Falls in the elderly are a public health problem. Consequences of falls are increased risk of hospitalization, which results in an increase in health care costs. It is estimated that 33% of individuals older than 65 years undergoes falls. Causes of falls can be distinguished in intrinsic and extrinsic predisposing conditions. The intrinsic causes can be divided into age-related physiological changes and pathological predisposing conditions. The age-related physiological changes are sight disorders, hearing disorders, alterations in the Central Nervous System, balance deficits, musculoskeletal alterations. The pathological conditions can be Neurological, Cardiovascular, Endocrine, Psychiatric, Iatrogenic. Extrinsic causes of falling are environmental factors such as obstacles, inadequate footwear. The treatment of falls must be multidimensional and multidisciplinary. The best instrument in evaluating elderly at risk is Comprehensive Geriatric Assessment (CGA). CGA allows better management resulting in reduced costs. The treatment should be primarily preventive acting on extrinsic causes; then treatment of chronic and acute diseases. Rehabilitation is fundamental, in order to improve residual capacity, motor skills, postural control, recovery of strength. There are two main types of exercises: aerobic and muscular strength training. Education of patient is a keypoint, in particular through the Back School. In conclusion falls in the elderly are presented as a "geriatric syndrome"; through a multidimensional assessment, an in-tegrated treatment and a rehabilitation program is possible to improve quality of life in elderly.
Purpose: To demonstrate that a tailored, supervised aerobic exercise after a general back-school rehabilitation program will improve outcomes for older patients with low back pain more than the general back-school program alone. Method: Twenty-two older patients with chronic nonspecific low back pain were recruited for this study, and they were randomly assigned to a control or an interventional group. Both groups received a standard back-school program, while subjects in the intervention group received an additional 15 minutes of the aerobic training program. The numerical pain rating scale (NPRS) and the Roland-Morris Questionnaire (RMQ) were used to assess pain intensity and disability before and after the 5-week treatment in both the participants' groups. Results: Reduction percentage was found significantly increased in the interventional group when compared with the control group for both the NPRS and the RMQ index (P < .05). Conclusion: An adapted aerobic exercise, together with a standard back-school program, was effective in reducing pain symptoms and disability in low back pain subjects rather than the back-school program alone. This should be used as an advice to practitioners while managing low back pain.
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