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Fall prevention

From Wikipedia, the free encyclopedia
This article is about prevention of falls in older adults and ill people. For fall protection in the workplace, see Fall protection.

Fall prevention includes any action taken to help reduce the number of accidental falls suffered by susceptible individuals, such as the elderly and people with neurological (Parkinson's, Multiple sclerosis, stroke survivors, Guillain-Barre, traumatic brain injury, incomplete spinal cord injury) or orthopedic (lower limb or spinal column fractures or arthritis, post-surgery, joint replacement, lower limb amputation, soft tissue injuries) indications.

Adults aged 65 years and older have a 30% chance of falling each year, making fall-related injuries the leading cause of accident-related death for this demographic.[1]

Impact of falls

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See also: Falls in older adults

Falls and fall-related injuries are among the most common but serious medical problems experienced by older adults. Nearly one-third of older people fall each year, half of which fall more than once per year.[2] Over 3 million Americans over the age of 65 visited hospital emergency departments in 2015 due to fall-related injuries, with over 1.6 million being admitted.[3] Because of decreased bone density due to osteoporosis, mobility, and reflexes, falls often result in hip fractures and other fractures, head injuries, and death in older adults. Accidental injuries are the fifth most common cause of death in older adults.[2] 75% of hip fracture patients do not recover completely and show signs of overall health deterioration.[2]

Predicting falls

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Insufficient evidence exists that any fall risk screening instrument is adequate for predicting falls.[4] While the strongest predictors of fall risk tend to include a history of falls during the past year, gait, and balance abnormalities,[5] existing models show a strong bias and therefore mostly fail to differentiate between adults that are at low risk and high risk of falling.[6][7]

Physical activity

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One of the most important things for fall prevention in elderly populations is to stay physically fit. Physical activity is important for older adults because it plays a major role in limiting the loss of muscle mass and strength, while also stimulating postural control.[8] There are some exercise types that have a higher rate of effectiveness for prevention of falls than others. Postural training is one of the main key exercises to prevent falls. It focuses on improving balance and stability. Pilates is a type of training shown to improve the postural system.[8]

It is important to combine muscle strengthening exercises and balance training together to ensure reduced risks of falls.[9] An older adult should be focusing more on strengthening their legs, hip, and core muscles. Strengthening these muscles will provide them with more stability. These exercises may minimize or reduce physical frailty.[10]

After the age of 50, adults experience a decrease in muscle mass (sarcopenia) by approximately 2% every year.[11] Resistance training can slow down the rate of loss in muscle mass and strength. It has been recommended that older adults participate in resistance training two to three times a week to weaken the effects of sarcopenia.[11] Resistance training also has a positive impact on older adults and can cause a major increase in strength and muscle size.[10] Having a resistance training regimen that includes challenging balance workouts for three or more hours per week results in a lesser chance of falling.[11] Resistance training has been shown to be beneficial beyond fall prevention, as it also helps improve functional mobility and activities of daily living such as walking endurance, gait speed, and stair climbing.[11]

Resistance exercise two or three times a week with ankle weights or elastic bands (Otago exercise) can rebuild lost muscle mass, improve balance and strength, and reduce falls in adults of all ages.[12][13]

Specialized facilities and programs like seniors' parks can support to keep the elderly in shape and increase their resistance to falling. These facilities contain specialized equipment and training stations where elderly people can exercise. The parks usually have an extended amount of space and different stages reserved for different body exercises.[14]

Multicomponent exercise with both aerobic and anaerobic components can provide positive outcomes together with specific balance integrations.[15]

Another type of exercise that can be beneficial in decreasing fall risk, specifically in older women, is pilates. Pilates is a safe form of exercise for older adults compared to a big gym setting due to its more serene and calm setting, which might also improve an older adult's mental stability and their quality of life. Pilates can effectively improve balance which in turn decreases the risk of fall. Pilates also leads to an increase in mobility as well which contributes to a lower fall risk. Due to pilates showing positive effects on balance, leg strength, and mental well-being, this allows older adults to be more physically and mentally strong. These factors can allow for elderly people to be more confident to decrease their fall risk.[16]

Other forms of training, such as aerobic, anaerobic, and proprioceptive exercises can also be used to increase balance to lower the risk of falls in the elderly population.[17]

Adherence

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Adherence is one of the challenges of a successful fall prevention exercise program. Average adherence in group-based fall prevention exercise programs is around 66%, mostly due to the highly repetitive nature of the programs and the extremely long duration required for noticeable benefits accrue.[18] Adherence to physical therapy can be even lower.[19] When adherence is below 70%, effectiveness of fall prevention physical exercise programs can drop to less than 10%.[18]

