Donnerstag, 27. September 2012

Effects of a fall prevention program including exercise on mobility and falls

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

Jensen J, Nyberg L, Rosendahl E, Gustafson Y, Lundin-Olsson L.

Source:  Department of Community Medicine and Rehabilitation, Geriatric Medicine and Physiotherapy, Umeå University, Sweden. jane.jensen@physiother.umu.se

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





Den vollständigen Artikel finden Sie hier -Effects of fall prevention program . pdf-Link:

http://pure.ltu.se/portal/files/2228730/Artikel.pdf




Kleingruppentraining und Personal Training Sturzprävention:   in Freiburg, Offenburg, Ortenau, Baden-Baden, Rastatt, Karlsruhe, Kraichgau, Pforzheim, Nordschwarzwald, Stuttgart.


JÖRG LINDER AKTIV-TRAINING
Mauerbergstraße 110
76534 Baden-Baden
Tel.: 07223 / 8004699
Mobil: 0177 / 4977232
Mail: info@aktiv-training.de
Fax: 07223 / 8005271 
Sturzprävention: www.sturztraining.de




Eingestellt von um Keine Kommentare:
Labels: , , ,

Effective Exercise for the Prevention of Falls

A  Systematic Review and Meta-Analysis
  1. Catherine Sherrington PhD,
  2. Julie C. Whitney MSc,
  3. Stephen R. Lord DSc,
  4. Robert D. Herbert PhD,
  5. Robert G. Cumming PhD,
  6. Jacqueline C. T. Close MD
Article first published online: 31 OCT 2008
DOI: 10.1111/j.1532-5415.2008.02014.x
OBJECTIVES: To determine the effects of exercise on falls prevention in older people and establish whether particular trial characteristics or components of exercise programs are associated with larger reductions in falls.
DESIGN: Systematic review with meta-analysis. Randomized controlled trials that compared fall rates in older people who undertook exercise programs with fall rates in those who did not exercise were included.
SETTING: Older people.
PARTICIPANTS: General community and residential care.
MEASUREMENTS: Fall rates.
RESULTS: The pooled estimate of the effect of exercise was that it reduced the rate of falling by 17% (44 trials with 9,603 participants, rate ratio (RR)=0.83, 95% confidence interval (CI)=0.75–0.91, P<.001, I2=62%). The greatest relative effects of exercise on fall rates (RR=0.58, 95% CI=0.48–0.69, 68% of between-study variability explained) were seen in programs that included a combination of a higher total dose of exercise (>50 hours over the trial period) and challenging balance exercises (exercises conducted while standing in which people aimed to stand with their feet closer together or on one leg, minimize use of their hands to assist, and practice controlled movements of the center of mass) and did not include a walking program.
CONCLUSION: Exercise can prevent falls in older people. Greater relative effects are seen in programs that include exercises that challenge balance, use a higher dose of exercise, and do not include a walking program. Service providers can use these findings to design and implement exercise programs for falls prevention.
The development and implementation of effective and cost-efficient strategies to prevent falls in older people is an urgent global health challenge. In developed countries, life expectancy for people aged 65 years old is approximately 17 years for men and 21 years for women. At least one-third of people aged 65 and older fall at least once annually,1 and falls account for more than half of the injury-related hospitalizations for older people.2 Fall rates in the general older population are reported to be 1.2 falls per person year.3
Falls in older people are not purely random events but can be predicted by assessing a number of risk factors.4,5 Some of these risk factors (e.g., reduced muscle strength and impaired balance and gait) can be modified using exercise, whereas others (e.g., poor vision, psychoactive medication use) require different intervention approaches. Exercise can be used as a stand-alone falls prevention intervention or as a component of a multifaceted program. Multifaceted interventions can prevent falls in the general community, in those at greater risk of falls, and in residential care facilities.4,6
Many trials have sought to establish the specific effect of exercise on fall rates, but a large proportion of these trials have been underpowered. The best way to interpret these trials may be to pool their data in a meta-analysis, but trials of the effects of exercise on fall rates vary in their quality, have been conducted on a range of populations, and employ exercise programs that differ greatly in their aims and content. Meta-analysis should therefore involve exploration of whether these factors “explain” (are associated with) estimates of the effect of exercise programs.7,8
A Cochrane review of fall prevention strategies6 conducted separate meta-analyses on different forms of exercise and concluded that some exercise programs can prevent falls in community dwellers (e.g., home exercise program of balance and strength training, a Tai Chi group program) but that others are unlikely to be beneficial (brisk walking in women with an upper limb fracture in the previous 2 years) or require further investigation (untargeted group-based exercise interventions and individual lower-limb strength training).

