Fall prevention

Last updated

Fall prevention includes any action taken to help reduce the number of accidental falls suffered by susceptible individuals, such as the elderly (idiopathic) and people with neurological (Parkinson's, Multiple sclerosis, stroke survivors, Guillain-Barre, traumatic brain injury, incomplete spinal cord injury) or orthopedic (lower limb or spinal column fractures or arthritis, post-surgery, joint replacement, lower limb amputation, soft tissue injuries) indications.

Contents

Adults aged 65 years and older have a 30% chance of falling each year, making fall-related injuries the leading cause of accident-related death for this demographic. [1] Current approaches to fall prevention are problematic because even though awareness is high among professionals that work with seniors and fall prevention activities are pervasive among community living establishments, [2] fall death rates among older adults have more than doubled. [3] The challenges are believed to be three-fold. First, insufficient evidence exists that any fall risk screening instrument is adequate for predicting falls. [4] While the strongest predictors of fall risk tend to include a history of falls during the past year, gait, and balance abnormalities, [5] existing models show a strong bias and therefore mostly fail to differentiate between adults that are at low risk and high risk of falling. [6] [7]

Second, current fall prevention interventions in the United States are limited between short-term individualized therapy provided by a high-cost physical therapist or longer-term wellness activity provided in a low-cost group setting. Neither arrangement is optimum in preventing falls over a large population, [8] especially as these evidence-based physical exercise programs have limited effectiveness [9] (approximately 25%). Even multifactorial interventions, [10] which include extensive physical exercise, medication adjustment, and environmental modification only lower fall risk by 31% after 12 months, [11] and by 21% after 24 months. [1] Questions around effectiveness of current approaches (physical exercise and multifactorial interventions) have been found in multiple settings, including long-term care facilities and hospitals. [12]

The final challenge is adherence. Average adherence in group-based fall prevention exercise programs is around 66%, mostly due to the highly repetitive nature of the programs and the extremely long duration required for noticeable benefits accrue. [13] Adherence to physical therapy can be even lower. [14] When adherence is below 70%, effectiveness of fall prevention physical exercise programs can drop to less than 10%. [13]

Practitioners are aware that the most successful approach to fall prevention utilizes a multimodal, motor-cognitive training approach [15] that could be introduced to all adults over 65. The scientific basis of this approach is an understanding of how the dual-task paradigm induces neuroplasticity in the brain, especially in aging populations. [16] This is driving a growing body of research that specifically links the cognitive sub-domains of attention and executive function (EF) to gait alterations and fall risk. [17] [18] [19] [20] [21]

Cost of falls

Falls and fall-related injuries are among the most common but serious medical problems experienced by older adults. Nearly one-third of older people fall each year, half of which fall more than once per year. [22] Over 3 million Americans over the age of 65 visited hospital emergency departments in 2015 due to fall-related injuries, with over 1.6 million being admitted. [23] Because of decreased bone density due to osteoporosis, mobility, and reflexes, falls often result in hip fractures and other fractures, head injuries, and death in older adults. Accidental injuries are the fifth most common cause of death in older adults. [22] 75% of hip fracture patients do not recover completely and show signs of overall health deterioration. [22]

Strategies and interventions

Motor-cognitive training is increasingly viewed as the gold standard for healthy aging and fall prevention. [24] [25] One approach that has been researched is the introduction of semi-immersive virtual reality simulation during treadmill training. [26] Initially conceptualized by the Tel Aviv Sourasky Medical Center with funding from the Michael J Fox Foundation and the European Commission, V-TIME [27] projects a real-time image of participants' feet onto a large screen at eye-level while the participants are walking on a treadmill. The virtual environment introduces multiple physical and cognitive challenges while the participant is in dynamic motion. This one approach to motor-cognitive training was found to repeatedly reduce falls by 50% [28] after 5 weeks of 15 sessions across multiple clinical trials and multiple indications (idiopathic, [29] Parkinson's, [30] Multiple sclerosis [31] ). The biological manifestations of this improvement were identified through functional MRI, which showed changes in brain activity patterns for patients that were exposed to combined motor-cognitive training, as opposed to exclusively physical training. [32]

Physical activity is important for older adults because it plays a major role in limiting the loss of muscle mass and strength, while also stimulating postural control. [33] There are some exercise types that have a higher rate of effectiveness for prevention of falls than others. Postural training is one of the main key exercises to prevent falls. It focuses on improving balance and stability, which is important. Pilates is a type of training shown to improve the postural system. [34] ] Resistance training also has a positive impact on older adults. It is shown that it causes a major increase in strength and muscle size. [35] It is important to combine muscle strengthening exercises and balance training together to ensure reduced risks of falls. [36] An older adult should be focusing more on strengthening their legs, hip, and core muscles. Strengthening these muscles will provide them with more stability. These exercises may minimize or reduce physical frailty. [35] The elderly population can benefit the most from exercising.

Other preventative measures with positive effects include strength and balance training, home risk assessment, [37] the withdrawal of psychotropic medication, cardiac pacing for those with carotid sinus hypersensitivity, and tai chi. Resistance exercise two or three times a week with ankle weights or elastic bands has been proven in tests to rebuild lost muscle mass, improve balance and strength, and reduce falls in adults of all ages: it was first tested in New Zealand by the Otago Medical School in four controlled trials, in which about 1,000 older adults with an average age 84 participated. [38] [39] Falls among a test group that did the Otago routines three times a week for 12 months was 35% fewer than a control group that did not use the routines. [40] Two similar 12-month tests were conducted in the US using residents in assisted and skilled nursing facilities with one group showing a 54% reduction in falls. [41] After the age of 50, adults experience a decrease in muscle mass (sarcopenia) by approximately 2% every year. [42] A systematic review concluded that resistance training can slow down the rate of loss in muscle mass and strength. It has been recommended that older adults participate in resistance training two to three times a week to weaken the effects of sarcopenia. [42] Assistive technology can also be applied, although it is mostly reactive in case of a fall. [43] Exercise as a single intervention has been shown to prevent falls in community-dwelling older adults. A systematic review suggests that having an exercise regimen that includes challenging balance workouts for three or more hours per week results in a lesser chance of falling. [42] Resistance training has been shown to be beneficial beyond fall prevention, as it also helps improve functional mobility and activities of daily living such as walking endurance, gait speed, and stair climbing. [42] Research explains that this significant increase in performance can be accomplished after the age of 90. For older adults to gain confidence in resistance training, which may ultimately lead to falling prevention effects, they must obtain the recommended amount of daily activity. [42] A clinical trial concluded that combining resistance and balance training showed a significant benefit in increasing stabilizer muscle strength and innervation through neuromuscular adaptions from performing resistance training on a dynamic surface. Stabilizer muscles in the trunk and lower extremities are activated through the balance aspect of the regiment. The trial also showed a significant improvement in walking speed which is a risk factor for morbidity, hospitalization, and disability. A meaningful change in walking speed is defined as an increase of 0.05 meters per second. The Resistance and Balance training group showed an improvement of 0.37 meters per second, contrasting the 0.11 meters per second improvement of the resistance training group. Dynamic balance, lower limb function, and walking speed are strong indicators of physical functionality and level of dependence. These skills are significant for preventing falls. [44]

The aim of medical management is to identify factors that can contribute to falls and fracture risk such as osteoporosis, multiple medications, balance and gait problems, loss of vision and a history of falls. Beers Criteria is a list of medications that are potentially inappropriate for use in the elderly and some of them increase the risk of falls. [45]

Falls are well known amongst community-dwelling individuals ages 65 and older. [46] The risk of fall-related incidents nearly doubles when individuals are institutionalized. [47] The impact on different falls in certain situation of fall prevention programs on the rate differences of falls in elderly population has not been reported. As well as cognitive impairment, functional impairment, gait, and balance disorders, certain medications can increase fall risk factors for patients. At an advanced age, these risk factors are double and more likely to occur. It's important to identify the risk factors that increase the likelihood of injurious falls. State-level fall prevention strategies can also mitigate fall risk for community-dwelling older adults. [46]