Environmental modification

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Grab rails on a longer-distance commuter train catering for mainly seated passengers
A staircase with metal handrails
Front-wheeled walker.
Grab bar mounted in a bathroom

The home environment can present many hazards. Common places for injurious falls include the bathtub and stairs. Changes to the home environment are aimed at reducing hazards and help support a person in daily activities; they include minimizing clutter, installing grab bars in the bathroom, and installing non-slip decals to slippery surfaces.[20]

Environmental modifications, like improving lighting, removing tripping hazards, and repairing uneven surfaces, further contribute to fall prevention. Addressing these hazards within everyday settings helps make interventions practical and accessible, empowering older adults to actively engage in improving their stability and reducing fall risks.[21]

Stairs can be improved by installing handrails on both sides, improving lighting, and adding colour contrast between steps. Improvement in lighting and luminance levels can aid elderly people in assessing and negotiating hazards. Occupational therapists can help clients improve fall prevention behaviours.[22] In addition, they can instruct clients and their family members on factors that contribute to falls, and implement environmental modifications and strategies to decrease the risk of falls.[22] There is currently insufficient scientific evidence to ensure the effectiveness of modification of the home environment to reduce injuries.[23] Evidence suggests that pre-discharge home assessments are associated with a reduced risk of falling.[24]

Safety technology

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Important improvements to prevent falls include handrails and grab bars, which should be easy to grip or grasp and should be near any stairs or change in floor level. Floors should always be flat and level, with no exposed corners or edges. Patterned floors can be dangerous if they create misleading or distorted images of the floor surface, and should be avoided.[25]

There are special handles and closed handgrips available in bathrooms and lavatories to help users bend down or over. For example, extra support for users when moving include walking sticks, crutches, and support frames, such as a walker. Flexible handles such as hanging straps can also be useful supports.[26]

Medication management

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Certain medications can increase fall risk factors for people. The aim of medical management is to identify factors that can contribute to falls and fracture risk such as osteoporosis, multiple medications, balance and gait problems, loss of vision and a history of falls.[27]

The Beers Criteria is a list of medications that are potentially inappropriate for use in the elderly and some of them increase the risk of falls.[27]

Healthcare

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In a clinical environment, fall prevention strategies include the use of specific tests for gait and balance assessments, multifactorial interventions, medication review, physical exercises, vision and footwear intervention, physiotherapy referral, environment modification, risk stratification, management of osteoporosis and fracture risk, and cardiovascular interventions.[28]

Challenges for falls prevention include such as transportation barriers, gaps in care continuity, and the need for sustained support for frail individuals. Long-term, sustainable fall-prevention programs benefit from partnerships between healthcare providers, caregivers, and community resources, helping to maintain independence and enhance quality of life for older adults. These efforts not only improve patient outcomes but also reduce the broader strain on healthcare systems, highlighting the societal value of comprehensive, community-based fall-prevention interventions.[29]

Questions around effectiveness of current approaches (physical exercise and multifactorial interventions) have been found in multiple settings, including long-term care facilities and hospitals.[30] Physical exercise programs seem to have limited effectiveness[31] (approximately 25%). Even multifactorial interventions,[32] which include extensive physical exercise, medication adjustment, and environmental modification only lower fall risk by 31% after 12 months,[33] and by 21% after 24 months.[1]

Occupational and physical therapy

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In older adults, physical training and perturbation therapy is directed to improving balance recovery responses and preventing falls.[34] Gait-related changes in the elderly provide a greater chance of stability during walking due to slower speed and greater base of support, but they also increase the chance of slipping or tripping and falling.[35] Appropriate joint moment generation is required to create sufficient push-off for balance recovery. Age-related changes in muscles, tendons, and neural structures may contribute to slower reactive responses. Interventions involving resistance training along with perturbation training may prove to be beneficial in improving muscle strength and balance recovery.[36]

Stroke exercises help patients regain mobility and strength in their bodies, and must be done regularly in order to regain muscle tone that helps prevent falls.[37]

In hospitals

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In hospitals, falls are the most common safety incident affecting the elderly. They represent a common concern for hospital staff and can cause a variety of injuries from minor to major and induce anxiety and a fear of falling. Educating patients and staff about falls can reduce their incidence. Interventions that address multiple factors can have a positive impact on hospital fall rates. These multi-factorial interventions can include improved nurse handover procedures, addressing the reaction time to call buttons, exercise therapies, hip protectors and safe footwear among others. Chair alarms, bed alarms, or wearable sensors do not seem to contribute to the prevention of falls on hospitals.[38][39]

