process”, many are preventable ( Skelton & Todd, 2004 ). Although their etiology is typically multifactorial, exercise interventions are routinely incorporated in programs aimed at preventing falls ( Sherrington et al., 2016 ). Regular participation in fall prevention exercise programs (FPEPs) has been
Oluwaseyi Osho, Oluwatoyosi Owoeye and Susan Armijo-Olivo
Marina Arkkukangas, Susanna Tuvemo Johnson, Karin Hellström, Elisabeth Anens, Michail Tonkonogi and Ulf Larsson
during an exercise period ( Kalapotharakos et al., 2010 ). This decline indicates that muscle strength especially deteriorates in older adults after an exercise intervention, an issue that needs to be addressed when planning long-term training regimens ( McArdle, Katch, & Katch, 2010 ). One known fall-prevention
B. Josea Kramer, Beth Creekmur, Michael N. Mitchell, Debra J. Rose, Jon Pynoos and Laurence Z. Rubenstein
The Fall Prevention Center of Excellence designed three progressive-intensity fall prevention program models, Increasing Stability Through Evaluation and Practice (InSTEP), to reduce risk in community-dwelling older adults. Each model included physical activity, medical risk, and home safety components and was implemented as a 12-week program for small class sizes (12–15 people) in community and senior centers. Change in fall rates and fall risk factors was assessed using a battery of performance tests, self-reports of function, and fall diaries in a 3-group within-subjects (N = 200) design measured at baseline, immediately postintervention, and at 3 and 9 months postintervention. Overall, participants experienced a reduction in falls, improved self-perception of gait and balance, and improved dynamic gait function. The medium-intensity InSTEP model signifcantly (p = .003) reduced self-reported falls in comparison with the other models. InSTEP is a feasible model for addressing fall risk reduction in community-dwelling older adults.
Harriet G. Williams and Gerhild Ullmann
Falls and fall-related injuries are critical issues for older adults; evidence indicates that multidimensional interventions that address modifiable risk factors can be successful in reducing falls. Few evidence-based fall prevention interventions exist due, in part, to complex issues associated with development and implementation. There is a need for a variety of such programs from which older adults may choose. We describe steps, outcomes, and issues involved in developing/implementing an evidenced-based fall prevention program in community settings.
The Stay In Balance program (SIB), developed by a team of professionals, local service providers and active older adults, was carried out with total of 135 older adults in several steps: developing objectives and program content, laboratory-based randomized controlled trial (RCT), pilot program in the community, community-based RCT, and implementation at 2 community sites.
Each step in development provided useful and different insights into needed changes in program content, equipment, support materials, training, and appropriate outcome measures.
Development of an evidenced-based fall prevention program requires a long term commitment on the part of all partners, University personnel, local service providers, and older adult participants; funding is also critical.
Leigh J. Allin, Maury A. Nussbaum and Michael L. Madigan
involves an attempt to maintain the center of mass over the base of support by reducing the speed of the slipping foot and stepping with the trailing (nonslipping) foot. 4 – 7 Task-specific, perturbation-based balance training is an emerging approach to fall prevention that aims to improve the reactive
Rachel Proffitt, Belinda Lange, Christina Chen and Carolee Winstein
The purpose of this study was to explore the subjective experience of older adults interacting with both virtual and real environments. Thirty healthy older adults engaged with real and virtual tasks of similar motor demands: reaching to a target in standing and stepping stance. Immersive tendencies and absorption scales were administered before the session. Game engagement and experience questionnaires were completed after each task, followed by a semistructured interview at the end of the testing session. Data were analyzed respectively using paired t tests and grounded theory methodology. Participants preferred the virtual task over the real task. They also reported an increase in presence and absorption with the virtual task, describing an external focus of attention. Findings will be used to inform future development of appropriate game-based balance training applications that could be embedded in the home or community settings as part of evidence-based fall prevention programs.
Tuo-Yu Chen and Megan C. Janke
This study examines whether participation in gardening predicts reduced fall risk and performance on balance and gait-speed measures in older adults. Data on adults age 65 and older (N = 3,237) from the Health and Retirement Study and Consumption and Activities Mail Survey were analyzed. Participants who spent 1 hr or more gardening in the past week were defined as gardeners, resulting in a total of 1,585 gardeners and 1,652 nongardeners. Independent t tests, chi square, and regression analyses were conducted to examine the relationship between gardening and health outcomes. Findings indicate that gardeners reported significantly better balance and gait speed and had fewer chronic conditions and functional limitations than nongardeners. Significantly fewer gardeners than nongardeners reported a fall in the past 2 yr. The findings suggest that gardening may be a potential activity to incorporate into future fall-prevention programs.
Elaine J. Trudelle-Jackson, Allen W. Jackson and James R. Morrow Jr.
Effect of muscle strength and balance on falls has not been well researched in healthy older women. The purpose of this study was to compare lower extremity strength and balance in older healthy women during each decade of life and to investigate which factors are different in women with a history of falling.
We retrospectively studied 240 women age 50-89 y. Measures of muscle strength, postural stability, and incidence of falls over the past year were obtained from client charts at Texas Woman’s University’s Health Promotion & Research Center from 1996 to 2002.
Strength declined significantly with age in all muscle groups except knee extensors. Age, hip flexor and abductor strength, and postural stability were significantly different in women who had fallen.
Strength decline was not consistent across muscle groups. Women who were older, had less hip flexor or abductor strength, or less balance were more likely to have fallen.
Ellen C. Jørstad-Stein, Klaus Hauer, Clemens Becker, Marc Bonnefoy, Rachel A. Nakash, Dawn A. Skelton and Sarah E. Lamb
The purpose of the study was to identify physical activity questionnaires for older adults that might be suitable outcome measures in clinical trials of fall-injury-prevention intervention and to undertake a systematic quality assessment of their measurement properties. PubMed, CINAHL, and PsycINFO were systematically searched to identify measurements and articles reporting the methodological quality of relevant measures. Quality extraction relating to content, population, reliability, validity, responsiveness, acceptability, practicality, and feasibility was undertaken. Twelve outcome measures met the inclusion criteria. There is limited evidence about the measures’ properties. None of the measures is entirely satisfactory for use in a large-scale trial at present. There is a need to develop suitable measures. The Stanford 7-day Physical Activity Recall Questionnaire and the Community Health Activities Model Program for Seniors questionnaire might be appropriate for further development. The results have implications for the designs of large-scale trials investigating many different geriatric syndromes.