Identification of elderly fallers by muscle strength measures

Abstract The original publication is available at http://link.springer.de/link/service/journals/00421/index.htm. For efficient prevention of falls among older adults, individuals at a high risk of falling need to be identified. In this study, we searched for muscle strength measures that best identified those individuals who would fall after a gait perturbation and those who recovered their balance. Seventeen healthy older adults performed a range of muscle strength tests. We measured maximum and rate of development of ankle plantar flexion moment, knee extension moment and whole leg push-off force, as well as maximum jump height and hand grip strength. Subsequently, their capacity to regain balance after tripping over an obstacle was determined experimentally. Seven of the participants were classified as fallers based on the tripping outcome. Maximum isometric push-off force in a leg press apparatus was the best measure to identify the fallers, as cross-validation of a discriminant model with this variable resulted in the best classification (86% sensitivity and 90% specificity). Jump height and hand grip strength were strongly correlated to leg press force (r = 0.82 and 0.59, respectively) and can also be used to identify fallers, although with slightly lower specificity. These results indicate that whole leg extension strength is associated with the ability to prevent a fall after a gait perturbation and might be used to identify the elderly at risk of falling.
Quelle:  http://en.scientificcommons.org/34613507

Full Text / pdf von:  Identification of elderly fallers by muscle strength measures - online im internet - Zugriff vom 02.102012: 

http://www.biomedsearch.com/attachments/00/18/07/17/18071745/421_2007_Article_613.pdf

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Balance and strength training in older adults

Intervention gains and Tai Chi maintenance

Wolfson L, Whipple R, Derby C, Judge J, King M, Amerman P, Schmidt J, Smyers D.

Source

Department of Neurology, University of Connecticut School of Medicine, Hartford, USA.

Abstract

 

OBJECTIVE: 

 

To determine the effect on balance and strength of 3 months of intensive balance and/or weight training followed by 6 months of low intensity Tai Chi training for maintenance of gains.

DESIGN: 

 

Randomized control intervention. Four groups in 2 x 2 design: Control, Balance, Strength, Balance + Strength, using blinded testers.

SETTING: 

 

Exercise and balance laboratory at University of Connecticut Health Center.

PARTICIPANTS: 

 

Subjects were 110 healthy community dwellers (mean age 80) who were free of dementia, neurological disease, and serious cardiovascular or musculoskeletal conditions.

INTERVENTIONS: 

 

Short-term training (3 months) occurred 3 times/week (45 minutes Balance and Strength, 90 minutes Balance + Strength). Balance training included equilibrium control exercises of firm and foam surfaces and center-of-pressure biofeedback. Strengthening consisted of lower extremity weight-lifting. All subjects than received long-term group Tai Chi instruction (6 months, 1 hour, 1 time/week).

MEASUREMENTS: 

 

Losses of balance during Sensory Organization Testing (LOB), single stance time (SST), voluntary limits of stability (FBOS), summed isokinetic torque of eight lower extremity movements (ISOK), and usual gait velocity (GVU).

RESULTS AND CONCLUSIONS: 

 

Balance training meaningfully improved all balance measures by restoring performance to a level analogous to an individual 3 to 10 years younger: LOB = -2.0 +/- 0.3 (adjusted paired differences, P < .005 ANOVA); SST = 7.0 +/- 1.2 sec; and FBOS = 9.0 +/- 2.0% of foot length (P < .05). Strengthening increased ISOK by 1.1 +/- 0.1 Nm kg-1 (P < .005). There was no interaction between balance and strength training. Significant gains persisted after 6 months of Tai Chi, although there was some decrement.

Quelle:   http://www.ncbi.nlm.nih.gov/pubmed/8617896



Full Text / pdf -  Balance and strength training in older adults: intervention gains and Tai Chi maintenance. von:  Wolfson L, Whipple R, Derby C, Judge J, King M, Amerman P, Schmidt J, Smyers D. - online im internet - Zugriff 30.09.2012:

http://www.white-lotus.com/Ken%20Documents/Balance%20and%20Strength%20Training%20in%20Older%20Adults%20Study.pdf

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Exercise in the Prevention of Falls in Older People

A Systematic Literature Review Examining the Rationale and the Evidence  

Authors: Carter N.D; Kannus P.; Khan K.M.

Source: Sports Medicine, Volume 31, Number 6, 1 June 2001 , pp. 427-438(12)

Abstract:

Falls are a major source of death and injury in elderly people. For example, they cause 90% of hip fractures and the current cost of hip fractures in the US is estimated to be about 10 billion dollars.

Age-related changes in the physiological systems (somatosensory, vestibular and visual) which contribute to the maintenance of balance are well documented in older adults. These changes coupled with age-related changes in muscle and bone are likely to contribute to an increased risk of falls in this population.

The integrated rehabilitation-based model of fall risk factors reveals multiple sites for interventions that may reverse fall risk factors. Regular exercise may be one way of preventing falls and fall-related fractures.

The evidence for this contention comes from a variety of sources. On the basis of 9 randomised controlled studies conducted since 1996, exercise appears to be a useful tool in fall prevention in older adults, significantly reducing the incidence of falls compared with control groups.

However, current limitations such as inconsistencies in the measurement of key dependent and independent variables do not, at present, permit a meta-analysis of intervention trials. Further investigation, using trials designed with the current limitations in mind, is necessary to establish the optimum exercise programme to maximise fall prevention in older adults. 

Quelle:  http://www.ingentaconnect.com/content/adis/smd/2001/00000031/00000006/art00003



 
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