In England, suggestions for preventing falls in acute hospitals include clarifying what roles and responsibilities staff members have in prevention, adopting a multidisciplinary approach, reducing the bureaucratic burden affecting risk assessment and monitoring, and providing patients personally tailored information about the risks and prevention of falls.[39][40]

Other measures

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Other preventative measures with positive effects include strength and balance training, home risk assessment,[24] the withdrawal of psychotropic medication, cardiac pacing for those with carotid sinus hypersensitivity, and tai chi. The introduction of semi-immersive virtual reality simulation during treadmill training might help the elderly to improve balance and reduce the risk of falls.[41]

Assistive technology can also help in prevention, although it is mostly reactive in case of a fall.[42]

Motor-cognitive training can also be beneficial for healthy aging and fall prevention.[43][44]

Bifocal spectacles and trifocal eyeglasses are used to provide refractory correction ideal for reading (12–24 inches (30–60 cm) when the wearer looks downward through them. Reading glasses are not ideal for safe walking, where correction for 4.5–5 feet (137–152 cm) would be more appropriate.

Risk factors of falls

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Older adults

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Adults over the age of 65 are more prone to falls than younger, healthy adults.[45][46] Most falls in older adults are due to:[47]

  • Living a sedentary lifestyle long term that increases loss of muscle function.[10]
  • Gait deviations – These are the main changes that occur in the gait patterns of older adults, which may contribute to the incidence of falls. Older adults may experience a 10–20% reduction in gait velocity and reduction in stride length, an increase in stance width and double support phase, or a bent posture.[48][49][50] Studies show that a wider stride does not necessarily increase stability, and may instead increase the likelihood of experiencing falls.[51]
  • Limitations in mobility – Loss of mobility increases the risk of falls in situations which, under normal circumstances, would pose a low risk of falling (such as walking up/down stairs).[52]
  • Reduced muscle strength, especially in the lower body, which leads to difficulties standing up.[53][54]
  • Poor reaction time – Aging is associated with the gradual slowing of an individual's reaction time.[55]
  • Accidents/environmental factors – Falls may occur due to dangerous or unstable surfaces, such as wet surfaces, ice, stairs, or rugs; or inappropriate footwear. Reliable floor slip resistance testing can help identify and remediate slippery floors that can cause preventable accidents.
  • Balance disorders – vertigo, syncope, unsteadiness, ataxias
  • Visual, sensory, motor, and cognitive impairment
  • Medications and alcohol consumption – Dizziness, drowsiness and confusion can occur as side effects of some medications. Alcohol consumption causes a delay in reflexes and diminishes balance and fine motor control via its inhibitory effects on nerve pathways in the cerebellum.[56]
  • Acute and chronic infections
  • Dehydration

Stroke

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Individuals who have had a stroke have higher fall rates. Approximately 30% fall at least once a year and 15% fall twice or more.[57] Risk factors for falls in stroke survivors are:[58]

  • Gait deviations – Disturbance of gait is a common problem post-stroke and a common contributor of falls, predicting a continual functional decline. Velocity, cadence, stride time, stride length, and temporal symmetry index are reduced and result in significant gait deterioration.[59] Reduced propulsion at push-off, decreased leg flexion during the swing phase, reduced stability during the stance phase, and reduced automaticity of walking occur.[57]
  • Reduced muscle tone and weakness
  • Side effects of drugs
  • Hypoglycemia
  • Hypotension
  • Communication disorders
  • Hemianopia
  • Visuospatial agnosia

Parkinson's disease

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Most people with Parkinson's disease (PD) fall and many experience recurrent falls.[60] A study reported that over 50% of persons with PD fell recurrently.[61] Direct and indirect causes of falls in patients with PD:[62]

Multiple sclerosis

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There is a high prevalence of falls among persons with multiple sclerosis (MS), with approximately 50% reporting a fall within the past six months.[63] About 30% of those individuals report falling multiple times.

  • Gait deviations – Gait variability is elevated in individuals with MS.[64] Stride length, cadence, and velocity decrease, while stance duration and cycle duration increase.[65]
  • Foot drop
  • Ataxia – vestibular ataxia results in loss of balance. Symptoms are exacerbated when the eyes are closed and the base of support is reduced.
  • Reduced proprioception
  • Improper or reduced use of assistive devices[66]
  • Vision – blurred vision, double vision, loss of peripheral vision
  • Cognitive changes – Approximately 50% of affected individuals experience difficulty with their cognition over the course of the disease, which affects planning, organizing, problem-solving, and the ability to accurately perceive the environment. When these problems interfere with walking, it may result in a fall.
  • Neurological medications – causes fatigue,[67] weakness, dizziness

Dementia

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Studies suggest that men are twice as likely to fall as women.[68] Common causes of falls in dementia include:

  • Gait deviations – Slower walking speed, reduced cadence, and step length, increased postural flexion, increased double support time[69]
  • Postural instability – Gait changes and impaired balance. People with balance deficits are at more risk of falling than those with a normal gait and intact balance.
  • Lack of physical exercise
  • Visual impairment - Blurry vision, low vision, and loss of peripheral vision. Eyesight cannot be fixed or corrected by glasses.
  • Fatigue
  • Medications – psychotropic drugs have effects on balance, reaction time and other sensorimotor functions, orthostatic hypotension, and extrapyramidal symptoms.

