|
|
ELDERLY FALL PREVENTION
Evidence for Interventions
Exercise
Exercise has been shown to reduce falls, in some studies by as much as 40%, and improve participant confidence; however the exact type of exercise program has not been clarified. Older people should be offered programs long-term exercise and balance training.[4, 15] Programs that focused solely on exercise training reduced the number of subsequent falls in community-dwelling participants; exercise alone was not effective among inhabitants of long-term care facilities. In community-dwelling studies programs that included strength and endurance were successful.[4] One study of community dwelling women at moderate risk used Tai Chi C’uan and significantly reduced falls in a 4 month follow-up period, however it requires further study before it can be recommended as the preferred balance training.[10] A randomized control trial used Nijmegen Falls Prevention Program for 5 weeks. Sessions were conducted twice weekly for 1.5 hours. Attendance rates were 87% for the exercise training program and 51% completed all the sessions. The program used low impact exercise, practiced balance, coordination and used routine obstacles to improve maneuvering in everyday complex environments. For example the program practices walking with poor visibility (carrying a tray that blocked view of feet), doing multiple cognitive and motor tasks (carrying a tray with cups while walking and listening to story that had to be retold later), and walking in crowded environment. Obstacle avoidance testing used a treadmill with an object slightly above the minimal foot lift at different points in the participants stride. Results showed that the incidence of falls in the exercise group fell from a baseline of 1.77 falls per person-year to 0.95 falls per person-year. In the control group there were 1.77 falls per person-year at baseline and 1.75 falls per person-year during the follow-up period. The fall incidence rate ratio was 0.54 (95% CI, 0.34-0.79). Subjective balance confidence improved in the exercise group by 6% and deteriorated by 2% in the control group at the end of the follow-up period. Obstacle avoidance tests improved in both groups; there was a 6% improvement in the control group and 12% in the exercise group. The authors felt the program was successful because it involved training in situations that were similar to hazards encountered everyday with components for balance, gait, and cognitive approaches for behavioral change.[16]
 |
|
|
| |
|
|
|
|