Studies have shown that there is a high agreement on guidelines for fall prevention across clinical practices. These include (but are not limited to): the use of specific tests for gait and balance assessments, multifactorial interventions, medication review, physical exercises, vision and footwear intervention, physiotherapy referral, environment modification, risk stratification, management of osteoporosis and fracture risk, and cardiovascular interventions. [48]

Balance of Older adults can be examined through the Burg Balance Scale. This test is useful for measuring the dependance of an older adult. The Burg Balance Scale can also be used to predict falls and postural balance inefficiencies through a 14 item test of functional movements the individual may be presented with throughout daily activities. Participants are scored and placed into levels of dependence based on their score. Individuals with the score 41-56 are designated as independent, scores 21-40 designation is walking with assistance (ie. cane or walker), and scores 0-20 designation is requiring a wheel chair. This test can be used as a measure of baseline ability and post intervention ability. [49]

Risk factors of falls

Older adults

Studies have shown that adults over the age of 65 are more prone to falls than younger, healthy adults. [50] [51] Most falls in older adults are due to: [52] Living a sedentary lifestyle long term can increase loss of muscle function. [35]

Stroke

Individuals who have had a stroke have higher fall rates. Approximately 30% fall at least once a year and 15% fall twice or more. [62] Risk factors for falls in stroke survivors are: [63]

Parkinson's disease

Most people with Parkinson's disease (PD) fall and many experience recurrent falls. [65] A study reported that over 50% of persons with PD fell recurrently. [66] Direct and indirect causes of falls in patients with PD: [67]

Multiple sclerosis

There is a high prevalence of falls among persons with multiple sclerosis (MS), with approximately 50% reporting a fall within the past six months. [68] About 30% of those individuals report falling multiple times.

Dementia

Studies suggest that men are twice as likely to fall as women. [73] Common causes of falls in dementia include:

Fear of falling (basophobia)

Basophobia is a term used in many circumstances to describe the fear of falling in either normal or special situations. It refers to uncomfortable sensations that may be experienced by older people. These sensations can include lower-body weakness or loss of balance, which can induce a frightening sensation of falling that can lead to serious and potentially fatal injuries. [75] [ self-published source? ]

Fear of falling has become a serious and common concern among older adults and impedes on one’s participation in daily activities. Negative consequences can result to impaired mobility, loss of independence, and a decreased quality of life. The state of an individual’s quality of life is important when regarding both positive and negative elements that may prohibit them from living life to the fullest. In some situations, the recurrent thought about falling has also been shown to lead to death within the elderly community. In a study done, experiences of falling were significantly associated with the fear of falling. The results showed that those who experienced falls within the previous month or previous year related their fall through recurrent thoughts of falling. [76] This may lead to low self-confidence even when participating in nonhazardous activates. Rates of fear of falling in older adult communities range from 21.0% to 85.0% among those who have a history of falls and 33.0% to 46.0% among those who do not have a history of falling. [77] Basophobia and its related activity avoidance among the elderly may lead to a vicious cycle of falls and functional impairment. It is important to be aware of this when working with the older population and recommending preventive strategies. Many strategies include the participation in community and home-based exercise programs, cognitive behavioral therapy, yoga, meditation, and practicing good sleep hygiene. [78] Restriction of these activities could lead to muscle weakness, postural instability, deconditioning and a higher prevalence of falls.

Healthy young individuals

Accidents are the most common cause of falls involving healthy adults, which may be the result of tripping on stairs, improper footwear, dark surroundings, slippery surfaces, uneven ground, or lack of exercise. Studies suggest that women are more prone to falling than men in all age groups. [79] The most common injuries among younger patients occur in the hands, wrists, knees, and ankles. [79]

Environmental modification

Grab rails on a longer-distance commuter train catering for mainly seated passengers Passenger compartment Class 440.jpg
Grab rails on a longer-distance commuter train catering for mainly seated passengers
A staircase with metal handrails BMF Gelander.jpg
A staircase with metal handrails
Front-wheeled walker. Walker. frame.jpg
Front-wheeled walker.
Grab bar mounted in a bathroom Grab bar.jpg
Grab bar mounted in a bathroom
Forearm crutch/cane Strongarm cane design 4 lg.jpg
Forearm crutch/cane

The home environment can present many hazards. Common places for injurious falls include the bathtub and stairs. Changes to the home environment are aimed at reducing hazards and help support a person in daily activities; they include minimizing clutter, installing grab bars in the bathroom, and installing non-slip decals to slippery surfaces. [80] Stairs can be improved by installing handrails on both sides, improving lighting, and adding colour contrast between steps. Improvement in lighting and luminance levels can aid elderly people in assessing and negotiating hazards. Occupational therapists can help clients improve fall prevention behaviours. [81] In addition, they can instruct clients and their family members on factors that contribute to falls, and implement environmental modifications and strategies to decrease the risk of falls. [81] There is currently insufficient scientific evidence to ensure the effectiveness of modification of the home environment to reduce injuries. [82] Evidence suggests that pre-discharge home assessments are associated with a reduced risk of falling. [37]

Safety technology

Important improvements to prevent falls include handrails and grab bars, which should be easy to grip or grasp and should be near any stairs or change in floor level. Floors should always be flat and level, with no exposed corners or edges. Patterned floors can be dangerous if they create misleading or distorted images of the floor surface, and should be avoided. [83]

There are special handles and closed handgrips available in bathrooms and lavatories to help users bend down or over. For example, extra support for users when moving include walking sticks, crutches, and support frames, such as a walker. Flexible handles such as hanging straps can also be useful supports. [84]

Eyeglasses selection and usage

Bifocal spectacles and trifocal eyeglasses are used to provide refractory correction ideal for reading (12–24 inches (30–60 cm) when the wearer looks downward through them. Reading glasses are not ideal for safe walking, where correction for 4.5–5 feet (137–152 cm) would be more appropriate.

Occupational and physical therapy

Studies show that balance, flexibility, strength, and motor-cognitive training not only improve mobility but also reduce the risk of falling.[ citation needed ] This may be achieved through group and home-based exercise programs or engagement with physical therapy clinics with the appropriate equipment. The majority of older adults do not exercise regularly and 35% of people over the age of 65 do not participate in any leisurely physical activities.[ citation needed ]

Older adults

In older adults, physical training and perturbation therapy is directed to improving balance recovery responses and preventing falls. [85] Gait-related changes in the elderly provide a greater chance of stability during walking due to slower speed and greater base of support, but they also increase the chance of slipping or tripping and falling. [86] Appropriate joint moment generation is required to create sufficient push-off for balance recovery. Age-related changes in muscles, tendons, and neural structures may contribute to slower reactive responses. Interventions involving resistance training along with perturbation training may prove to be beneficial in improving muscle strength and balance recovery. [87]

Stroke recovery

Stroke exercises help patients regain mobility and strength in their bodies, and must be done regularly in order to regain muscle tone that helps prevent falls. [88]

Exercises for prevention

One of the most important things for fall prevention in elderly populations is to stay physically fit. Specialized facilities and programs like seniors' parks are a good place to keep the elderly in shape and increase their resistance to falling. These facilities contain specialized equipment and training stations where elderly people can exercise. The parks usually have an extended amount of space and different stages reserved for different body exercises. Research suggests that participation in such programs successfully mitigates fall risk in the majority of attendees. [89]

There are many exercise programs that the elderly population can use to help decrease risk of falls. Falls occur in 25% of the senior population above 65 years of age. And falls cause 32,000 deaths a year in the United States. One research done with older adults and balance showed that multicomponent exercise with both aerobic and anaerobic components provide positive outcomes together with specific balance integrations. [90] The program combined balance, strength, and functional training, Another research has shown that Multi-system Physiological Exercise or MPE has potential to reduce risk of falls. [91] This study placed 36 individuals into a MPE group and compared to a baseline of a control group. It was found that the MPE group had improvements in proprioception, or awareness in space, hand reaction time, and sway path compared to the control group. Home exercise programs have been tested to the individual needs of the participant. The home exercise program called T&E (Test and Exercise) was compared to two other fall prevention programs such as the Otago and Helsana programs. The T&E programs allowed for higher participation from the individuals which lead to a larger effect on their quality of life. [92] The exercises most attuned for the prevention of falls includes multicomponent resistance training and specified balance training. Implementation of these exercises have been shown to reduce risk of falls and should be incorporated in exercise programs for older adults with a fall risk. Physical and Occupational therapist use similar exercises to treat fall risk patients. [92] Structured exercise programs allow seniors to reduce fall risk and generally increase quality of life. Proprioception (the ability to sense where the body is in a space) increases and muscular strength and endurance allow for older adults to help themselves if a fall where to occur.