Fear of falling

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Main article: Fear of falling

Basophobia is a term used in many circumstances to describe the fear of falling in either normal or special situations. It refers to uncomfortable sensations that may be experienced by older people. These sensations can include lower-body weakness or loss of balance, which can induce a frightening sensation of falling that can lead to serious and potentially fatal injuries.[70][self-published source?]

Fear of falling has become a serious and common concern among older adults and impedes on one's participation in daily activities. Negative consequences can result to impaired mobility, loss of independence, and a decreased quality of life. The state of an individual's quality of life is important when regarding both positive and negative elements that may prohibit them from living life to the fullest. In some situations, the recurrent thought about falling has also been shown to lead to death within the elderly community. In a study done, experiences of falling were significantly associated with the fear of falling. The results showed that those who experienced falls within the previous month or previous year related their fall through recurrent thoughts of falling.[71] This may lead to low self-confidence even when participating in nonhazardous activates. Rates of fear of falling in older adult communities range from 21.0% to 85.0% among those who have a history of falls and 33.0% to 46.0% among those who do not have a history of falling.[72] Basophobia and its related activity avoidance among the elderly may lead to a vicious cycle of falls and functional impairment. It is important to be aware of this when working with the older population and recommending preventive strategies. Many strategies include the participation in community and home-based exercise programs, cognitive behavioral therapy, yoga, meditation, and practicing good sleep hygiene.[73] Restriction of these activities could lead to muscle weakness, postural instability, deconditioning and a higher prevalence of falls.

Healthy young individuals

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Accidents are the most common cause of falls involving healthy adults, which may be the result of tripping on stairs, improper footwear, dark surroundings, slippery surfaces, uneven ground, or lack of exercise. Studies suggest that women are more prone to falling than men in all age groups.[74] The most common injuries among younger patients occur in the hands, wrists, knees, and ankles.[74]

