Intense Tai Chi Exercise Training and Fall Occurrences

 Abstract:  Intense Tai Chi Exercise Training and Fall Occurrences in Older, Transitionally Frail Adults: A Randomized, Controlled Trial

 Keywords:

• exercise;
• falls;
• balance;
• aging;
• tai chi

Objectives: To determine whether an intense tai chi (TC) exercise program could reduce the risk of falls more than a wellness education (WE) program in older adults meeting criteria for transitioning to frailty.

Design: Randomized, controlled trial of 48 weeks duration.

Setting: Twenty congregate living facilities in the greater Atlanta area.

Participants: Sample of 291 women and 20 men aged 70 to 97.

Measurements: Demographics, time to first fall and all subsequent falls, functional measures, Sickness Impact Profile, Centers for Epidemiologic Studies—Depression Scale, Activities-specific Balance Confidence Scale, Falls Efficacy Scales, and adherence to interventions.

Results: The risk ratio (RR) of falling was not statistically different in the TC group and the WE group (RR=0.75, 95% confidence interval (CI)=0.52–1.08), P=.13). Over the 48 weeks of intervention, 46% (n=132) of the participants did not fall; the percentage of participants that fell at least once was 47.6% for the TC group and 60.3% for the WE group.

Conclusion: TC did not reduce the RR of falling in transitionally frail, older adults, but the direction of effect observed in this study, together with positive findings seen previously in more-robust older adults, suggests that TC may be clinically important and should be evaluated further in this high-risk population.

Quelle:  http://onlinelibrary.wiley.com/doi/10.1046/j.1532-5415.2003.51552.x/abstract

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The Effect of Multidimensional Exercises .....

....... on Balance, Mobility, and Fall Risk in Community-Dwelling Older Adults

1. Anne Shumway-Cook,
2. William Gruber,
3. Margaret Baldwin and
4. Shiquan Liao

Abstract

Background and Purpose. 

This prospective clinical investigation examined the effects of a multidimensional exercise program on balance, mobility, and risk for falls in community-dwelling older adults with a history of falling. Factors used to predict adherence and a successful response to exercise were identified. 

Subjects. A total of 105 community-dwelling older adults (≥65 years of age) with a history of two or more falls in the previous 6 months (no neurologic diagnosis) participated. They were classified into (1) a control group of fallers (n=21), (2) a fully adherent exercise group (n=52), and (3) a partially adherent exercise group (n=32). 

Methods. Following evaluation, each patient received an individualized exercise program addressing the impairments and functional disabilities identified during the assessment. The control group received no intervention. Changes in performance on five clinical tests of balance and mobility and fall risk were compared among groups.  

Results. Both exercise groups scored better than the control group on all measures of balance and mobility. Although both exercise groups showed a reduction in fall risk compared with the control group, the greatest reduction was found in the fully adherent exercise group. Factors associated with successful response to exercise included degree of adherence to exercise program and pretest score on the Tinetti Mobility Assessment.  

Conclusion and Discussion. Exercise can improve balance and mobility function and reduce the likelihood for falls among community-dwelling older adults with a history of falling. The amount of exercise needed to achieve these results, however, could not be determined from this study.

Quelle:  http://www.physicaltherapyjournal.com/content/77/1/46.short


Full Text / pdf - online im internet - Zugriff 01.10.2012 -  The Effect of Multidimensional Exercises on Balance, Mobility, and Fall Risk in Community-Dwelling Older Adults

http://www.physicaltherapyjournal.com/content/77/1/46.full.pdf+html

JÖRG LINDER AKTIV-TRAINING – Ihr Personal Trainer für Sturzprävention, Osteoporoseprävention  und Gesundheitstraining  in Baden-Baden, Karlsruhe, Pfalz, Offenburg, Kehl, Ortenau, Freiburg, Breisgau, Pforzheim, Heidelberg, Ludwigshafen, Mannheim, Stuttgart   (überregional auf Anfrage)

