to assess study design, outcomes, limitations, and author's conclusions. Corroborative themes were identified and the authors responsible for the contributing research were cited as they came up. Nineteen randomized controlled trials were identified, between 1990 and 2018, using MEDLINE, PubMed, Cochrane, CINAHL, and Web of Science databases. Studies involving adults greater than age 60 in high-risk community or nursing home populations in the English language with a duration longer than or equal to 6 weeks with focuses on either lowrisk balance, strength, or combination of both and wholebody vibration. Results: Balance exercise training increased balance at 6 and 12-month intervals involving balance, strength, and cognitive training. Discussion: Insignificant results were seen in whole-body vibration and differing results existed for Tai Chi. It is important to recognize that although exercises help reduce the risk of falling and play a significant role in improving mobility safely, there will always be a risk of falls.
New South Wales Public Health Bulletin, 2011
This systematic review update includes 54 randomised controlled trials and confirms that exercise as a single intervention can prevent falls (pooled rate ratio 0.84, 95% CI 0.77-0.91). Metaregression revealed programs that included balance training, contained a higher dose of exercise and did not include walking training to have the greatest effect on reducing falls. We therefore recommend that exercise for falls prevention should provide a moderate or high challenge to balance and be undertaken for at least 2 hours per week on an ongoing basis. Additionally, we recommend that: falls prevention exercise should target both the general community and those at high risk for falls; exercise may be undertaken in a group or home-based setting; strength and walking training may be included in addition to balance training but high risk individuals should not be prescribed brisk walking programs; and other health-related risk factors should also be addressed.
PHYSICAL THERAPY INTERVENTIONS IN THE PREVENTION OF FALLS IN OLDER ADULTS (Atena Editora)
PHYSICAL THERAPY INTERVENTIONS IN THE PREVENTION OF FALLS IN OLDER ADULTS (Atena Editora), 2024
Falls represent a significant challenge to the health of older people, with the potential to cause severe injuries and negatively impact quality of life. Physical therapy plays a key role in preventing falls in older people, offering a variety of therapeutic approaches to improve the functionality of this population. This literature review critically examines studies on physical therapy approaches to preventing falls in older people, intending to provide a comprehensive overview of the effectiveness of these interventions and guide clinical practice. A systematic search was carried out in the PubMed, PeDRO, Scielo, and Web of Science databases to identify published studies investigating physical therapeutic approaches to preventing falls in older people. Original studies that evaluated muscle-strengthening interventions, dual-task exercises, and home guidance and reported outcomes related to fall prevention were included. Analysis of studies revealed that muscle strengthening is an effective intervention in preventing falls in older people, resulting in significant improvements in muscle strength, balance, and functionality. Dual-task exercises have demonstrated effectiveness, challenging the sensorimotor and cognitive systems, and improving the ability to perform complex tasks while maintaining balance. Additionally, home guidelines, including environmental modifications, safety strategies, and education about risk behaviors, were useful in reducing the risk of falls in older adults. These approaches are promising strategies for preventing falls in older adults and improving muscle strength, balance, functionality, and safety in older adults.
Effect of home-based exercise on falls in community-dwelling older adults: an umbrella review
Sport Sciences for Health
Aims The aim of this review study was to examine the effectiveness of home-based and community-based exercise programmes in the rate of falls and improving physical functioning in community-dwelling older adults. Methods All types of home-based and community-based exercise interventions were searched. From 1186 studies identified, 14 studies were selected for the umbrella review. Most studies had high methodological quality. The types of interventions were multi-functional programmes (n = 11 studies) and Otago Exercise Programme (OEP) (n = 3 studies). Results The results showed that home-based and community-based exercise interventions can reduce falls by 22-32%. Studies that included meta-analysis showed that the clinical significance of home-based interventions in fall prevention and improving physical function was moderate to high. Conclusions In conclusion, home-based and community-based exercise interventions are a safe, effective, and feasible method of fall prevention that could be implemented with minimum supervision by allied health professionals to maximise autonomy, self-efficacy, and adherence in community-dwelling older adults.
BMJ (Clinical research ed.), 2012
To determine whether a lifestyle integrated approach to balance and strength training is effective in reducing the rate of falls in older, high risk people living at home. Three arm, randomised parallel trial; assessments at baseline and after six and 12 months. Randomisation done by computer generated random blocks, stratified by sex and fall history and concealed by an independent secure website. Residents in metropolitan Sydney, Australia. Participants aged 70 years or older who had two or more falls or one injurious fall in past 12 months, recruited from Veteran's Affairs databases and general practice databases. Exclusion criteria were moderate to severe cognitive problems, inability to ambulate independently, neurological conditions that severely influenced gait and mobility, resident in a nursing home or hostel, or any unstable or terminal illness that would affect ability to do exercises. Three home based interventions: Lifestyle integrated Functional Exercise (LiFE) app...
The Role of Exercise in Fall Prevention for Older Adults
Clinics in Geriatric Medicine, 2010
Regular participation in physical activity or exercise is not only integral to the maintenance of good health and functional independence in older adulthood, 1 but also serves a primary role in the prevention of numerous chronic diseases (eg, type 2 diabetes, cardiovascular disease, osteoporosis, certain types of cancer) 2 and cognitive decline. 3 Conversely, inactivity doubles the risk of developing a disability that will adversely affect mobility as well as the ability to perform even the most basic activities of daily life. This downward spiral in physical function ultimately results in heightened risk for both loss of functional independence and falls. 4 Depending on the level of risk identified, physical activity or exercise may serve a primary, secondary, or tertiary role in the prevention of falls. 5 In its primary role, regular engagement in physical activity can prevent the onset of pathological conditions and system impairments that may lead to disability and heightened risk for falls. Slowing the progression of disease and system impairments is physical activity's secondary role, while its tertiary role, for those older adults who have reached a level of system impairment or disease progression that can no longer be slowed, lies in the restoration of function to a level that allows for as much autonomy as possible in the performance of basic daily activities. THE BENEFITS OF PHYSICAL ACTIVITY (AND EXERCISE) IN REDUCING FALLS: OVERVIEW OF RESEARCH FINDINGS As of 2009, more than 600 published articles have investigated various intervention strategies aimed at lowering fall rates and/or fall risk among older adults. Of the multiple strategies investigated, exercise, either as a stand-alone intervention strategy or as an important component of a multifactorial intervention strategy, has been described as one of the "best buys" in fall prevention.