See also

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References

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  1. ^ a b Finnegan, Susanne; Seers, Kate; Bruce, Julie (June 2019). "Long-term follow-up of exercise interventions aimed at preventing falls in older people living in the community: a systematic review and meta-analysis". Physiotherapy. 105 (2): 187–199. doi:10.1016/j.physio.2018.09.002. PMID 30846193.
  2. ^ a b c Moylan KC, Binder EF (June 2007). "Falls in older adults: risk assessment, management and prevention". The American Journal of Medicine. 120 (6): 493.e1–6. doi:10.1016/j.amjmed.2006.07.022. PMID 17524747.
  3. ^ Centers for Disease Control and Prevention. "Non-fatal injury report". WISQARS database. US Government. Archived from the original on 6 March 2018. Retrieved 2 December 2017.
  4. ^ Gates, Simon; Smith, Lesley A.; Fisher, Joanne D.; Lamb, Sarah E. (2008). "Systematic review of accuracy of screening instruments for predicting fall risk among independently living older adults". Journal of Rehabilitation Research and Development. 45 (8): 1105–1116. doi:10.1682/JRRD.2008.04.0057 (inactive 1 November 2024). ISSN 1938-1352. PMID 19235113.{{cite journal}}: CS1 maint: DOI inactive as of November 2024 (link)
  5. ^ Ganz DA, Bao Y, Shekelle PG, Rubenstein LZ (January 2007). "Will my patient fall?". JAMA. 297 (1): 77–86. doi:10.1001/jama.297.1.77. PMID 17200478.
  6. ^ Park, Seong-Hi (January 2018). "Tools for assessing fall risk in the elderly: a systematic review and meta-analysis". Aging Clinical and Experimental Research. 30 (1): 1–16. doi:10.1007/s40520-017-0749-0. ISSN 1720-8319. PMID 28374345. S2CID 24579938.
  7. ^ Gade, Gustav Valentin; Jørgensen, Martin Grønbech; Ryg, Jesper; Riis, Johannes; Thomsen, Katja; Masud, Tahir; Andersen, Stig (2021-05-04). "Predicting falls in community-dwelling older adults: a systematic review of prognostic models". BMJ Open. 11 (5): e044170. doi:10.1136/bmjopen-2020-044170. ISSN 2044-6055. PMC 8098967. PMID 33947733.
  8. ^ a b Patti, Antonino; Zangla, Daniele; Sahin, Fatma Nese; Cataldi, Stefania; Lavanco, Gioacchino; Palma, Antonio; Fischietti, Francesco (2021-04-02). "Physical exercise and prevention of falls. Effects of a Pilates training method compared with a general physical activity program: A randomized controlled trial". Medicine. 100 (13): e25289. doi:10.1097/MD.0000000000025289. hdl:10447/527083. PMC 8021317. PMID 33787615.
  9. ^ Overstall, P. W. (May 2003). "The use of balance training in elderly people with falls". Reviews in Clinical Gerontology. 13 (2): 153–161. doi:10.1017/S0959259803013273. ISSN 1469-9036.
  10. ^ a b c Evans, W J (1999-01-01). "Exercise training guidelines for the elderly". Medicine and Science in Sports and Exercise. 31 (1): 12–17. doi:10.1097/00005768-199901000-00004. ISSN 1530-0315. PMID 9927004.
  11. ^ a b c d Papa EV, Dong X, Hassan M (13 June 2017). "Resistance training for activity limitations in older adults with skeletal muscle function deficits: a systematic review". Clinical Interventions in Aging. 12: 955–961. doi:10.2147/CIA.S104674. PMC 5479297. PMID 28670114.
  12. ^ Izquierdo, Mikel; Merchant, R.A.; Morley, J.E.; Anker, S.D.; Aprahamian, I.; Arai, H.; Aubertin-Leheudre, M.; Bernabei, R.; Cadore, E.L.; Cesari, M.; Chen, L.-K.; de Souto Barreto, P.; Duque, G.; Ferrucci, L.; Fielding, R.A. (2021-07-01). "International Exercise Recommendations in Older Adults (ICFSR): Expert Consensus Guidelines". The Journal of Nutrition, Health and Aging. 25 (7): 824–853. doi:10.1007/s12603-021-1665-8. hdl:11343/289542. ISSN 1279-7707. PMID 34409961.
  13. ^ Wu, Shuang; Guo, Yongzhen; Cao, Zeng; Nan, Jiahui; Zhang, Qiuxiang; Hu, Mingyue; Ning, Hongting; Huang, Weiping; Xiao, Lily Dongxia; Feng, Hui (2024-09-01). "Effects of Otago exercise program on physical function in older adults: A systematic review and meta-analysis of randomized controlled trials". Archives of Gerontology and Geriatrics. 124: 105470. doi:10.1016/j.archger.2024.105470. ISSN 0167-4943. PMID 38718487.