Another type of exercise that has been seen to be beneficial in decreasing fall risk, specifically in older women, is pilates. Pilates has been found to be a safe form of exercise for older adults compared to a big gym setting due to its more serene and calm setting, which also can improve an older adult’s mental stability and their quality of life. Pilates was found to effectively improve balance which was able to decrease their risk of fall. Studies show that pilates leads to an increase in mobility as well which contributes to a lower fall risk. Due to pilates showing positive effects on balance, leg strength, and mental well-being, this allows older adults to be more physically and mentally strong. These factors can allow for elderly people to be more confident to decrease their fall risk. [93] Studies have also found VR on Xbox Kinect is beneficial for an elderly persons’ balance and their fear of falling. A study conducted on 60 older individuals living in a nursing home participated in VR exercises on an Xbox Kinect for 30-45 minutes every week for 6 weeks. Once the study was completed, those in the intervention group were found to have better balance as well as a decreased score of fear of falling. [94] Other forms of training, such as aerobic, anaerobic, and proprioceptive exercises can also be used to increase balance to lower the risk of falls in the elderly population. There have been a couple of studies that have found that an increase in muscle strength will also strengthen an older person’s balance due to their nervous and muscular systems are not as fully functional. One of these exercises is Tai-Chi, which not only improves balance, but also quality of life, flexibility, and strength. [95]

Environmental modifications, like improving lighting, removing tripping hazards, and repairing uneven surfaces, further contribute to fall prevention. Addressing these hazards within everyday settings helps make interventions practical and accessible, empowering older adults to actively engage in improving their stability and reducing fall risks. [96]

Challenges such as transportation barriers, gaps in care continuity, and the need for sustained support for frail individuals are noted in the research. Long-term, sustainable fall-prevention programs benefit from partnerships between healthcare providers, caregivers, and community resources, helping to maintain independence and enhance quality of life for older adults. These efforts not only improve patient outcomes but also reduce the broader strain on healthcare systems, highlighting the societal value of comprehensive, community-based fall-prevention interventions. [97]

See also

Related Research Articles

<span class="mw-page-title-main">Osteoporosis</span> Skeletal disorder

Osteoporosis is a systemic skeletal disorder characterized by low bone mass, micro-architectural deterioration of bone tissue leading to more porous bone, and consequent increase in fracture risk.

<span class="mw-page-title-main">Exercise</span> Physical activity that improves health

Exercise is physical activity that enhances or maintains fitness and overall health. which is performed for various reasons, including weight loss or maintenance, to aid growth and improve strength, develop muscles and the cardiovascular system, prevent injuries, hone athletic skills, improve health, or simply for enjoyment. Many people choose to exercise outdoors where they can congregate in groups, socialize, and improve well-being as well as mental health.

<span class="mw-page-title-main">Geriatrics</span> Specialty that focuses on health care of elderly people

Geriatrics, or geriatric medicine, is a medical specialty focused on providing care for the unique health needs of the elderly. The term geriatrics originates from the Greek γέρων geron meaning "old man", and ιατρός iatros meaning "healer". It aims to promote health by preventing, diagnosing and treating disease in older adults. There is no defined age at which patients may be under the care of a geriatrician, or geriatric physician, a physician who specializes in the care of older people. Rather, this decision is guided by individual patient need and the caregiving structures available to them. This care may benefit those who are managing multiple chronic conditions or experiencing significant age-related complications that threaten quality of daily life. Geriatric care may be indicated if caregiving responsibilities become increasingly stressful or medically complex for family and caregivers to manage independently.

<span class="mw-page-title-main">Strength training</span> Performance of physical exercises designed to improve strength

Strength training, also known as weight training or resistance training, involves the performance of physical exercises that are designed to improve physical strength. It is often associated with the lifting of weights. It can also incorporate a variety of training techniques such as bodyweight exercises, isometrics, and plyometrics.

<span class="mw-page-title-main">Sarcopenia</span> Muscle loss due to ageing or immobility

Sarcopenia is a type of muscle loss that occurs with aging and/or immobility. It is characterized by the degenerative loss of skeletal muscle mass, quality, and strength. The rate of muscle loss is dependent on exercise level, co-morbidities, nutrition and other factors. The muscle loss is related to changes in muscle synthesis signalling pathways. It is distinct from cachexia, in which muscle is degraded through cytokine-mediated degradation, although the two conditions may co-exist. Sarcopenia is considered a component of frailty syndrome. Sarcopenia can lead to reduced quality of life, falls, fracture, and disability.

<span class="mw-page-title-main">Anterior cruciate ligament injury</span> Ligament injury near the knee

An anterior cruciate ligament injury occurs when the anterior cruciate ligament (ACL) is either stretched, partially torn, or completely torn. The most common injury is a complete tear. Symptoms include pain, an audible cracking sound during injury, instability of the knee, and joint swelling. Swelling generally appears within a couple of hours. In approximately 50% of cases, other structures of the knee such as surrounding ligaments, cartilage, or meniscus are damaged.

<span class="mw-page-title-main">Bodyweight exercise</span> Strength-training exercise to provide resistance against gravity

Bodyweight exercises are strength training exercises that use an individual's own weight to provide resistance against gravity. Bodyweight exercises can enhance a range of biomotor abilities including strength, power, endurance, speed, flexibility, coordination and balance. Such strength training has become more popular among recreational and professional athletes. Bodyweight training uses simple abilities like pushing, pulling, squatting, bending, twisting and balancing. Movements such as the push-up, the pull-up, and the sit-up are among the most common bodyweight exercises.

<span class="mw-page-title-main">Frailty syndrome</span> Weakness in elderly person

Frailty is a common and clinically significant grouping of symptoms that occurs in aging and older adults. These symptoms can include decreased physical abilities such as walking, excessive fatigue, and weight and muscle loss leading to declined physical status. In addition, frailty encompasses a decline in both overall physical function and physiologic reserve of organ systems resulting in worse health outcomes for this population. This syndrome is associated with increased risk of heart disease, falls, hospitalization, and death. In addition, it has been shown that adults living with frailty face more anxiety and depression symptoms than those who do not. The presence of frailty varies based on the assessment technique, however it is estimated that 4-16% of the population over 65 years old is living with frailty.

<span class="mw-page-title-main">Balance (ability)</span> Ability to maintain the line of gravity of a body

Balance in biomechanics, is an ability to maintain the line of gravity of a body within the base of support with minimal postural sway. Sway is the horizontal movement of the centre of gravity even when a person is standing still. A certain amount of sway is essential and inevitable due to small perturbations within the body or from external triggers. An increase in sway is not necessarily an indicator of dysfunctional balance so much as it is an indicator of decreased sensorimotor control.

Aquatic therapy refers to treatments and exercises performed in water for relaxation, fitness, physical rehabilitation, and other therapeutic benefit. Typically a qualified aquatic therapist gives constant attendance to a person receiving treatment in a heated therapy pool. Aquatic therapy techniques include Ai Chi, Aqua Running, Bad Ragaz Ring Method, Burdenko Method, Halliwick, Watsu, and other aquatic bodywork forms. Therapeutic applications include neurological disorders, spine pain, musculoskeletal pain, postoperative orthopedic rehabilitation, pediatric disabilities, pressure ulcers, and disease conditions, such as osteoporosis.

<span class="mw-page-title-main">Falls in older adults</span> Age-related health problem

Falls in older adults are a significant cause of morbidity and mortality and are a major class of preventable injuries. Falling is one of the most common accidents that cause a loss in the quality of life for older adults, and is usually precipitated by a loss of balance and weakness in the legs. The cause of falling in old age is often multifactorial and may require a multidisciplinary approach both to treat any injuries sustained and to prevent future falls. Falls include dropping from a standing position or from exposed positions such as those on ladders or stepladders. The severity of injury is generally related to the height of the fall. The state of the ground surface onto which the victim falls is also important, harder surfaces causing more severe injury. Falls can be prevented by ensuring that carpets are tacked down, that objects like electric cords are not in one's path, that hearing and vision are optimized, dizziness is minimized, alcohol intake is moderated and that shoes have low heels or rubber soles.

