Efficacy of Physical Exercise in Preventing Falls in Older Adults With Cognitive Impairment: A Systematic Review and Meta-Analysis

Chan, Wai-Chi; Yeung, Wing‐Fai; Wong, Corine Sau Man; Lam, Linda Chiu Wa; Chung, Ka Fai; Luk, James Ka-Hay; Lee, Jenny Shun Wah; Law, Angeline

doi:10.1016/j.jamda.2014.08.007

Cited by 84 publications

(56 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Among the 108 potentially relevant publications, 59 were considered eligible for inclusion and 49 were excluded (Fig 1 and S2 Table). Twenty-eight of the included systematic reviews performed meta-analyses [34–59] and thirty-one systematic reviews reported results of the included studies as a narrative summary [60–91]. Fifty-seven out of 59 reviews used Pubmed to search for primary studies.…”

Section: Resultsmentioning

confidence: 99%

“…Exercise was the most frequent intervention included in the reviews (50), with 18 articles containing exercise as the only intervention [37, 44, 47, 48, 50, 53, 65–67, 69, 71, 72, 76, 79, 84, 87, 88, 91] (S4 Table). The next most frequent interventions fell under Environment in the form of environmental modifications (28 articles) [35, 38–40, 45, 46, 51, 52, 54–59, 63, 68, 70, 73, 74, 77, 78, 80–83, 86, 92], assistive and protective aids (24 reviews) [35, 38–40, 42, 43, 45, 51, 55, 56, 58, 59, 62, 63, 68, 70, 74, 77, 78, 82, 83, 86, 93, 94], staff education (15 SRs) [35, 38, 39, 45, …”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Effectiveness of Non-Pharmacological Interventions to Prevent Falls in Older People: A Systematic Overview. The SENATOR Project ONTOP Series

Rimland¹,

Abraha²,

Dell’Aquila³

et al. 2016

PLoS ONE

View full text Add to dashboard Cite

BackgroundFalls are common events in older people, which cause considerable morbidity and mortality. Non-pharmacological interventions are an important approach to prevent falls. There are a large number of systematic reviews of non-pharmacological interventions, whose evidence needs to be synthesized in order to facilitate evidence-based clinical decision making.ObjectivesTo systematically examine reviews and meta-analyses that evaluated non-pharmacological interventions to prevent falls in older adults in the community, care facilities and hospitals.MethodsWe searched the electronic databases Pubmed, the Cochrane Database of Systematic Reviews, EMBASE, CINAHL, PsycINFO, PEDRO and TRIP from January 2009 to March 2015, for systematic reviews that included at least one comparative study, evaluating any non-pharmacological intervention, to prevent falls amongst older adults. The quality of the reviews was assessed using AMSTAR and ProFaNE taxonomy was used to organize the interventions.ResultsFifty-nine systematic reviews were identified which consisted of single, multiple and multifactorial non-pharmacological interventions to prevent falls in older people. The most frequent ProFaNE defined interventions were exercises either alone or combined with other interventions, followed by environment/assistive technology interventions comprising environmental modifications, assistive and protective aids, staff education and vision assessment/correction. Knowledge was the third principle class of interventions as patient education. Exercise and multifactorial interventions were the most effective treatments to reduce falls in older adults, although not all types of exercise were equally effective in all subjects and in all settings. Effective exercise programs combined balance and strength training. Reviews with a higher AMSTAR score were more likely to contain more primary studies, to be updated and to perform meta-analysis.ConclusionsThe aim of this overview of reviews of non-pharmacological interventions to prevent falls in older people in different settings, is to support clinicians and other healthcare workers with clinical decision-making by providing a comprehensive perspective of findings.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Effectiveness of Non-Pharmacological Interventions to Prevent Falls in Older People: A Systematic Overview. The SENATOR Project ONTOP Series

Rimland¹,

Abraha²,

Dell’Aquila³

et al. 2016

PLoS ONE

View full text Add to dashboard Cite

show abstract

“…Como fator preventivo e de controle destas alterações, o exercício físico vem a contribuir para a conservação ou até mesmo melhora das alterações abordadas acima, pois ao se desenvolver um determinado tipo de exercício físico, devemos levar em consideração a necessidade do mesmo, assim procurando sempre a facilitar a execução das AVDs de idosos (PLUMMER et al, 2016;CHAN et al, 2015;ZHANG;SHUAI, 2015;KARR et al, 2014;GINÉ-GARRICA et al, 2014;VRIES et al, 2012).…”

unclassified

Avaliação Da Flexibilidade E Força Muscular De Membros Inferiores Em Idosas Praticantes De Hidroginástica

Oliveira¹,

Pereira²,

Antunes

et al. 2017

SaudPesq

View full text Add to dashboard Cite

Este estudo teve como objetivo avaliar a flexibilidade e força muscular de membros inferiores de idosas praticantes de hidroginástica no município de Sarandi, Estado do Paraná. Foram avaliadas 31 idosas praticantes de hidroginástica. Para a avaliação da flexibilidade foi utilizado o teste de Sentar e Alcançar e para a avaliação de força muscular de membros inferiores foi utilizado o teste de sentar e levantar de cadeira em 30 segundos. A análise de dados foi realizada por meio da estatística descritiva e inferencial.