  14. ^ "Los Parques de Mayores: Análisis y propuestas de intervención" [The Parks for the Elderly: Analysis and intervention proposals] (PDF) (in Spanish). Seville, Spain: Universidad Pablo de Olavide. Archived (PDF) from the original on 2021-07-14. Retrieved 2020-12-03.
  15. ^ Thomas, Ewan; Battaglia, Giuseppe; Patti, Antonino; Brusa, Jessica; Leonardi, Vincenza; Palma, Antonio; Bellafiore, Marianna (July 2019). "Physical activity programs for balance and fall prevention in elderly: A systematic review". Medicine. 98 (27): e16218. doi:10.1097/MD.0000000000016218. PMC 6635278. PMID 31277132.
  16. ^ Długosz-Boś, Małgorzata; Filar-Mierzwa, Katarzyna; Stawarz, Robert; Ścisłowska-Czarnecka, Anna; Jankowicz-Szymańska, Agnieszka; Bac, Aneta (January 2021). "Effect of Three Months Pilates Training on Balance and Fall Risk in Older Women". International Journal of Environmental Research and Public Health. 18 (7): 3663. doi:10.3390/ijerph18073663. ISSN 1660-4601. PMC 8037700. PMID 33915843.
  17. ^ Thomas, Ewan; Battaglia, Giuseppe; Patti, Antonino; Brusa, Jessica; Leonardi, Vincenza; Palma, Antonio; Bellafiore, Marianna (July 2019). "Physical activity programs for balance and fall prevention in elderly: A systematic review". Medicine. 98 (27): e16218. doi:10.1097/MD.0000000000016218. PMC 6635278. PMID 31277132.
  18. ^ a b Osho, Oluwaseyi; Owoeye, Oluwatoyosi; Armijo-Olivo, Susan (2018-04-01). "Adherence and Attrition in Fall Prevention Exercise Programs for Community-Dwelling Older Adults: A Systematic Review and Meta-Analysis". Journal of Aging and Physical Activity. 26 (2): 304–326. doi:10.1123/japa.2016-0326. ISSN 1543-267X. PMID 28771111.
  19. ^ R, Salazar (2019). "2019 Survey Results: Outpatient PT & OT Clinicians & Clinic Owners". Retrieved June 2, 2020.
  20. ^ Lin JT, Lane JM (January 2008). "Nonpharmacologic management of osteoporosis to minimize fracture risk". Nature Clinical Practice. Rheumatology. 4 (1): 20–5. doi:10.1038/ncprheum0702. PMID 18172445. S2CID 24451002.
  21. ^ Robitaille, Yvonne; Laforest, Sophie; Fournier, Michel; Gauvin, Lise; Parisien, Manon; Corriveau, Hélène; Trickey, Francine; Damestoy, Nicole (November 2005). "Moving Forward in Fall Prevention: An Intervention to Improve Balance Among Older Adults in Real-World Settings". American Journal of Public Health. 95 (11): 2049–2056. doi:10.2105/AJPH.2004.057612. ISSN 0090-0036. PMC 1449482. PMID 16195514.
  22. ^ a b Howard B, Baca R, Bilger M, Cali S, Kotarski A, Parrett K, Skibinski K (2018-07-03). "Investigating Older Adults' Expressed Needs Regarding Falls Prevention". Physical & Occupational Therapy in Geriatrics. 36 (2–3): 201–220. doi:10.1080/02703181.2018.1520380. ISSN 0270-3181. S2CID 81971080.
  23. ^ Turner S, Arthur G, Lyons RA, Weightman AL, Mann MK, Jones SJ, et al. (February 2011). "Modification of the home environment for the reduction of injuries". The Cochrane Database of Systematic Reviews. 2011 (2): CD003600. doi:10.1002/14651858.CD003600.pub3. PMC 7003565. PMID 21328262.
  24. ^ a b Lockwood KJ, Taylor NF, Harding KE (April 2015). "Pre-discharge home assessment visits in assisting patients' return to community living: A systematic review and meta-analysis". Journal of Rehabilitation Medicine. 47 (4): 289–99. doi:10.2340/16501977-1942. PMID 25782842.
  25. ^ McKinney R (26 March 2020). "Exciting Advancements in Fall Prevention Technology". Safesite. Archived from the original on 26 November 2020. Retrieved 3 December 2020.
  26. ^ "Prevent Accidents in the Bathroom with These Toilet Safety Rails". AgingInPlace.org. 4 December 2018. Archived from the original on 27 January 2021. Retrieved 3 December 2020.[unreliable medical source?]
  27. ^ a b Fick DM, Cooper JW, Wade WE, Waller JL, Maclean JR, Beers MH (8 December 2003). "Updating the Beers criteria for potentially inappropriate medication use in older adults: results of a US consensus panel of experts". Archives of Internal Medicine. 163 (22): 2716–24. doi:10.1001/archinte.163.22.2716. PMID 14662625. S2CID 21193386.