<span class="mw-page-title-main">Falling (accident)</span> Cause of injury or death

Falling is the action of a person or animal losing stability and ending up in a lower position, often on the ground. It is the second-leading cause of accidental death worldwide and a major cause of personal injury, especially for the elderly. Falls in older adults are a major class of preventable injuries. Construction workers, electricians, miners, and painters are occupations with high rates of fall injuries.

<span class="mw-page-title-main">Management of cerebral palsy</span>

Over time, the approach to cerebral palsy management has shifted away from narrow attempts to fix individual physical problems – such as spasticity in a particular limb – to making such treatments part of a larger goal of maximizing the person's independence and community engagement. Much of childhood therapy is aimed at improving gait and walking. Approximately 60% of people with CP are able to walk independently or with aids at adulthood. However, the evidence base for the effectiveness of intervention programs reflecting the philosophy of independence has not yet caught up: effective interventions for body structures and functions have a strong evidence base, but evidence is lacking for effective interventions targeted toward participation, environment, or personal factors. There is also no good evidence to show that an intervention that is effective at the body-specific level will result in an improvement at the activity level, or vice versa. Although such cross-over benefit might happen, not enough high-quality studies have been done to demonstrate it.

<span class="mw-page-title-main">Geriatric trauma</span> Medical condition

Geriatric trauma refers to a traumatic injury that occurs to an elderly person. People around the world are living longer than ever. In developed and underdeveloped countries, the pace of population aging is increasing. By 2050, the world's population aged 60 years and older is expected to total 2 billion, up from 900 million in 2015. While this trend presents opportunities for productivity and additional experiences, it also comes with its own set of challenges for health systems. More so than ever, elderly populations are presenting to the Emergency Department following traumatic injury. In addition, given advances in the management of chronic illnesses, more elderly adults are living active lifestyles and are at risk of traumatic injury. In the United States, this population accounts for 14% of all traumatic injuries, of which a majority are just mainly from falls.

Normal aging movement control in humans is about the changes in the muscles, motor neurons, nerves, sensory functions, gait, fatigue, visual and manual responses, in men and women as they get older but who do not have neurological, muscular or neuromuscular disorder. With aging, neuromuscular movements are impaired, though with training or practice, some aspects may be prevented.

Video game rehabilitation is a process of using common video game consoles and methodology to target and improve physical and mental weaknesses through therapeutic processes. Video games are becoming an integral part of occupational therapy practice in acute, rehabilitation, and community settings. The design for video games in rehabilitation is focused on a number of fundamental principles, such as reward, goals, challenge, and meaningful play. 'Meaningful play' emerges from the relationship between player action and system outcome, apparent to the player through, visual, physical and aural feedback. Platforms that feature motion control, notably the Nintendo Wii, Microsoft's Xbox Kinect, Sony's Eye Toy, and virtual reality have all been effective in this field of research. Methodologies have been applied to all age groups, from toddlers to the elderly. It has been used in a variety of cases ranging from stroke rehabilitation, cerebral palsy and other neurological impairments, to tendinitis and multiple sclerosis. Researchers have promoted such technology based on the personalization of gaming systems to patients, allowing for further engagement and interaction. Additionally, gaming consoles have the ability to capture real-time data and provide instant feedback to the patients using the systems. Currently, several researchers have performed case studies to demonstrate the benefits of this technology. Repeat trials and experiments have shown that outcomes are easily replicated among various groups worldwide. Additionally, the outcomes have increased interest in the field, growing experiments beyond simple case studies to experiments with a larger participant base.

<span class="mw-page-title-main">Thurmon E. Lockhart</span> American biomedical engineer

Thurmon E. Lockhart is an American biomedical engineer, researcher and educator. He is the Inaugural MORE Foundation Professor of Life in Motion at Arizona State University, a guest professor at Ghent University in Belgium and, serves as a research affiliate faculty at Mayo Clinic College of Medicine and Science. He is an associate editor of Annals of Biomedical Engineering and academic and guest editor of the Sensors journal He has worked significantly to bring research to practice with various businesses to reduce falls.

The benefits of physical activity range widely. Most types of physical activity improve health and well-being.

Locomotive syndrome is a medical condition of decreased mobility due to disorders of the locomotor system. The locomotor system comprises bones, joints, muscles and nerves. It is a concept put forward by three professional medical societies in Japan: the Japanese Society for Musculoskeletal Medicine, the Japanese Orthopaedic Association, and the Japanese Clinical Orthopaedic Association. Locomotive syndrome is generally found in the ageing population as locomotor functions deteriorate with age. Symptoms of locomotive syndrome include limitations in joint mobility, pain, balance disorder, malalignment and gait abnormality. Locomotive syndrome is commonly caused by chronic locomotive organ diseases. Diagnosis and assessment of locomotive syndrome is done using several tests such as the stand-up and two-step tests. The risk of having locomotive syndrome can be decreased via adequate nutrition, attainment of an exercise habit and being active.

Cathie Sherrington FAHMS is an Australian physiotherapist who is an expert in fall prevention and physical activity promotion. She is the deputy director of the Institute for Musculoskeletal Health, a research collaboration between the University of Sydney and Sydney Local Health District, where she is the lead researcher of the Physical Activity, Ageing and Disability Research stream, co-leader of the Global Fragility Fracture and an National Health and Medical Research Council Leadership Fellow. She is a professor at the University of Sydney School of Public Health in the Faculty of Medicine and Health and president of the Australia and New Zealand Fall Prevention Society and leads the Centre of Research Excellence in the Prevention of Fall-related Injuries.