 

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Practical implementation of an exercise‐based falls prevention programme

1. Melinda M. Gardner,
2. David M. Buchner  ,
3. M. Clare Robertson and
4. A. John Campbell

Abstract

Muscle weakness and impaired balance are risk factors underlying many falls and fall injuries experienced by older people. Fall prevention strategies have included exercise programmes that lower the risk of falling by improving strength and balance. We have developed an individually tailored, home‐based, strength and balance retraining programme, which has proven successful in reducing falls and moderate fall injuries in people aged 80 years and older. Here we describe a simple assessment of strength and balance and the content and delivery of a falls prevention exercise programme.

Key words:exercise; falls; older people

Quelle:  http://ageing.oxfordjournals.org/content/30/1/77.short



Online im internet - Zugriff 01.10.2012 -

Practical implementation of an exercise‐based falls prevention programme -

Full Text / pdf:  http://ageing.oxfordjournals.org/content/30/1/77.full.pdf+html

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Exercise Training for Rehabilitation and Secondary Prevention of Falls

Exercise Training for Rehabilitation and Secondary Prevention of Falls in Geriatric Patients with a History of Injurious Falls

1. Klaus Hauer PhD¹,
2. Brenda Rost¹,
3. Kirstin Rütschle¹,
4. Hedda Opitz¹,
5. Norbert Specht MD¹,
6. Peter Bärtsch MD²,
7. Peter Oster MD¹,
8. Günter Schlierf MD¹

Abstract

Keywords:

• geriatric patients;
• injurious falls;
• physical training
•  

OBJECTIVE: To determine the safety and efficacy of an exercise protocol designed to improve strength, mobility, and balance and to reduce subsequent falls in geriatric patients with a history of injurious falls.

DESIGN: A randomized controlled 3-month intervention trial, with an additional 3-month follow-up.

SETTING: Out-patient geriatric rehabilitation unit.

PARTICIPANTS: Fifty-seven female geriatric patients (mean age 82 ± 4.8 years; range 75–90) admitted to acute care or inpatient rehabilitation with a history of recurrent or injurious falls including patients with acute fall-related fracture.

INTERVENTION: Ambulatory training of strength, functional performance, and balance 3 times per week for 3 months. Patients of the control group attended a placebo group 3 times a week for 3 months. Both groups received an identical physiotherapeutic treatment 2 times a week, in which strengthening and balance training were excluded.

MEASUREMENTS: Strength, functional ability, motor function, psychological parameters, and fall rates were assessed by standardized protocols at the beginning (T1) and the end (T2) of intervention. Patients were followed up for 3 months after the intervention (T3).

RESULTS: No training-related medical problems occurred in the study group. Forty-five patients (79%) completed all assessments after the intervention and follow-up period. Adherence was excellent in both groups (intervention 85.4 ± 27.8% vs control 84.2 ± 29.3%).

The patients in the intervention group increased strength, functional motor performance, and balance significantly. Fall-related behavioral and emotional restrictions were reduced significantly. Improvements persisted during the 3-month follow-up with only moderate losses.

For patients of the control group, no change in strength, functional performance, or emotional status could be documented during intervention and follow-up. Fall incidence was reduced nonsignificantly by 25% in the intervention group compared with the control group (RR:0.753 CI:0.455–1.245).

CONCLUSIONS: Progressive resistance training and progressive functional training are safe and effective methods of increasing strength and functional performance and reducing fall-related behavioral and emotional restrictions during ambulant rehabilitation in frail, high-risk geriatric patients with a history of injurious falls.