A limitation to this approach is that it combines programs that may be different (e.g., group programs that are of low and high intensity) and separates programs that share key features (e.g., balance training).
This study sought to establish the effect of exercise on fall rates, with a major aim of explaining between-trial variability. Meta-regression methods were used to investigate whether particular features of study populations, exercise programs, and study design were associated with the size of estimates of effects of exercise on fall rates.


Quelle:   http://onlinelibrary.wiley.com/doi/10.1111/j.1532-5415.2008.02014.x/full?globalMessage=0

Das vollständige pdf finden Sie hier:

http://onlinelibrary.wiley.com/doi/10.1111/j.1532-5415.2008.02014.x/pdf




 
Sturzprävention in Freiburg, Offenburg, Ortenau, Baden-Baden, Rastatt, Karlsruhe, Kraichgau, Pforzheim, Nordschwarzwald, Stuttgart.


JÖRG LINDER AKTIV-TRAINING
Mauerbergstraße 110
76534 Baden-Baden
Tel.: 07223 / 8004699
Mobil: 0177 / 4977232
Mail: info@aktiv-training.de
Fax: 07223 / 8005271 
Sturzprävention: www.sturztraining.de




Eingestellt von um Keine Kommentare:
Labels: , , ,

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



 
Sturzprävention in Freiburg, Offenburg, Ortenau, Baden-Baden, Rastatt, Karlsruhe, Kraichgau, Pforzheim, Nordschwarzwald, Stuttgart.


JÖRG LINDER AKTIV-TRAINING
Mauerbergstraße 110
76534 Baden-Baden
Tel.: 07223 / 8004699
Mobil: 0177 / 4977232
Mail: info@aktiv-training.de
Fax: 07223 / 8005271 
Sturzprävention: www.sturztraining.de




Eingestellt von um Keine Kommentare:
Labels: , , ,

A Randomized Controlled Trial of Fall Prevention Strategies in Old Peoples’ Homes

A Randomized Controlled Trial of Fall Prevention Strategies in Old Peoples’ Homes

McMurdo MET, Millar AM, Daly F

Gerontology 2000;46:83–87 (DOI: 10.1159/000022139) 

 Abstract:
 
Background: 

Falls are a major cause of morbidity in old age. A small number of fall prevention trials in cognitively intact community-dwelling older people have been effective. This study set out to examine the preventability of falls in older people living in institutional care. 

Objective: 

To evaluate the effectiveness of falls risk factor assessment/modification and seated balance exercise training in reducing falls among elderly people living in residential care. Methods: 133 residents with a mean age of 84± (SD) 6.8 years were allocated at random by home to receive either a 6-month falls risk factor assessment/modification and seated balance exercise training programme (n = 77) or 6 months of reminiscence therapy (n = 56). The risk factors targeted were postural hypotension, polypharmacy, visual acuity, and ambient lighting levels. Falls risk factor assessments and recommendation for modifications were performed at baseline in the intervention group and assessments repeated at 6 months. Functional reach, reaction time, timed up-and- go, grip strength, spinal flexibility, and Philadelphia Geriatric Centre Morale Scale and Mini-Mental State Examination scores were determined at baseline and at 6 months by a ‘blind’ observer. Falls and fractures were then monitored in both groups during a 7- to 12-month falls-monitoring follow-up period. 

Results: 

Only 90 of 133 (67.7%) residents completed the 6-month intervention period, and 84 (63.2%) completed the 7- to 12-month falls-monitoring follow-up period. Both prevalence of postural hypotension (p = 0.0005) and poor visual acuity (p = 0.04) were reduced in the intervention group. There was no difference between the groups in the number of falls sustained, the risk of falling [odds ratio 0.45 (95% CI 0.19–1.14)], or in the risk of recurrent falling [odds ratio 1.07 (95% CI 0.40–2.97)]. No significant differences were found between the groups with regard to change in other outcome measures. 

Conclusions: 

 The high drop-out rate reduced the power of this study to detect any effect of the interventions used. It is possible that either the exercises were not sufficiently vigorous or that to improve balance exercises must be performed standing. Further research is required to identify effective fall prevention strategies for elderly people in residential settings.  