References

  1. 1 2 Finnegan, Susanne; Seers, Kate; Bruce, Julie (June 2019). "Long-term follow-up of exercise interventions aimed at preventing falls in older people living in the community: a systematic review and meta-analysis". Physiotherapy. 105 (2): 187–199. doi: 10.1016/j.physio.2018.09.002 . PMID   30846193.
  2. ↑ Harris-Kojetin, L; Sengupta, M (2018-11-11). "Falls Among Assisted Living Residents: Results from the 2016 National Study of Long-Term Care Providers". Innovation in Aging. 2 (Suppl 1): 766. doi:10.1093/geroni/igy023.2833. ISSN   2399-5300. PMC   6228283 .
  3. ↑ "Important Facts about Falls | Home and Recreational Safety | CDC Injury Center". www.cdc.gov. 2019-02-01. Retrieved 2021-12-02.
  4. ↑ Gates, Simon; Smith, Lesley A.; Fisher, Joanne D.; Lamb, Sarah E. (2008). "Systematic review of accuracy of screening instruments for predicting fall risk among independently living older adults". Journal of Rehabilitation Research and Development. 45 (8): 1105–1116. doi:10.1682/JRRD.2008.04.0057 (inactive 1 November 2024). ISSN   1938-1352. PMID   19235113.{{cite journal}}: CS1 maint: DOI inactive as of November 2024 (link)
  5. ↑ Ganz DA, Bao Y, Shekelle PG, Rubenstein LZ (January 2007). "Will my patient fall?". JAMA. 297 (1): 77–86. doi:10.1001/jama.297.1.77. PMID   17200478.
  6. ↑ Park, Seong-Hi (January 2018). "Tools for assessing fall risk in the elderly: a systematic review and meta-analysis". Aging Clinical and Experimental Research. 30 (1): 1–16. doi:10.1007/s40520-017-0749-0. ISSN   1720-8319. PMID   28374345. S2CID   24579938.
  7. ↑ Gade, Gustav Valentin; Jørgensen, Martin Grønbech; Ryg, Jesper; Riis, Johannes; Thomsen, Katja; Masud, Tahir; Andersen, Stig (2021-05-04). "Predicting falls in community-dwelling older adults: a systematic review of prognostic models". BMJ Open. 11 (5): e044170. doi:10.1136/bmjopen-2020-044170. ISSN   2044-6055. PMC   8098967 . PMID   33947733.
  8. ↑ Gillespie, LD; Gillespie, WJ; Robertson, MC; Lamb, SE; Cumming, RG; Rowe, BH (December 2003). "Interventions for preventing falls in elderly people". Physiotherapy. 89 (12): 692–693. doi:10.1016/s0031-9406(05)60487-7. ISSN   0031-9406.
  9. ↑ Sherrington, Catherine; Fairhall, Nicola; Kwok, Wing; Wallbank, Geraldine; Tiedemann, Anne; Michaleff, Zoe A.; Ng, Christopher A. C. M.; Bauman, Adrian (2020-11-26). "Evidence on physical activity and falls prevention for people aged 65+ years: systematic review to inform the WHO guidelines on physical activity and sedentary behaviour". The International Journal of Behavioral Nutrition and Physical Activity. 17 (1): 144. doi: 10.1186/s12966-020-01041-3 . ISSN   1479-5868. PMC   7689963 . PMID   33239019.
  10. ↑ Mahoney, Jane E. (2010-07-12). "Why Multifactorial Fall-Prevention Interventions May Not Work". Archives of Internal Medicine. 170 (13): 1117–1119. doi:10.1001/archinternmed.2010.193. ISSN   0003-9926. PMID   20625016.
  11. ↑ Tinetti, Mary E.; Baker, Dorothy I.; McAvay, Gail; Claus, Elizabeth B.; Garrett, Patricia; Gottschalk, Margaret; Koch, Marie L.; Trainor, Kathryn; Horwitz, Ralph I. (1994-09-29). "A Multifactorial Intervention to Reduce the Risk of Falling among Elderly People Living in the Community". New England Journal of Medicine. 331 (13): 821–827. doi: 10.1056/NEJM199409293311301 . ISSN   0028-4793. PMID   8078528.
  12. ↑ Cameron ID, Dyer SM, Panagoda CE, Murray GR, Hill KD, Cumming RG, Kerse N (September 2018). "Interventions for preventing falls in older people in care facilities and hospitals". The Cochrane Database of Systematic Reviews. 9 (9): CD005465. doi:10.1002/14651858.CD005465.pub4. PMC   6148705 . PMID   30191554.
  13. 1 2 Osho, Oluwaseyi; Owoeye, Oluwatoyosi; Armijo-Olivo, Susan (2018-04-01). "Adherence and Attrition in Fall Prevention Exercise Programs for Community-Dwelling Older Adults: A Systematic Review and Meta-Analysis". Journal of Aging and Physical Activity. 26 (2): 304–326. doi:10.1123/japa.2016-0326. ISSN   1543-267X. PMID   28771111.
  14. ↑ R, Salazar (2019). "2019 Survey Results: Outpatient PT & OT Clinicians & Clinic Owners" . Retrieved June 2, 2020.
  15. ↑ Mirelman A, Rochester L, Maidan I, Del Din S, Alcock L, Nieuwhof F, et al. (September 2016). "Addition of a non-immersive virtual reality component to treadmill training to reduce fall risk in older adults (V-TIME): a randomised controlled trial" (PDF). Lancet. 388 (10050): 1170–82. doi:10.1016/S0140-6736(16)31325-3. PMID   27524393. S2CID   15303981. Archived from the original (PDF) on 2021-07-14. Retrieved 2021-07-14.
  16. ↑ Raichlen DA, Alexander GE (2023). "Why Your Brain Needs Exercise". Scientific American. 322 (1): 26. doi:10.1038/scientificamerican0120-26. PMID   39014823.
  17. ↑ Hausdorff, Jeffrey M.; Doniger, Glen M.; Springer, Shmuel; Yogev, Galit; Simon, Ely S.; Giladi, Nir (December 2006). "A Common Cognitive Profile in Elderly Fallers and in Patients with Parkinson's Disease: The Prominence of Impaired Executive Function and Attention". Experimental Aging Research. 32 (4): 411–429. doi:10.1080/03610730600875817. ISSN   0361-073X. PMC   1868891 . PMID   16982571.
  18. ↑ Mayor, Susan (2016-02-04). "Parkinson's disease diagnosis is preceded by increased risk of falls, study finds". BMJ. 352: i695. doi:10.1136/bmj.i695. ISSN   1756-1833. PMID   26849893. S2CID   40522797.
  19. ↑ Herman, Talia; Mirelman, Anat; Giladi, Nir; Schweiger, Avraham; Hausdorff, Jeffrey M. (2010-05-19). "Executive Control Deficits as a Prodrome to Falls in Healthy Older Adults: A Prospective Study Linking Thinking, Walking, and Falling". The Journals of Gerontology: Series A. 65A (10): 1086–1092. doi:10.1093/gerona/glq077. ISSN   1758-535X. PMC   2949331 . PMID   20484336.
  20. ↑ Holtzer, Roee; Friedman, Rachel; Lipton, Richard B.; Katz, Mindy; Xue, Xiaonan; Verghese, Joe (2007). "The relationship between specific cognitive functions and falls in aging". Neuropsychology. 21 (5): 540–548. doi:10.1037/0894-4105.21.5.540. ISSN   1931-1559. PMC   3476056 . PMID   17784802.
  21. ↑ Springer, Shmuel; Giladi, Nir; Peretz, Chava; Yogev, Galit; Simon, Ely S.; Hausdorff, Jeffrey M. (2006-03-15). "Dual-tasking effects on gait variability: The role of aging, falls, and executive function". Movement Disorders. 21 (7): 950–957. doi:10.1002/mds.20848. ISSN   0885-3185. PMID   16541455. S2CID   34812135.
  22. 1 2 3 Moylan KC, Binder EF (June 2007). "Falls in older adults: risk assessment, management and prevention". The American Journal of Medicine. 120 (6): 493.e1–6. doi:10.1016/j.amjmed.2006.07.022. PMID   17524747.
  23. ↑ Centers for Disease Control and Prevention. "Non-fatal injury report". WISQARS database. US Government. Archived from the original on 6 March 2018. Retrieved 2 December 2017.
  24. ↑ Herold, Fabian; Hamacher, Dennis; Schega, Lutz; Müller, Notger G. (2018). "Thinking While Moving or Moving While Thinking – Concepts of Motor-Cognitive Training for Cognitive Performance Enhancement". Frontiers in Aging Neuroscience. 10: 228. doi: 10.3389/fnagi.2018.00228 . ISSN   1663-4365. PMC   6089337 . PMID   30127732.