Quelle:  http://onlinelibrary.wiley.com/doi/10.1046/j.1532-5415.2001.49004.x/abstract?deniedAccessCustomisedMessage=&userIsAuthenticated=true

Exercise Training for Rehabilitation and Secondary Prevention of Falls in Geriatric Patients with a History of Injurious Falls

Online im internet - Zugriff: 30.09.2012 . Full Text / pdf: 

http://knowledgetranslation.ca/sysrev/articles/project51/Hauer2001.pdf

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Prevention of falls and consequent injuries in elderly people

Review / von:

• Prof Pekka Kannus, MD^{a, b, ,} ,
• Harri Sievänen, ScD^a,
• Mika Palvanen, MD^a,
• Teppo Järvinen, MD^b,
• Jari Parkkari, MD^c

• ^a Accident & Trauma Research Centre, UKK Institute for Health Promotion Research, Tampere, Finland
• ^b Department of Surgery, Tampere University Medical School and University Hospital, Tampere, Finland
• ^c Tampere Research Centre of Sports Medicine, UKK Institute for Health Promotion Research, Tampere, Finland

Abstract / Summary

Injuries resulting from falls in elderly people are a major public-health concern, representing one of the main causes of longstanding pain, functional impairment, disability, and death in this population.

The problem is going to worsen, since the rates of such injuries seem to be rising in many areas, as is the number of elderly people in both the developed and developing world.

Many methods and programmes to prevent such injuries already exist, including regular exercise, vitamin D and calcium supplementation, withdrawal of psychotropic medication, cataract surgery, professional environment hazard assessment and modification, hip protectors, and multifactorial preventive programmes for simultaneous assessment and reduction of many of the predisposing and situational risk factors.

To receive broader-scale effectiveness, these programmes will need systematic implementation. Care must be taken, however, to rigorously select the right actions for those people most likely to benefit, such as vitamin D and calcium supplementation and hip protectors for elderly people living in institutions.

Quelle:   http://www.sciencedirect.com/science/article/pii/S0140673605676040


Prevention of falls and consequent injuries in elderly people - Full Text / pdf:

http://www.grg-bs.it/usr_files/eventi/journal_club/programma/falls_lancet.pdf

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Relationship between Balance Ability and Lower Extremity Muscular Strength in the Elderly

Comparison by Gender, Age, and Tokyo Metropolitan Institute of Gerontology (TMIG) Index of Competence

Tatsuya HIRASE¹⁾, Shigeru INOKUCHI²⁾, Jun SHIOZUKA¹⁾, Kazumi NAKAHARA²⁾, Nobuou MATSUSAKA²⁾

 

1) Department of Rehabilitation Medicine, Nijigaoka Hospital 2) Department of Physical Therapy, Graduate School of Health Sciences, Nagasaki University 

Released 2008/11/21   

 

Keywords: the elderly, balance ability, lower extremity muscular strength

Abstract:

[Purpose] We studied the relationship between balance ability and lower extremity muscular strength in the elderly, and compared the data by gender, age, and the TMIG index of competence scores. 

[Subjects] The subjects of this study were 69 persons with an average age of 77.4 years. 

[Methods] Balance ability was assessed using center of gravity sway data for a static-standing posture and the Functional Reach Test (FRT) scores. Lower extremity muscular strength was assessed using measurements of knee extensor and ankle dorsiflexor strengths. For the age group analysis, subjects were divided into those above and below the median age(≤78 years and ≥79). For the activity level analysis, subjects were divided according to their TMIG index of competence score into those with scores of <11 and those with scores of ≥11. 

[Results] The study showed that lower extremity strength was negatively correlated with sway of center of gravity and positively correlated with FRT scores. Negative correlation between sway of the center of gravity and lower extremity strength was observed in women aged ≥79 whose TMIG index of competence score was <11. In contrast, lower extremity strength was positively correlated with FRT in women aged ≤78 whose TMIG index of competence score was ≥11. 

[Conclusion] In the elderly, there seem to be different characteristics that are dependent on physical ability in the relationship between balance ability and lower extremity muscular strength.

Quelle:   https://www.jstage.jst.go.jp/article/rika/23/5/23_5_641/_article

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