Copyright © 2000 S. Karger AG, Basel




Quelle:  http://content.karger.com/ProdukteDB/produkte.asp?Aktion=ShowAbstractBuch&ArtikelNr=22139&ProduktNr=225842



Sturzprävention in Freiburg, Offenburg, Ortenau, Baden-Baden, Rastatt, Karlsruhe, Kraichgau, Pforzheim, Nordschwarzwald, Stuttgart.


JÖRG LINDER AKTIV-TRAINING
Mauerbergstraße 110
76534 Baden-Baden
Tel.: 07223 / 8004699
Mobil: 0177 / 4977232
Mail: info@aktiv-training.de
Fax: 07223 / 8005271 
Sturzprävention: www.sturztraining.de






Eingestellt von um Keine Kommentare:
Labels: , , , ,

Effects of Sun-style Tai Chi exercise on physical fitness and fall prevention in fall-prone older adults

Abstract  / Keywords:
  • fall avoidance efficacy;
  • falls;
  • nursing;
  • older adults;
  • physical fitness;
  • Tai Chi exercise
Aim.  This paper reports a study to determine changes in the physical fitness (knee and ankle muscle strength, balance, flexibility, and mobility), fall avoidance efficacy, and fall episodes of institutionalized older adults after participating in a 12-week Sun-style Tai Chi exercise programme.

Background.  Fall prevention has a high priority in health promotion for older people because a fall is associated with serious morbidity in this population. Regular exercise is effective in fall prevention for older adults because of improvements in strength and balance. Tai Chi exercise is considered to offer great potential for health promotion and rehabilitation, particularly in the maintenance of good mental and physical condition in older people.

Methods.  A quasi-experimental design with a non-equivalent control group was used. Data were collected from September 2001 to January 2002. A total of 68 fall-prone older adults with a mean age of 77·8 years participated in the study, and 29 people in the Tai Chi group and 30 controls completed the post-test measures. The Tai Chi exercise programme was provided three times a week for 12 weeks in the experimental group. Data were analysed for group differences using t-tests.

Results.  At post-test, the experimental group showed significantly improved muscle strength in knee and ankle flexors (P < 0·001) and extensors (P < 0·01), and improved flexibility (P < 0·01) and mobility (P < 0·001) compared with the control group. There was no significant group difference in fall episodes, but the relative risk ratio for the Tai Chi exercise group compared with the control group was 0·62. The experimental group reported significantly more confidence in fall avoidance than did the control group.

Conclusion.  The findings reveal that Tai Chi exercise programmes can safely improve physical strength and reduce fall risk for fall-prone older adults in residential care facilities.

Quelle:   http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2648.2005.03480.x/abstract?globalMessage=0






JÖRG LINDER AKTIV-TRAINING
Mauerbergstraße 110
76534 Baden-Baden
Tel.: 07223 / 8004699
Mobil: 0177 / 4977232
Mail: info@aktiv-training.de
Fax: 07223 / 8005271 



Eingestellt von um Keine Kommentare:
Labels: , , ,

Freitag, 21. September 2012

Vibrationstraining / Fitvibe: Personal-Vibrationstraining

Vibrationstraining / Fitvibe: Personal-Vibrationstraining: Personal-Vibrationstraining:  Kombinieren Sie Vibrationstraining mit Übungen zur Verbesserung der Mobilität (beispielsweise aus dem Power-Y...
Eingestellt von um Keine Kommentare:

Donnerstag, 20. September 2012

Post-Run Yoga Flexibility Routine

Nach dem Laufen sollst Du ruhen und unbedingt etwas für die Flexibilität tun:


Video von: Post-Run Yoga Flexibility Routine   /   http://www.youtube.com/watch?v=HBLVMR4Asi8&feature=relmfu



JÖRG LINDER AKTIV-TRAINING – Ihr Personal Trainer für Baden-Baden, Sinzheim, Bühl,  Karlsruhe, Offenburg, Freiburg, Breisgau, Pforzheim, Stuttgart   (überregional auf Anfrage)

JÖRG LINDER AKTIV-TRAINING
Mauerbergstraße 110
76534 Baden-Baden
Tel.: 07223 / 8004699
Mobil: 0177 / 4977232
Mail: info@aktiv-training.de
Fax: 07223 / 8005271
Gesundheitsmanagement: www.gesundheitsmanager-24.de












Eingestellt von um Keine Kommentare:
Labels: , , , , ,
Abonnieren Posts (Atom)