  25. ↑ Chung, Seok Jong; Lee, Jae Jung; Lee, Phil Hyu; Sohn, Young H. (2020). "Emerging Concepts of Motor Reserve in Parkinson's Disease". Journal of Movement Disorders. 13 (3): 171–184. doi:10.14802/jmd.20029. PMC   7502292 . PMID   32854486.
  26. ↑ Rapaport L (18 August 2016). "Virtual reality treadmills help prevent falls in elderly". Reuters. Archived from the original on 29 October 2018. Retrieved 6 January 2021.
  27. ↑ Mirelman, Anat; Rochester, Lynn; Reelick, Miriam; Nieuwhof, Freek; Pelosin, Elisa; Abbruzzese, Giovanni; Dockx, Kim; Nieuwboer, Alice; Hausdorff, Jeffrey M (2013-02-06). "V-TIME: a treadmill training program augmented by virtual reality to decrease fall risk in older adults: study design of a randomized controlled trial". BMC Neurology. 13 (1): 15. doi: 10.1186/1471-2377-13-15 . ISSN   1471-2377. PMC   3602099 . PMID   23388087.
  28. ↑ Mirelman, Anat; Rochester, Lynn; Maidan, Inbal; Del Din, Silvia; Alcock, Lisa; Nieuwhof, Freek; Rikkert, Marcel Olde; Bloem, Bastiaan R; Pelosin, Elisa; Avanzino, Laura; Abbruzzese, Giovanni (September 2016). "Addition of a non-immersive virtual reality component to treadmill training to reduce fall risk in older adults (V-TIME): a randomised controlled trial". The Lancet. 388 (10050): 1170–1182. doi:10.1016/s0140-6736(16)31325-3. ISSN   0140-6736. PMID   27524393. S2CID   15303981.
  29. ↑ Del Din, Silvia; Galna, Brook; Lord, Sue; Nieuwboer, Alice; Bekkers, Esther M. J.; Pelosin, Elisa; Avanzino, Laura; Bloem, Bastiaan R.; Olde Rikkert, Marcel G. M.; Nieuwhof, Freek; Cereatti, Andrea (2020-05-22). "Falls Risk in Relation to Activity Exposure in High-Risk Older Adults". The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences. 75 (6): 1198–1205. doi:10.1093/gerona/glaa007. ISSN   1758-535X. PMC   7243591 . PMID   31942969.
  30. ↑ Pelosin, Elisa; Cerulli, Cecilia; Ogliastro, Carla; Lagravinese, Giovanna; Mori, Laura; Bonassi, Gaia; Mirelman, Anat; Hausdorff, Jeffrey M; Abbruzzese, Giovanni; Marchese, Roberta; Avanzino, Laura (2019-03-15). "A Multimodal Training Modulates Short Afferent Inhibition and Improves Complex Walking in a Cohort of Faller Older Adults With an Increased Prevalence of Parkinson's Disease". The Journals of Gerontology: Series A. 75 (4): 722–728. doi:10.1093/gerona/glz072. ISSN   1079-5006. PMID   30874799.
  31. ↑ Peruzzi, Agnese; Cereatti, Andrea; Della Croce, Ugo; Mirelman, Anat (January 2016). "Effects of a virtual reality and treadmill training on gait of subjects with multiple sclerosis: a pilot study". Multiple Sclerosis and Related Disorders. 5: 91–96. doi:10.1016/j.msard.2015.11.002. ISSN   2211-0348. PMID   26856951.
  32. ↑ Siegel-Itzkovich J (31 October 2017). "Sourasky researchers explain how virtual reality helps prevent falls by Parkinson's patients". The Jerusalem Post . Archived from the original on 27 December 2020. Retrieved 6 January 2021.
  33. ↑ Patti, Antonino; Zangla, Daniele; Sahin, Fatma Nese; Cataldi, Stefania; Lavanco, Gioacchino; Palma, Antonio; Fischietti, Francesco (2021-04-02). "Physical exercise and prevention of falls. Effects of a Pilates training method compared with a general physical activity program: A randomized controlled trial". Medicine. 100 (13): e25289. doi:10.1097/MD.0000000000025289. hdl: 10447/527083 . PMC   8021317 . PMID   33787615.
  34. ↑ Patti, Antonino; Zangla, Daniele; Sahin, Fatma Nese; Cataldi, Stefania; Lavanco, Gioacchino; Palma, Antonio; Fischietti, Francesco (2021-04-02). "Physical exercise and prevention of falls. Effects of a Pilates training method compared with a general physical activity program: A randomized controlled trial". Medicine. 100 (13): e25289. doi:10.1097/MD.0000000000025289. hdl: 10447/527083 . PMC   8021317 . PMID   33787615.
  35. 1 2 3 Evans, W J (1999-01-01). "Exercise training guidelines for the elderly". Medicine and Science in Sports and Exercise. 31 (1): 12–17. doi:10.1097/00005768-199901000-00004. ISSN   1530-0315. PMID   9927004.
  36. ↑ Overstall, P. W. (May 2003). "The use of balance training in elderly people with falls". Reviews in Clinical Gerontology. 13 (2): 153–161. doi:10.1017/S0959259803013273. ISSN   1469-9036.
  37. 1 2 Lockwood KJ, Taylor NF, Harding KE (April 2015). "Pre-discharge home assessment visits in assisting patients' return to community living: A systematic review and meta-analysis". Journal of Rehabilitation Medicine. 47 (4): 289–99. doi: 10.2340/16501977-1942 . PMID   25782842.
  38. ↑ Izquierdo, Mikel; Merchant, R.A.; Morley, J.E.; Anker, S.D.; Aprahamian, I.; Arai, H.; Aubertin-Leheudre, M.; Bernabei, R.; Cadore, E.L.; Cesari, M.; Chen, L.-K.; de Souto Barreto, P.; Duque, G.; Ferrucci, L.; Fielding, R.A. (2021-07-01). "International Exercise Recommendations in Older Adults (ICFSR): Expert Consensus Guidelines". The Journal of Nutrition, Health and Aging. 25 (7): 824–853. doi:10.1007/s12603-021-1665-8. hdl: 11343/289542 . ISSN   1279-7707. PMID   34409961.
  39. ↑ Wu, Shuang; Guo, Yongzhen; Cao, Zeng; Nan, Jiahui; Zhang, Qiuxiang; Hu, Mingyue; Ning, Hongting; Huang, Weiping; Xiao, Lily Dongxia; Feng, Hui (2024-09-01). "Effects of Otago exercise program on physical function in older adults: A systematic review and meta-analysis of randomized controlled trials". Archives of Gerontology and Geriatrics. 124: 105470. doi:10.1016/j.archger.2024.105470. ISSN   0167-4943. PMID   38718487.
  40. ↑ Campbell AJ, Robertson MC (March 2003). Otago Exercise Programme to prevent falls in older adults (PDF). Otago Medical School. p. 3. ISBN   978-0-478-25194-4. Archived (PDF) from the original on 2021-01-20. Retrieved 2020-12-27.
  41. ↑ "Upgraded SNF restorative program reduces falls". I Advance Senior Care. 28 July 2015. Archived from the original on 13 August 2020. Retrieved 27 December 2020.
  42. 1 2 3 4 5 Papa EV, Dong X, Hassan M (13 June 2017). "Resistance training for activity limitations in older adults with skeletal muscle function deficits: a systematic review". Clinical Interventions in Aging. 12: 955–961. doi: 10.2147/CIA.S104674 . PMC   5479297 . PMID   28670114.
  43. ↑ Hill KD, Suttanon P, Lin SI, Tsang WW, Ashari A, Hamid TA, et al. (January 2018). "What works in falls prevention in Asia: a systematic review and meta-analysis of randomized controlled trials". BMC Geriatrics. 18 (1): 3. doi: 10.1186/s12877-017-0683-1 . PMC   5756346 . PMID   29304749.
  44. ↑ Jiang, Guiping; Tan, Xiaohuan; Zou, Jiling; Wu, Xueping (2024-09-17). "A 24-Week Combined Resistance and Balance Training Program Improves Physical Function in Older Adults: A Randomized Controlled Trial". Journal of Strength & Conditioning Research. doi:10.1519/JSC.0000000000004941. ISSN   1064-8011.
  45. ↑ Fick DM, Cooper JW, Wade WE, Waller JL, Maclean JR, Beers MH (8 December 2003). "Updating the Beers criteria for potentially inappropriate medication use in older adults: results of a US consensus panel of experts". Archives of Internal Medicine. 163 (22): 2716–24. doi:10.1001/archinte.163.22.2716. PMID   14662625. S2CID   21193386.
