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Osteoporosis International
Published in: Osteoporosis International 10/2019

01-10-2019 | Concise Clinical Review

Practical tips for prescribing exercise for fall prevention

Authors: I. B. Rodrigues, M. Ponzano, L. M. Giangregorio

Published in: Osteoporosis International | Issue 10/2019

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Abstract

Clinical relevance

There is strong evidence from meta-analyses that exercise as a single intervention can reduce the number and risk of falls in community-dwelling older adults, yet not all types of exercise are equal.

Observations

Programs that include 3 h a week of exercise and provide a high challenge to balance can reduce falls by almost 40%. Reactive and volitional stepping interventions have also been shown to reduce falls by about 50%. Evidence is less clear regarding the efficacy of exercise in individuals who have experienced a stroke, who live in long-term care, who have been recently discharged from the hospital, or who have visual impairments, but there is some evidence that multifactorial programs may be useful.

Conclusion

Depending on the population, exercise as a single or as part of a multifactorial intervention may be beneficial in reducing falls.
Literature
1.
Kellogg International Work Group on the Prevention of Falls by the Elderly (1987) The prevention of falls in later life. A report of the Kellogg International Work Group on the Prevention of Falls by the Elderly. Dan Med Bull 34((Suppl.4):1–24
2.
Schrag A, Choudhury M, Kaski D, Gallagher DA (2015) Why do patients with Parkinson’ s disease fall? A cross-sectional analysis of possible causes of falls. Nat Partn J 1(15011):1–6
3.
Giangregorio L, Papaioannou A, MacIntyre N, Ashe M, Heinonen A, Shipp K et al (2014) Too Fit To Fracture: exercise recommendations for individuals with osteoporosis or osteoporotic vertebral fracture. Osteoporos Int 25(3):821–835CrossRefPubMedPubMedCentral
4.
Iwasaki S, Yamasoba T (2015) Dizziness and imbalance in the elderly: age-related decline in the vestibular system. Ageing Dis 6(1):38–47CrossRef
5.
6.
Stel V, Smit J, Pluijm S, Lips P (2004) Consequences of falling in older men and women and risk factors for health service use and functional decline. Age Ageing 33(1):58–65CrossRefPubMed
7.
8.
Eng JJ, Chu KS (2002) Reliability and comparison of weight-bearing ability during standing tasks for individuals with chronic stroke. Arch Phys Med Rehabil 83(8):1138–1144CrossRefPubMedPubMedCentral
9.
Deandrea S, Lucenteforte E, Bravi F, Foschi R, La Vecchia C, Negri E (2010) Risk factors for falls in community-dwelling older people: a systematic review and meta-analysis. Epidemiology. 21(5):658–668CrossRefPubMed
10.
11.
PhysiopediaContributors. Base of support. Physiopedia
12.
Tricco AC, Thomas SM, Veroniki AA, Hamid JS, Cogo E, Strifler L et al (2017) Comparisons of interventions for preventing falls in older adults a systematic review and meta-analysis. JAMA 318(17):1687–1699CrossRefPubMedPubMedCentral
13.
El-khoury F, Cassou B, Charles M, Dargent-molina P (2013) The effect of fall prevention exercise programmes on fall induced injuries in community dwelling older adults: systematic review and meta-analysis of ranomised controlled trials. BMJ 6234(October):1–13
14.
Sherrington C, Michaleff ZA, Fairhall N, Paul SS, Tiedemann A, Whitney J et al (2017) Exercise to prevent falls in older adults: an updated systematic review and meta-analysis. Br J Sports Med 51:1749–1757CrossRef
15.
Williams DR, Watt HC, Lees AJ (2006) Predictors of falls and fractures in bradykinetic rigid syndromes: a retrospective study. J Neurol Neurosurg Psychiatry 77(4):468–473CrossRefPubMedPubMedCentral
16.
17.
Blaylock SE, Vogtle LK (2017) Falls prevention interventions for older adults with low vision: a scoping review. Can J Occup Ther 84(3):139–147CrossRefPubMed
18.
Dillon L, Clemson L, Ramulu P, Sherrington C, Keay L (2018) A systematic review and meta-analysis of exercise-based falls prevention strategies in adults aged 50+ years with visual impairment. Ophthalmic Physiol Opt 38(4):456–467CrossRefPubMed
19.
20.
Sherrington C, Lord SR, Vogler CM, Close JCT, Howard K, Dean CM, et al (2014) A post-hospital home exercise program improved mobility but increased falls in older people: a randomised controlled trial. 9(9)
21.
22.
23.
Cameron I, Gillespie L, Robertson M, Murray G, Hill K, Cumming R, et al (2013) Interventions for preventing falls in older people in care facilities and hospitals (Review). Cochrane Database Syst Rev. (12).
24.
25.
Puts M, Toubasi S, Andrew M, Ashe M, Ploeg J, Atkinson E et al (2017) Interventions to prevent or reduce the level of frailty in community-dwelling older adults: a scoping review of the literature and international policies. Age Ageing 46(3):383–392PubMedPubMedCentral
26.
Lee SH, Hee RN, Kim S (2017) Exercise interventions for preventing falls among older people in care facilities: a meta-analysis. Worldviews Evid-Based Nurs. 74–80.CrossRefPubMed
