Physiotherapy in the prevention of falls in older people

Sherrington, Catherine; Tiedemann, Anne

doi:10.1016/j.jphys.2015.02.011

Cited by 85 publications

(63 citation statements)

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“…A possible explanation for the lack of an intervention effect in this study is that social dancing does not contain the necessary “training elements” to achieve a sufficient balance challenge needed for reducing falls [38]. Previous RCTs that showed improved balance through dance were designed as “dance-training” [15,17,20].…”

Section: Discussionmentioning

confidence: 99%

“…For example, the RCT by Federici and colleagues [15] included specific dynamic and static balance exercises and coordination exercise along with Caribbean dancing [15]; in contrast, our program had no additions of balance exercises and the ballroom dances or folk dances do not provide opportunities for standing without support or standing on one leg for a long time, which are elements identified as high balance challenge exercises [3,38]. The dance programs, however, provided many elements of stepping practice [38], a factor that may have induced the improvement in gait speed. The improvement in gait speed may be important, as gait speed is a strong predictor not only for falls [11] but also for survival [39,40].…”

Section: Discussionmentioning

confidence: 99%

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Social Dancing and Incidence of Falls in Older Adults: A Cluster Randomised Controlled Trial

et al. 2016

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BackgroundThe prevention of falls among older people is a major public health challenge. Exercises that challenge balance are recognized as an efficacious fall prevention strategy. Given that small-scale trials have indicated that diverse dance styles can improve balance and gait of older adults, two of the strongest risk factors for falls in older people, this study aimed to determine whether social dance is effective in i) reducing the number of falls and ii) improving physical and cognitive fall-related risk factors.Methods and FindingsA parallel two-arm cluster randomized controlled trial was undertaken in 23 self-care retirement villages (clusters) around Sydney, Australia. Eligible villages had to have an appropriate hall for dancing, house at least 60 residents, and not be currently offering dance as a village activity. Retirement villages were randomised using a computer generated randomisation method, constrained using minimisation. Eligible participants had to be a resident of the village, be able to walk at least 50 m, and agree to undergo physical and cognitive testing without cognitive impairment. Residents of intervention villages (12 clusters) were offered twice weekly one-hour social dancing classes (folk or ballroom dancing) over 12 mo (80 h in total). Programs were standardized across villages and were delivered by eight dance teachers. Participants in the control villages (11 clusters) were advised to continue with their regular activities. Main outcomes: falls during the 12 mo trial and Trail Making Tests. Secondary outcomes: The Physiological Performance Assessment (i.e., postural sway, proprioception, reaction time, leg strength) and the Short Physical Performance Battery; health-related physical and mental quality of life from the Short-Form 12 (SF-12) Survey. Data on falls were obtained from 522 of 530 (98%) randomised participants (mean age 78 y, 85% women) and 424 (80%) attended the 12-mo reassessment, which was lower among folk dance participants (71%) than ballroom dancing (82%) or control participants (82%, p = 0.04). Mean attendance at dance classes was 51%. During the period, 444 falls were recorded; there was no significant difference in fall rates between the control group (0.80 per person-year) and the dance group (1.03 per person-year). Using negative binomial regression with robust standard errors the adjusted Incidence Rate Ratio (IRR) was 1.19 (95% CI: 95% CI = 0.83, 1.71). In exploratory post hoc subgroup analysis, the rate of falls was higher among dance participants with a history of multiple falls (IRR = 2.02, 95% CI: 1.15, 3.54, p = 0.23 for interaction) and with the folk dance intervention (IRR = 1.68, 95% CI: 1.03, 2.73). There were no significant between-group differences in executive function test (TMT-B = 2.8 s, 95% CI: −6.2, 11.8). Intention to treat (ITT) analysis revealed no between-group differences at 12-mo follow-up in the secondary outcome measures, with the exception of postural sway, favouring the control group. Exploratory post hoc analysis by study comple...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Social Dancing and Incidence of Falls in Older Adults: A Cluster Randomised Controlled Trial

et al. 2016

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“…Several studies have revealed that fall incidence among older adults can be reduced by training (Gillespie et al, 2012;Sherrington et al, 2011). Conventional training programs often focus on aspects, like maintaining balance in standing tasks or safe obstacle negotiation (Sherrington and Tiedemann, 2015). In contrast, most falls are due to mechanical perturbations during walking, such as trips or slips (Krasovsky et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

Transfer and retention effects of gait training with anterior-posterior perturbations to postural responses after medio-lateral gait perturbations in older adults

Rieger

Papegaaij²,

Pijnappels

et al. 2020

Clinical Biomechanics

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“…[1][2][3] Falls can be prevented by treating underlying conditions, making modifications to the home environment and engaging in strength and balance exercises. 4 General practitioners (GPs) and allied health professionals (AHPs) can promote fall prevention through identifying and managing individual fall risks; for example, physiotherapists can provide a tailored exercise program, 5 while podiatrists can investigate and treat foot conditions that contribute to unsteady gait. 6 Research regarding GP referral and collaboration with AHPs for fall prevention in the Australian context is limited.…”

Section: Introductionmentioning

confidence: 99%

Influences on general practitioner referral to allied health professionals for fall prevention in primary care

et al. 2019

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Objective To explore influences on referral for fall prevention from general practitioners (GPs) to allied health professionals (AHPs) to better equip AHPs engage with GPs regarding fall prevention. Methods Qualitative, semi‐structured interviews with GPs (n = 24), practice nurses (n = 3) and AHPs (n = 15) and field notes were analysed inductively using constant comparative methods. Results Three main themes regarding influences on GP referral to AHPs for fall prevention were identified as follows: GPs' knowledge of AHPs; The “reliable and good” AHP; and Patient feedback‐Patient choice. Three‐way communication and trust between GP, patient and AHP underpinned each of these themes. Conclusions Strategies for encouraging GP referral include AHPs personally contacting GPs to explain their services; writing to GPs about every patient seen; and being aware that interprofessional relationships are based on trust and take time to develop. GPs and AHPs are encouraged to communicate directly rather than relying on patients to convey verbal information.

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Physiotherapy in the prevention of falls in older people

Abstract: [Sherrington C, Tiedemann A (2015) Physiotherapy in the prevention of falls in older people.Journal of Physiotherapy61: 54-60].

Cited by 85 publications

References 34 publications

Social Dancing and Incidence of Falls in Older Adults: A Cluster Randomised Controlled Trial

Social Dancing and Incidence of Falls in Older Adults: A Cluster Randomised Controlled Trial

Transfer and retention effects of gait training with anterior-posterior perturbations to postural responses after medio-lateral gait perturbations in older adults

Influences on general practitioner referral to allied health professionals for fall prevention in primary care

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