  46. 1 2 "State of Safety: A State-by-State Report". National Safety Council. 2021. Archived from the original on 2021-06-04. Retrieved 2020-12-27.
  47. ↑ dos Reis KM, de Jesus CA (December 2015). "Cohort study of institutionalized elderly people: fall risk factors from the nursing diagnosis". Revista Latino-Americana de Enfermagem. 23 (6): 1130–8. doi:10.1590/0104-1169.0285.2658. PMC   4664014 . PMID   26626005.
  48. ↑ Montero-Odasso, Manuel M.; Kamkar, Nellie; Pieruccini-Faria, Frederico; Osman, Abdelhady; Sarquis-Adamson, Yanina; Close, Jacqueline; Hogan, David B.; Hunter, Susan Winifred; Kenny, Rose Anne; Lipsitz, Lewis A.; Lord, Stephen R.; Madden, Kenneth M.; Petrovic, Mirko; Ryg, Jesper; Speechley, Mark (2021-12-01). "Evaluation of Clinical Practice Guidelines on Fall Prevention and Management for Older Adults: A Systematic Review". JAMA Network Open. 4 (12): e2138911. doi:10.1001/jamanetworkopen.2021.38911. ISSN   2574-3805. PMC   8674747 . PMID   34910151.
  49. ↑ Ulfiana, Elida (2020-08-07). "The Effect of Balance Exercise on Postural Balance of Elderly as Fall Prevention in Institutionalized Elderly". Indian Journal of Public Health Research & Development. 11 (7). doi:10.37506/ijphrd.v11i7. ISSN   0976-5506.
  50. ↑ Gillespie L (February 2013). Tovey D (ed.). "Preventing falls in older people: the story of a Cochrane review". The Cochrane Database of Systematic Reviews. 2013 (2): ED000053. doi:10.1002/14651858.ED000053. PMC   10846353 . PMID   23543586.
  51. ↑ Yoshikawa TT, Cobbs EL, Brummel-Smith K (1993). Ambulatory Geriatric Care. Mosby. ISBN   978-0-8016-6543-1.[ page needed ]
  52. ↑ O'Loughlin JL, Robitaille Y, Boivin JF, Suissa S (February 1993). "Incidence of and risk factors for falls and injurious falls among the community-dwelling elderly". American Journal of Epidemiology. 137 (3): 342–54. doi:10.1093/oxfordjournals.aje.a116681. PMID   8452142.
  53. ↑ Winter DA, Patla AE, Frank JS, Walt SE (June 1990). "Biomechanical walking pattern changes in the fit and healthy elderly". Physical Therapy. 70 (6): 340–7. doi:10.1093/ptj/70.6.340. PMID   2345777.
  54. ↑ Elble RJ, Thomas SS, Higgins C, Colliver J (February 1991). "Stride-dependent changes in gait of older people". Journal of Neurology. 238 (1): 1–5. doi:10.1007/BF00319700. PMID   2030366. S2CID   20197857.
  55. ↑ Snijders AH, van de Warrenburg BP, Giladi N, Bloem BR (January 2007). "Neurological gait disorders in elderly people: clinical approach and classification". The Lancet. Neurology. 6 (1): 63–74. doi:10.1016/S1474-4422(06)70678-0. PMID   17166803. S2CID   31984607.
  56. ↑ Maki BE (March 1997). "Gait changes in older adults: predictors of falls or indicators of fear". Journal of the American Geriatrics Society. 45 (3): 313–20. doi:10.1111/j.1532-5415.1997.tb00946.x. PMID   9063277. S2CID   31970427.
  57. ↑ Musich S, Wang SS, Ruiz J, Hawkins K, Wicker E (March 2018). "The impact of mobility limitations on health outcomes among older adults". Geriatric Nursing. 39 (2): 162–169. doi: 10.1016/j.gerinurse.2017.08.002 . PMID   28866316. S2CID   3981042.
  58. ↑ Chatzistergos, Panagiotis E.; Healy, Aoife; Balasubramanian, Gayathri; Sundar, Lakshmi; Ramachandran, Ambady; Chockalingam, Nachiappan (September 2020). "Reliability and validity of an enhanced paper grip test; A simple clinical test for assessing lower limb strength" (PDF). Gait & Posture. 81: 120–125. doi:10.1016/j.gaitpost.2020.07.011. PMID   32711330. S2CID   220773361.
  59. ↑ "Falls". Medline Plus. U.S. National Library of Medicine. Archived from the original on 2021-01-09. Retrieved 2020-12-27.
  60. ↑ "Caídas en personas mayores: riesgo, causas y prevención" [Falls in the elderly: risks, causes and prevention]. Geriatricarea (in Spanish). 16 March 2016. Archived from the original on 24 October 2020. Retrieved 3 December 2020.[ unreliable medical source? ]
  61. ↑ Edith, Sullivan; Margaret, Rosenbloom; Anjali, Deshmukh; John, Desmond; Adolf, Pfefferbaum (1995). "Alcohol and the cerebellum". Alcohol Health and Research World. 19 (2): 138–141. PMC   6875723 . PMID   31798074.
  62. 1 2 Weerdesteyn V, de Niet M, van Duijnhoven HJ, Geurts AC (2008). "Falls in individuals with stroke". Journal of Rehabilitation Research and Development. 45 (8): 1195–213. doi:10.1682/JRRD.2007.09.0145 (inactive 1 November 2024). hdl: 2066/70270 . PMID   19235120. ProQuest   215286948.{{cite journal}}: CS1 maint: DOI inactive as of November 2024 (link)
  63. ↑ Tsur A, Segal Z (April 2010). "Falls in stroke patients: risk factors and risk management". The Israel Medical Association Journal. 12 (4): 216–9. PMID   20803880.
  64. ↑ Yang YR, Chen YC, Lee CS, Cheng SJ, Wang RY (February 2007). "Dual-task-related gait changes in individuals with stroke". Gait & Posture. 25 (2): 185–90. doi:10.1016/j.gaitpost.2006.03.007. PMID   16650766.
  65. ↑ Allen NE, Schwarzel AK, Canning CG (5 March 2013). "Recurrent falls in Parkinson's disease: a systematic review". Parkinson's Disease. 2013: 906274. doi: 10.1155/2013/906274 . PMC   3606768 . PMID   23533953.
  66. ↑ Wood BH, Bilclough JA, Bowron A, Walker RW (June 2002). "Incidence and prediction of falls in Parkinson's disease: a prospective multidisciplinary study". Journal of Neurology, Neurosurgery, and Psychiatry. 72 (6): 721–5. doi:10.1136/jnnp.72.6.721. PMC   1737913 . PMID   12023412. S2CID   18378056.
  67. ↑ Koller WC, Silver DE, Lieberman A (December 1994). "An algorithm for the management of Parkinson's disease". Neurology. 44 (12 Suppl 10): S1-52. PMID   7854513.
  68. ↑ Finlayson ML, Peterson EW, Cho CC (September 2006). "Risk factors for falling among people aged 45 to 90 years with multiple sclerosis". Archives of Physical Medicine and Rehabilitation. 87 (9): 1274–9, quiz 1287. doi:10.1016/j.apmr.2006.06.002. PMID   16935067.
  69. ↑ Socie MJ, Sosnoff JJ (2013). "Gait variability and multiple sclerosis". Multiple Sclerosis International. 2013: 645197. doi: 10.1155/2013/645197 . PMC   3603667 . PMID   23533759.
  70. ↑ Severini G, Manca M, Ferraresi G, Caniatti LM, Cosma M, Baldasso F, et al. (June 2017). "Evaluation of Clinical Gait Analysis parameters in patients affected by Multiple Sclerosis: Analysis of kinematics". Clinical Biomechanics. 45: 1–8. doi:10.1016/j.clinbiomech.2017.04.001. PMID   28390935. S2CID   24378620.
  71. ↑ Cattaneo D, De Nuzzo C, Fascia T, Macalli M, Pisoni I, Cardini R (June 2002). "Risks of falls in subjects with multiple sclerosis". Archives of Physical Medicine and Rehabilitation. 83 (6): 864–7. doi:10.1053/apmr.2002.32825. PMID   12048669.
  72. ↑ Krupp LB, Christodoulou C (May 2001). "Fatigue in multiple sclerosis". Current Neurology and Neuroscience Reports. 1 (3): 294–8. doi:10.1007/s11910-001-0033-7. PMID   11898532. S2CID   28222172.
  73. ↑ van Dijk PT, Meulenberg OG, van de Sande HJ, Habbema JD (April 1993). "Falls in dementia patients". The Gerontologist. 33 (2): 200–4. doi:10.1093/geront/33.2.200. PMID   8468012.
  74. ↑ Shaw FE (2003). "Falls in older people with dementia" (PDF). Great Aging. 6 (7): 37–40. Archived (PDF) from the original on 2020-12-05. Retrieved 2020-12-27.
