Feasibility and effectiveness of a nurse-led community exercise programme for prevention of falls among frail elderly people: A multi-centre controlled trial

Abstract

Objective: To determine whether an exercise programme provided by public health nurses is effective in improving physical function and psychological status in elderly people, in reducing falls and risk factors for falls in elderly people, and whether the intervention is a feasible programme within the community. Design: Controlled intervention trial. Subjects: Participants included 144 persons in the intervention group and 124 persons in the control group, who were living at home, aged over 65 years, and with 5 or more risk factors for falls identified using the questionnaire for fall assessment (Suzuki). Methods: For participants in the intervention group, an exercise programme was provided by public health nurses. This comprised a weekly exercise class of 2 hours for 17 weeks, supplemented by daily home exercises. Number of risk factors, physical function and psychological status were compared between the intervention and control groups before and after intervention. The number of further falls during the intervention was also compared between the 2 groups. Results: The programme significantly improved physical function and emotional status, and reduced the number of falls and risk factors for falls. The excellent adherence rate represented broad acceptance of the intervention. Conclusion: The intervention programme was effective and feasible to operate in the community.

Characteristics of optimum falls prevention exercise programmes for community-dwelling older adults using the FITT principle

“…Many studies stated that their programmes met these guidelines in relation to one or both types of training [4,30,32,35,47], but most did not provide sufficient detail of exercise intensity. All studies in which guideline intensities were explicitly not met did not significantly reduce falls incidence [28,29,42,55]. This highlights that strengthening and endurance exercise must be of an appropriate intensity to achieve training effects and the ensuing clinical benefits.…”

“…Studies aiming for daily exercise reduced falls rates by approximately 21-47 % [2,17,28,30,62], although adherence to the desired frequency was poor. After 1 year, Barnett et al [2] found that only 13 % of participants were exercising daily at home, with the vast majority (91 %) exercising just once per week outside of group exercise classes.…”

Self-reported Home Exercise and Younger Age Predict Improved Health-related Quality of Life among Community-Dwelling Elderly Participants in a Three-month Group Exercise Class

“…As a result of the increasing numbers of elderly people with musculoskeletal disease in developed countries, including Japan (WHO Scientific Group, 2003), a variety of class-based exercise regimens have been proposed for older people to prevent falls (Inokuchi et al, 2007;Suzuki et al, 2004), control pain (Baker et al, 2001;Ettinger et al, 1997), and strengthen muscles in the extremities (Ades et al, 1996;Baker et al, 2001;McCartney et al, 1995). Several previous studies consistently showed that exercise interventions were effective on muscle strength, walking (speed or distance), and chair-rise performance for the elderly (Keysor and Jette, 2001; Latham et al, 2004;Rubenstein et al, 2000).…”

Nursing care for the prevention of falls in the elderly: an integrative review

“…This intervention included a set two-hour sessions of weekly exercises, developed during 17 weeks and complemented by daily home exercises and an educational program about falls, which was developed in periods of about 15 minutes between exercises. This study showed physical improvements and reduction in the rate of falls and risk factors for falls and suggested that the program supplemented by exercises at home with good adherence resulted in significant improvements [18].…”