27.
28.
Okubo Y, Schoene D, Lord SR (2016) Step training improves reaction time, gait and balance and reduces falls in older people: a systematic review and meta-analysis. BJSM. 1–9.
29.
Gillespie L, Robertson M, Gillespie W, Sherrington C, Gates S, Clemson L, et al (2015) Interventions for preventing falls in older people living in the community (Review) Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev 9(CD007146)
30.
Youkhana S, Dean CM, Wolff M, Sherrington C, Tiedemann A (2016) Yoga-based exercise improves balance and mobility in people aged 60 and over: a systematic review and meta-analysis. Age Ageing 45(1):21–29CrossRefPubMed
31.
Liu-Ambrose T, Donaldson MG, Ahamed Y, Graf P, Cook WL, Close J et al (2008) Otago home-based strength and balance retraining improves executive functioning in older fallers: a randomized controlled trial. J Am Geriatr Soc 56(10):1821–1830CrossRefPubMed
32.
Clemson L, Fiatarone Singh MA, Bundy A, Cumming RG, Manollaras K, O’Loughlin P et al (2012) Integration of balance and strength training into daily life activity to reduce rate of falls in older people (the LiFE study): randomised parallel trial. BMJ 345(7870):1–15
33.
Lai CC, Tu YK, Wang TG, Huang YT, Chien KL (2018) Effects of resistance training, endurance training and whole-body vibration on lean body mass, muscle strength and physical performance in older people: a systematic review and network meta-analysis. Age Ageing 47(3):367–373CrossRefPubMed
34.
Katzman WB, Vittinghoff E, Lin F, Schafer A, Long RK, Wong S et al (2017) Targeted spine strengthening exercise and posture training program to reduce hyperkyphosis in older adults: results from the study of hyperkyphosis, exercise, and function (SHEAF) randomized controlled trial. Osteoporos Int 28(10):2831–2841CrossRefPubMedPubMedCentral
35.
Kado DM, Miller-martinez D, Lui L, Ensrud KE (2014) Hyperkyphosis, kyphosis progression, and risk of non-spine fractures in older community dwelling women: the Study of Osteoporotic Fractures (SOF). Am Soc Bone Miner Res 29(10):2210–2216CrossRef
36.
Nichols DS (1997) Balance retraining after stroke using force platform biofeedback. Phys Ther 77(5):553–558CrossRefPubMed
37.
Picorelli AMA, Pereira LSM, Pereira DS, Felício D, Sherrington C (2014) Adherence to exercise programs for older people is influenced by program characteristics and personal factors: a systematic review. J Physiother 60(3):151–156CrossRefPubMed
38.
39.
40.
Campbell A, Robertson M, Gardner M, Norton R, Tilyard M, Buchner D (1997) Randomised controlled trial of a general practice programme of home based exercise to prevent falls in elderly women. Br Med J 315:1065–1069CrossRef
41.
Robertson M, Campbell A, Gardner M, Devlin N (2002) Preventing injuries in older people by preventing falls: a meta-analysis of individual-level data. J Am Geriatr Soc 50:905–911CrossRefPubMed
42.
Thomas S, Mackintosh S, Halbert J (2010) Does the “Otago exercise programme” reduce mortality and falls in older adults?: a systematic review and meta-analysis. Age Ageing 39(6):681–687CrossRefPubMed
43.
Davis JC, Robertson MC, Ashe MC, Liu-Ambrose T, Khan KM, Marra CA (2010) Does a home-based strength and balance programme in people aged ≥80 years provide the best value for money to prevent falls? A systematic review of economic evaluations of falls prevention interventions. Br J Sports Med 44(2):80–89CrossRefPubMed
44.
Clemson L, Singh MF, Bundy A, Cumming RG, Weissel E, Munro J et al (2010) LiFE Pilot Study: a randomised trial of balance and strength training embedded in daily life activity to reduce falls in older adults. Aust Occup Ther J 57(1):42–50CrossRefPubMed
45.
Giangregorio L, McGill S, Wark J, Laparade J, Heinonen A, Ashe M et al (2015) Too Fit To Fracture: outcomes of a Delphi consensus process on physical activity. Osteoporos Int:1175–1186
46.
Panel on Prevention of Falls in Older Persons (2011) Summary of the updated american geriatrics society/british geriatrics society clinical practice guideline for prevention of falls in older persons. J Am Geriatr Soc 59(1):148–157CrossRef
47.
Podsiadlo D, Richardson S (1991) The timed “Up & Go” A test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 39:132–148CrossRef
48.
Berg K, Wood-Dauphinee S, WIlliams J, Gayton D (1989) Measuring balance in the elderly; preliminary development of an instrument. Physiother Can 41:304–311CrossRef
49.
Tinetti M (1986) Performance-oriented assessment of mobility problems in elderly patients. J Am Geriatr Soc 34:119–126CrossRefPubMed
Metadata
Title
Practical tips for prescribing exercise for fall prevention
Authors
I. B. Rodrigues
M. Ponzano
L. M. Giangregorio
Publication date
01-10-2019
Publisher
Springer London
Published in
Osteoporosis International / Issue 10/2019
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-019-05141-0

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