  75. ↑ Olesen J (10 February 2014). "Fear of Falling Phobia - Basiphobia". FEAROF.NET. Archived from the original on 30 November 2020. Retrieved 3 December 2020.
  76. ↑ Chen, Wei-Cheng; Li, Yang-Tzu; Tung, Tao-Hsin; Chen, Chieh; Tsai, Ching-Yao (2021-07-02). "The relationship between falling and fear of falling among community-dwelling elderly". Medicine. 100 (26): e26492. doi:10.1097/MD.0000000000026492. PMC   8257838 . PMID   34190176.
  77. ↑ Souza, Larissa Franciny de; Canever, Jaquelini Betta; Moreira, Bruno de Souza; Danielewicz, Ana Lúcia; Avelar, Núbia Carelli Pereira de (2022-02-09). "Association Between Fear of Falling and Frailty in Community-Dwelling Older Adults: A Systematic Review". Clinical Interventions in Aging. 17: 129–140. doi: 10.2147/CIA.S328423 . PMC   8843349 . PMID   35173427.
  78. ↑ Camerlingo, Claudia (2023-05-15). "The complexity of basophobia and aging: covariates and consequences". European Review. Retrieved 2024-11-07.
  79. 1 2 Talbot LA, Musiol RJ, Witham EK, Metter EJ (August 2005). "Falls in young, middle-aged and older community dwelling adults: perceived cause, environmental factors and injury". BMC Public Health. 5 (1): 86. doi: 10.1186/1471-2458-5-86 . PMC   1208908 . PMID   16109159.
  80. ↑ Lin JT, Lane JM (January 2008). "Nonpharmacologic management of osteoporosis to minimize fracture risk". Nature Clinical Practice. Rheumatology. 4 (1): 20–5. doi:10.1038/ncprheum0702. PMID   18172445. S2CID   24451002.
  81. 1 2 Howard B, Baca R, Bilger M, Cali S, Kotarski A, Parrett K, Skibinski K (2018-07-03). "Investigating Older Adults' Expressed Needs Regarding Falls Prevention". Physical & Occupational Therapy in Geriatrics. 36 (2–3): 201–220. doi:10.1080/02703181.2018.1520380. ISSN   0270-3181. S2CID   81971080.
  82. ↑ Turner S, Arthur G, Lyons RA, Weightman AL, Mann MK, Jones SJ, et al. (February 2011). "Modification of the home environment for the reduction of injuries". The Cochrane Database of Systematic Reviews. 2011 (2): CD003600. doi:10.1002/14651858.CD003600.pub3. PMC   7003565 . PMID   21328262.
  83. ↑ McKinney R (26 March 2020). "Exciting Advancements in Fall Prevention Technology". Safesite. Archived from the original on 26 November 2020. Retrieved 3 December 2020.
  84. ↑ "Prevent Accidents in the Bathroom with These Toilet Safety Rails". AgingInPlace.org. 4 December 2018. Archived from the original on 27 January 2021. Retrieved 3 December 2020.[ unreliable medical source? ]
  85. ↑ Gerards MH, McCrum C, Mansfield A, Meijer K (December 2017). "Perturbation-based balance training for falls reduction among older adults: Current evidence and implications for clinical practice". Geriatrics & Gerontology International. 17 (12): 2294–2303. doi:10.1111/ggi.13082. PMC   5763315 . PMID   28621015.
  86. ↑ Pijnappels M, Reeves ND, Maganaris CN, van Dieën JH (April 2008). "Tripping without falling; lower limb strength, a limitation for balance recovery and a target for training in the elderly". Journal of Electromyography and Kinesiology. 18 (2): 188–96. doi:10.1016/j.jelekin.2007.06.004. PMID   17761436.
  87. ↑ Larsson L, Degens H, Li M, Salviati L, Lee YI, Thompson W, et al. (January 2019). "Sarcopenia: Aging-Related Loss of Muscle Mass and Function". Physiological Reviews. 99 (1): 427–511. doi:10.1152/physrev.00061.2017. PMC   6442923 . PMID   30427277.
  88. ↑ Rasche P, Mertens A, Bröhl C, Theis S, Seinsch T, Wille M, et al. (8 May 2017). "The "Aachen fall prevention App" - a Smartphone application app for the self-assessment of elderly patients at risk for ground level falls". Patient Safety in Surgery. 11: 14. doi: 10.1186/s13037-017-0130-4 . PMC   5422970 . PMID   28503199.
  89. ↑ "Los Parques de Mayores: Análisis y propuestas de intervención" [The Parks for the Elderly: Analysis and intervention proposals](PDF) (in Spanish). Seville, Spain: Universidad Pablo de Olavide. Archived (PDF) from the original on 2021-07-14. Retrieved 2020-12-03.
  90. ↑ Thomas, Ewan; Battaglia, Giuseppe; Patti, Antonino; Brusa, Jessica; Leonardi, Vincenza; Palma, Antonio; Bellafiore, Marianna (July 2019). "Physical activity programs for balance and fall prevention in elderly: A systematic review". Medicine. 98 (27): e16218. doi:10.1097/MD.0000000000016218. PMC   6635278 . PMID   31277132.
  91. ↑ Chittrakul, Jiraporn; Siviroj, Penprapa; Sungkarat, Somporn; Sapbamrer, Ratana (January 2020). "Multi-System Physical Exercise Intervention for Fall Prevention and Quality of Life in Pre-Frail Older Adults: A Randomized Controlled Trial". International Journal of Environmental Research and Public Health. 17 (9): 3102. doi: 10.3390/ijerph17093102 . ISSN   1660-4601. PMC   7246743 . PMID   32365613.
  92. 1 2 Mittaz Hager, Anne-Gabrielle; Mathieu, Nicolas; Lenoble-Hoskovec, Constanze; Swanenburg, Jaap; de Bie, Rob; Hilfiker, Roger (2019-01-14). "Effects of three home-based exercise programmes regarding falls, quality of life and exercise-adherence in older adults at risk of falling: protocol for a randomized controlled trial". BMC Geriatrics. 19 (1): 13. doi: 10.1186/s12877-018-1021-y . ISSN   1471-2318. PMC   6332592 . PMID   30642252.
  93. ↑ Długosz-Boś, Małgorzata; Filar-Mierzwa, Katarzyna; Stawarz, Robert; Ścisłowska-Czarnecka, Anna; Jankowicz-Szymańska, Agnieszka; Bac, Aneta (January 2021). "Effect of Three Months Pilates Training on Balance and Fall Risk in Older Women". International Journal of Environmental Research and Public Health. 18 (7): 3663. doi: 10.3390/ijerph18073663 . ISSN   1660-4601. PMC   8037700 . PMID   33915843.
  94. ↑ Zahedian-Nasab, Noorolla; Jaberi, Azita; Shirazi, Fatemeh; Kavousipor, Somayyeh (2021-09-25). "Effect of virtual reality exercises on balance and fall in elderly people with fall risk: a randomized controlled trial". BMC Geriatrics. 21 (1): 509. doi: 10.1186/s12877-021-02462-w . ISSN   1471-2318. PMC   8465759 . PMID   34563120.
  95. ↑ Thomas, Ewan; Battaglia, Giuseppe; Patti, Antonino; Brusa, Jessica; Leonardi, Vincenza; Palma, Antonio; Bellafiore, Marianna (July 2019). "Physical activity programs for balance and fall prevention in elderly: A systematic review". Medicine. 98 (27): e16218. doi:10.1097/MD.0000000000016218. PMC   6635278 . PMID   31277132.
  96. ↑ Robitaille, Yvonne; Laforest, Sophie; Fournier, Michel; Gauvin, Lise; Parisien, Manon; Corriveau, Hélène; Trickey, Francine; Damestoy, Nicole (November 2005). "Moving Forward in Fall Prevention: An Intervention to Improve Balance Among Older Adults in Real-World Settings". American Journal of Public Health. 95 (11): 2049–2056. doi:10.2105/AJPH.2004.057612. ISSN   0090-0036. PMC   1449482 . PMID   16195514.
  97. ↑ Rubenstein, Laurence Z.; Josephson, Karen R. (September 2006). "Falls and Their Prevention in Elderly People: What Does the Evidence Show?". Medical Clinics of North America. 90 (5): 807–824. doi:10.1016/j.mcna.2006.05.013. PMID   16962843.

Further reading

This page is based on this Wikipedia article
Text is available under the CC BY-SA 4.0 license; additional terms may apply.
Images, videos and audio are available under their respective licenses.