show abstract

“…Increased mechanical loading from exercise can improve bone fragility according to Wolff's law, which is expected to prevent non-fall-related vertebral fracture. In contrast, however, the exercise-related improvement of skeletal fragility could not efficiently act to prevent fall-related non-vertebral fractures such as in the hip because bones adapt to mechanical environment associated with physical activity, as indicated for example by trabecular pattern in the hip (Singh index), but not to falls that result in the different direction of force.On the other hand, a number of studies have confirmed that exercise plays significant roles in preventing falls [7][8][9][10][11]; in the EFOPS trial, approximately half of low-trauma fractures resulted from falls [1]. The latest meta-analysis of the associations between measures of balance and lower-extremity muscle strength/power suggests that these components are independent of each other [12] and indeed combined resistance and balance-jumping exercise for 5 years effectively reduced injurious falls compared to resistance or balance-jumping exercise alone in older women [13].…”

mentioning

confidence: 99%

“…On the other hand, a number of studies have confirmed that exercise plays significant roles in preventing falls [7][8][9][10][11]; in the EFOPS trial, approximately half of low-trauma fractures resulted from falls [1]. The latest meta-analysis of the associations between measures of balance and lower-extremity muscle strength/power suggests that these components are independent of each other [12] and indeed combined resistance and balance-jumping exercise for 5 years effectively reduced injurious falls compared to resistance or balance-jumping exercise alone in older women [13].…”

mentioning

confidence: 99%

Possible different roles of exercise in preventing vertebral and hip fractures

et al. 2016

View full text Add to dashboard Cite

Dear Editor, In postmenopausal women, a recent 16-year follow-up analysis of the Erlangen Fitness and Osteoporosis Prevention Study (EFOPS) by Kemmler and colleagues [1] showed significantly fewer major osteoporotic fractures including vertebral and hip fractures in the exercise group compared to the control group (rate ratio 0.37, 95 % confidence interval 0.14 to 0.88, p = .027). This is important evidence demonstrating that longterm multipurpose exercise programs can reduce low-trauma fracture risk in older adults. Here, we would like to discuss possible different roles of exercise in preventing vertebral and hip fractures on the basis of skeletal adaptation to mechanical environment (Wolff's law) [2].There is no doubt that exercise is a useful nonpharmacologic approach for preventing fragility fractures [3,4], although it was recently pointed out that exercise was recommended by less than half of guidelines about the management of osteoporosis [5]. The EFOPS trial found that long-term multipurpose exercise programs continuously slowed the age-related bone loss in the lumbar spine and hip [1,6]. Increased mechanical loading from exercise can improve bone fragility according to Wolff's law, which is expected to prevent non-fall-related vertebral fracture. In contrast, however, the exercise-related improvement of skeletal fragility could not efficiently act to prevent fall-related non-vertebral fractures such as in the hip because bones adapt to mechanical environment associated with physical activity, as indicated for example by trabecular pattern in the hip (Singh index), but not to falls that result in the different direction of force.On the other hand, a number of studies have confirmed that exercise plays significant roles in preventing falls [7][8][9][10][11]; in the EFOPS trial, approximately half of low-trauma fractures resulted from falls [1]. The latest meta-analysis of the associations between measures of balance and lower-extremity muscle strength/power suggests that these components are independent of each other [12] and indeed combined resistance and balance-jumping exercise for 5 years effectively reduced injurious falls compared to resistance or balance-jumping exercise alone in older women [13]. However, fall prevention is a hard task in aged adults, especially older than 80 years, as highlighted by recent large randomized trials [14-16] and pharmacologic therapies of sarcopenia [17][18][19] are expected to enhance the effects of exercise on fall prevention. Nevertheless, not only falling but also bone fragility should be targeted to prevent hip fracture in elderly people.Finally, bones normally respond to the change in local mechanical environment at each skeletal site to maintain resultant elastic deformation (strain) of bone; increased or decreased bone strain from physical activity would induce bone gain or loss, respectively [2]. Consequently, an ideal strategy to improve skeletal fragility is developing an agent that has the effect of mechanical strain-related stimulus; such alternative dru...

show abstract

Efficacy of Physical Exercise in Preventing Falls in Older Adults With Cognitive Impairment: A Systematic Review and Meta-Analysis

Cited by 84 publications

References 29 publications

Effectiveness of Non-Pharmacological Interventions to Prevent Falls in Older People: A Systematic Overview. The SENATOR Project ONTOP Series

Effectiveness of Non-Pharmacological Interventions to Prevent Falls in Older People: A Systematic Overview. The SENATOR Project ONTOP Series

Avaliação Da Flexibilidade E Força Muscular De Membros Inferiores Em Idosas Praticantes De Hidroginástica

Possible different roles of exercise in preventing vertebral and hip fractures

Contact Info

Product

Resources

About