Effectiveness of a Community-Based Multifactorial Intervention on Falls and Fall Risk Factors in Community-Living Older Adults: A Randomized, Controlled Trial

Shumway-Cook, Anne; Silver, Ilene F.; LeMier, Mary; York, Sally; Cummings, Peter; Koepsell, Thomas D.

doi:10.1093/gerona/62.12.1420

Cited by 153 publications

(134 citation statements)

References 43 publications

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“…This was in agreement with Andersen et al, [40] who declared that patients may have weakness of the extensors and flexors at the ankle and of knee flexors with preservation of strength of the knee extensors and of muscles at the wrist and elbow. The distribution of muscular weakness confirmed that a distal neuropathic process is the cause of the impaired motor performance.…”

Section: Discussionsupporting

confidence: 92%

Improved postural and gait performances by ankle rehabilitation program among people have lower limb ulcers

Othman¹,

Sweif²,

Zanaty³

2017

International Journal of Therapies and Rehabilitation Research

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Section: Discussionsupporting

confidence: 92%

Improved postural and gait performances by ankle rehabilitation program among people have lower limb ulcers

Othman¹,

Sweif²,

Zanaty³

2017

International Journal of Therapies and Rehabilitation Research

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“…낙상을 예방하기 위한 중재는 근력강화운동, 음악과 함께 하는 좌식운동, 유연성 및 균형운동, 스트레칭 및 점진적 율동운동, 태극 운동, 탄성밴드를 이용한 운동 (Liu & So, 2008;Nelson et al, 2004;Rejeski et al, 2008;Shumway-Cook et al, 2007)과 교육, 환경수정요법 과 영양보충요법 등 (Clemson et al, 2004;Mahoney et al, 2007;Tinetti, Richman, & Powell, 1990 …”

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Effects of a Fall Prevention Program on Physical Fitness and Psychological Functions in Community Dwelling Elders

Kwon

2011

J Korean Acad Nurs

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Purpose: This study was done to identify effects of a fall prevention program on physical fitness and psychological functions in community dwelling elders. Methods: A quasi-experimental study was carried out with a nonequivalent control group pre & post-test design. The program, which included exercises and education, consisted of a 12-week group program and an 8-week self-management program using a health calendar. An experimental group (32) and a control group (21) participated. Results: There were significant differences in SPPB (t= -3.92, p< .001), TUG test (t= 4.94, p< .001), standing with right leg (t= -3.60, p= .001), standing with left leg (t= -3.74, p< .001), front and rear maximum step length test (t= -4.34, p< .001), right-left maximum step length test (t= -2.65, p= .011), and fall efficacy (t= -2.42, p= .019). Fall efficacy, fear of falling and depression showed significant differences following the 12-week exercise program and 8-week self-management program in the experimental group. Conclusion: Study findings indicate that the fall prevention program is an effective nursing intervention to enhance physical fitness and psychological functions for elders. Using a health calendar, the self-management program was more effective for psychological functions compared to only the group program. Therefore, health providers should develop diversified fall prevention programs which include motivation plans to encourage clients in participating.

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“…Most falls prevention studies in community dwelling older people have delivered the intervention in the primary care setting, in which the interventions are delivered by staff working in the community, and with general practitioners providing the medical intervention 28 The consensus appears to be that the components of a successful falls prevention intervention are strength and balance training, home hazards assessment and medical/medication review; the setting in which these components are delivered is of less importance, as long as it is acceptable to the intended participants.…”

Section: Setting For Interventionsmentioning

confidence: 99%

Preventing falls in older people

2015

Nursing Standard

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Preventing falls in older peopleSimon Conroy Falls are a major cause of injury fear of falling and death affecting 24% of older people annually. Falls have a major impact on hospital services, and are an important cause of carer strain and admission to long term care.Multifactorial interventions delivered to fallers are effective in reducing falls rates by 25%. However, no UK studies have evaluated the role of screening older people living in the primary care setting and offering those at high risk a falls prevention programme. This work describes two studies -the evaluation of a postal falls risk screening tool, and a randomised controlled trial assessing the benefits of offering a falls prevention programme to those identified as being at high risk.335 older people were recruited into the screening study, using a modified version of the Falls Risk Assessment Tool. The sensitivity was 79%, specificity 58%, positive predictive value 50% and the negative predictive value 83%.In the RCT, 364 community-dwelling older people at high risk of falls were randomised into a pragmatic, multicentre trial evaluating falls prevention programmes. 181 were allocated to the control group and 183 to the intervention.The primary outcome was the rate of falls; the adjusted IRR was 0.73 (0.51-1.03), p=0.071. There were no significant differences between the groups in terms of the proportion of fallers, recurrent fallers, medically verified falls, injurious falls, time to first fall or time to second fall. Nor were there significant differences in terms of institutionalisation, mortality, basic or extended activities of daily living, or fear of falling.Further work on the acceptability and implementation of falls prevention interventions is required, but subject to these conditions being met and a supportive cost-effectiveness analysis, the totality of the evidence suggests that screening and intervening for individuals at high risk of fall may be effective. 4 ACKNOWLEDGMENTS

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Effectiveness of a Community-Based Multifactorial Intervention on Falls and Fall Risk Factors in Community-Living Older Adults: A Randomized, Controlled Trial

Abstract: A community-based multifaceted intervention was effective in improving balance, mobility, and leg strength, all known fall risk factors. Although the incidence of falls was lower, the confidence interval included the possibility of no intervention effect on falls.

Cited by 153 publications

References 43 publications

Improved postural and gait performances by ankle rehabilitation program among people have lower limb ulcers

Improved postural and gait performances by ankle rehabilitation program among people have lower limb ulcers

Effects of a Fall Prevention Program on Physical Fitness and Psychological Functions in Community Dwelling Elders

Preventing falls in older people

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