  28. ^ Montero-Odasso, Manuel M.; Kamkar, Nellie; Pieruccini-Faria, Frederico; Osman, Abdelhady; Sarquis-Adamson, Yanina; Close, Jacqueline; Hogan, David B.; Hunter, Susan Winifred; Kenny, Rose Anne; Lipsitz, Lewis A.; Lord, Stephen R.; Madden, Kenneth M.; Petrovic, Mirko; Ryg, Jesper; Speechley, Mark (2021-12-01). "Evaluation of Clinical Practice Guidelines on Fall Prevention and Management for Older Adults: A Systematic Review". JAMA Network Open. 4 (12): e2138911. doi:10.1001/jamanetworkopen.2021.38911. ISSN 2574-3805. PMC 8674747. PMID 34910151.
  29. ^ Rubenstein, Laurence Z.; Josephson, Karen R. (September 2006). "Falls and Their Prevention in Elderly People: What Does the Evidence Show?". Medical Clinics of North America. 90 (5): 807–824. doi:10.1016/j.mcna.2006.05.013. PMID 16962843.
  30. ^ Cameron ID, Dyer SM, Panagoda CE, Murray GR, Hill KD, Cumming RG, Kerse N (September 2018). "Interventions for preventing falls in older people in care facilities and hospitals". The Cochrane Database of Systematic Reviews. 9 (9): CD005465. doi:10.1002/14651858.CD005465.pub4. PMC 6148705. PMID 30191554.
  31. ^ Sherrington, Catherine; Fairhall, Nicola; Kwok, Wing; Wallbank, Geraldine; Tiedemann, Anne; Michaleff, Zoe A.; Ng, Christopher A. C. M.; Bauman, Adrian (2020-11-26). "Evidence on physical activity and falls prevention for people aged 65+ years: systematic review to inform the WHO guidelines on physical activity and sedentary behaviour". The International Journal of Behavioral Nutrition and Physical Activity. 17 (1): 144. doi:10.1186/s12966-020-01041-3. ISSN 1479-5868. PMC 7689963. PMID 33239019.
  32. ^ Mahoney, Jane E. (2010-07-12). "Why Multifactorial Fall-Prevention Interventions May Not Work". Archives of Internal Medicine. 170 (13): 1117–1119. doi:10.1001/archinternmed.2010.193. ISSN 0003-9926. PMID 20625016.
  33. ^ Tinetti, Mary E.; Baker, Dorothy I.; McAvay, Gail; Claus, Elizabeth B.; Garrett, Patricia; Gottschalk, Margaret; Koch, Marie L.; Trainor, Kathryn; Horwitz, Ralph I. (1994-09-29). "A Multifactorial Intervention to Reduce the Risk of Falling among Elderly People Living in the Community". New England Journal of Medicine. 331 (13): 821–827. doi:10.1056/NEJM199409293311301. ISSN 0028-4793. PMID 8078528.
  34. ^ Gerards MH, McCrum C, Mansfield A, Meijer K (December 2017). "Perturbation-based balance training for falls reduction among older adults: Current evidence and implications for clinical practice". Geriatrics & Gerontology International. 17 (12): 2294–2303. doi:10.1111/ggi.13082. PMC 5763315. PMID 28621015.
  35. ^ Pijnappels M, Reeves ND, Maganaris CN, van Dieën JH (April 2008). "Tripping without falling; lower limb strength, a limitation for balance recovery and a target for training in the elderly". Journal of Electromyography and Kinesiology. 18 (2): 188–96. doi:10.1016/j.jelekin.2007.06.004. PMID 17761436.
  36. ^ Larsson L, Degens H, Li M, Salviati L, Lee YI, Thompson W, et al. (January 2019). "Sarcopenia: Aging-Related Loss of Muscle Mass and Function". Physiological Reviews. 99 (1): 427–511. doi:10.1152/physrev.00061.2017. PMC 6442923. PMID 30427277.
  37. ^ Rasche P, Mertens A, Bröhl C, Theis S, Seinsch T, Wille M, et al. (8 May 2017). "The "Aachen fall prevention App" - a Smartphone application app for the self-assessment of elderly patients at risk for ground level falls". Patient Safety in Surgery. 11: 14. doi:10.1186/s13037-017-0130-4. PMC 5422970. PMID 28503199.
  38. ^ Morris, Meg E; Webster, Kate; Jones, Cathy; Hill, Anne-Marie; Haines, Terry; McPhail, Steven; Kiegaldie, Debra; Slade, Susan; Jazayeri, Dana; Heng, Hazel; Shorr, Ronald; Carey, Leeanne; Barker, Anna; Cameron, Ian (2022-05-01). "Interventions to reduce falls in hospitals: a systematic review and meta-analysis". Age and Ageing. 51 (5). doi:10.1093/ageing/afac077. ISSN 0002-0729. PMC 9078046. PMID 35524748.
  39. ^ a b Imison, Candace (24 October 2024). "Frailty: research shows how to improve care". NIHR Evidence. National Institute for Health and Care Research. doi:10.3310/nihrevidence_64717.
  40. ^ Randell, Rebecca; McVey, Lynn; Wright, Judy; Zaman, Hadar; Cheong, V-Lin; Woodcock, David M; Healey, Frances; Dowding, Dawn; Gardner, Peter; Hardiker, Nicholas R; Lynch, Alison; Todd, Chris; Davey, Christopher; Alvarado, Natasha (March 2024). "Practices of falls risk assessment and prevention in acute hospital settings: a realist investigation". Health and Social Care Delivery Research: 1–194. doi:10.3310/JWQC5771. ISSN 2755-0079.
