Implementation of multifactorial interventions for fall and fracture prevention

1. A. John Campbell ¹ and
2. M. Clare Robertson

Abstract

Over 60% of falls experienced by older people result from multiple aetiological factors. Preventing falls in individual patients requires the identification and treatment of these interacting factors. Multifactorial interventions have been successful in some, but not all, fall prevention trials. 

Preventing falls in populations requires selection of the population most likely to benefit, and selection of the particular interventions shown to have been effective in this group. The implementation of preventive measures has been low despite strong evidence that fall and fractures can be reduced. 

Misconceptions about the potential for prevention in old age, the time to effect improvement, resource issues and the nature of the interventions contribute to the low uptake. An improved system of delivery of proven preventive measures is needed. 

Quelle:  http://ageing.oxfordjournals.org/content/35/suppl_2/ii60.short

Full Text / pdf:  http://ageing.oxfordjournals.org/content/35/suppl_2/ii60.full.pdf+html

Keywords Google Scholar:  exercise and fall-prevention



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Effects of a fall prevention program

Effects of a fall prevention program including exercise on mobility and falls in frail older people living in residential care facilities.

Abstract

BACKGROUND AND AIMS:

Impaired mobility is one of the strongest predictors for falls in older people. We hypothesized that exercise as part of a fall prevention program would have positive effects, both short- and long-term, on gait, balance and strength in older people at high risk of falling and with varying levels of cognition, residing in residential care facilities. A secondary hypothesis was that these effects would be associated with a reduced risk of falling.

METHODS:

187 out of all residents living in 9 facilities, > or =65 years of age were at high risk of falling. The facilities were cluster-randomized to fall intervention or usual care. The intervention program comprised: education, environment, individually designed exercise, drug review, post-fall assessments, aids, and hip protectors. Data were adjusted for baseline performance and clustering.

RESULTS:

At 11 weeks, positive intervention effects were found on independent ambulation (FAC, p=0.026), maximum gait speed (p=0.002), and step height (> or =10 cm, p<0.001), but not significantly on the Berg Balance Scale. At 9 months (long-term outcome), 3 intervention and 15 control residents had lost the ability to walk (p=0.001). Independent ambulation and maximum gait speed were maintained in the intervention group but deteriorated in the control group (p=0.001). Residents with both higher and lower cognition benefited in most outcome measures. No association was found between improved mobility and reduced risk of falling.

CONCLUSIONS:

Exercise, as part of a fall prevention program, appears to preserve the ability to walk, maintain gait speed, ambulate independently, and improve step height. Benefits were found in residents with both lower and higher cognitive impairment, but were not found to be associated with a reduced risk of falling.

Quelle:  http://www.ncbi.nlm.nih.gov/pubmed/15575122

JÖRG LINDER AKTIV-TRAINING

Mauerbergstraße 110

76534 Baden-Baden

Tel.: 07223 / 8004699

Mobil: 0177 / 4977232

Mail: info@aktiv-training.de

Fax: 07223 / 8005271 

web: www.aktiv-training.de

weblog: www.aktiv-training.de/blog/

Gesundheitsmanagement: www.gesundheitsmanager-24.de
Sturzprävention: www.sturztraining.de