  41. ^ Ren, Yuanyuan; Lin, Chenli; Zhou, Qin; Yingyuan, Zhang; Wang, Guodong; Lu, Aming (19 January 2023). "Effectiveness of virtual reality games in improving physical function, balance and reducing falls in balance-impaired older adults: A systematic review and meta-analysis". Archives of Gerontology and Geriatrics. 108: 104924. doi:10.1016/j.archger.2023.104924.
  42. ^ Hill KD, Suttanon P, Lin SI, Tsang WW, Ashari A, Hamid TA, et al. (January 2018). "What works in falls prevention in Asia: a systematic review and meta-analysis of randomized controlled trials". BMC Geriatrics. 18 (1): 3. doi:10.1186/s12877-017-0683-1. PMC 5756346. PMID 29304749.
  43. ^ Herold, Fabian; Hamacher, Dennis; Schega, Lutz; Müller, Notger G. (2018). "Thinking While Moving or Moving While Thinking – Concepts of Motor-Cognitive Training for Cognitive Performance Enhancement". Frontiers in Aging Neuroscience. 10: 228. doi:10.3389/fnagi.2018.00228. ISSN 1663-4365. PMC 6089337. PMID 30127732.
  44. ^ Chung, Seok Jong; Lee, Jae Jung; Lee, Phil Hyu; Sohn, Young H. (2020). "Emerging Concepts of Motor Reserve in Parkinson's Disease". Journal of Movement Disorders. 13 (3): 171–184. doi:10.14802/jmd.20029. PMC 7502292. PMID 32854486.
  45. ^ Gillespie L (February 2013). Tovey D (ed.). "Preventing falls in older people: the story of a Cochrane review". The Cochrane Database of Systematic Reviews. 2013 (2): ED000053. doi:10.1002/14651858.ED000053. PMC 10846353. PMID 23543586.
  46. ^ Yoshikawa TT, Cobbs EL, Brummel-Smith K (1993). Ambulatory Geriatric Care. Mosby. ISBN 978-0-8016-6543-1.[page needed]
  47. ^ O'Loughlin JL, Robitaille Y, Boivin JF, Suissa S (February 1993). "Incidence of and risk factors for falls and injurious falls among the community-dwelling elderly". American Journal of Epidemiology. 137 (3): 342–54. doi:10.1093/oxfordjournals.aje.a116681. PMID 8452142.
  48. ^ Winter DA, Patla AE, Frank JS, Walt SE (June 1990). "Biomechanical walking pattern changes in the fit and healthy elderly". Physical Therapy. 70 (6): 340–7. doi:10.1093/ptj/70.6.340. PMID 2345777.
  49. ^ Elble RJ, Thomas SS, Higgins C, Colliver J (February 1991). "Stride-dependent changes in gait of older people". Journal of Neurology. 238 (1): 1–5. doi:10.1007/BF00319700. PMID 2030366. S2CID 20197857.
  50. ^ Snijders AH, van de Warrenburg BP, Giladi N, Bloem BR (January 2007). "Neurological gait disorders in elderly people: clinical approach and classification". The Lancet. Neurology. 6 (1): 63–74. doi:10.1016/S1474-4422(06)70678-0. PMID 17166803. S2CID 31984607.
  51. ^ Maki BE (March 1997). "Gait changes in older adults: predictors of falls or indicators of fear". Journal of the American Geriatrics Society. 45 (3): 313–20. doi:10.1111/j.1532-5415.1997.tb00946.x. PMID 9063277. S2CID 31970427.
  52. ^ Musich S, Wang SS, Ruiz J, Hawkins K, Wicker E (March 2018). "The impact of mobility limitations on health outcomes among older adults". Geriatric Nursing. 39 (2): 162–169. doi:10.1016/j.gerinurse.2017.08.002. PMID 28866316. S2CID 3981042.
  53. ^ Chatzistergos, Panagiotis E.; Healy, Aoife; Balasubramanian, Gayathri; Sundar, Lakshmi; Ramachandran, Ambady; Chockalingam, Nachiappan (September 2020). "Reliability and validity of an enhanced paper grip test; A simple clinical test for assessing lower limb strength" (PDF). Gait & Posture. 81: 120–125. doi:10.1016/j.gaitpost.2020.07.011. PMID 32711330. S2CID 220773361.
  54. ^ "Falls". Medline Plus. U.S. National Library of Medicine. Archived from the original on 2021-01-09. Retrieved 2020-12-27.
  55. ^ "Caídas en personas mayores: riesgo, causas y prevención" [Falls in the elderly: risks, causes and prevention]. Geriatricarea (in Spanish). 16 March 2016. Archived from the original on 24 October 2020. Retrieved 3 December 2020.[unreliable medical source?]
  56. ^ Edith, Sullivan; Margaret, Rosenbloom; Anjali, Deshmukh; John, Desmond; Adolf, Pfefferbaum (1995). "Alcohol and the cerebellum". Alcohol Health and Research World. 19 (2): 138–141. PMC 6875723. PMID 31798074.
  57. ^ a b Weerdesteyn V, de Niet M, van Duijnhoven HJ, Geurts AC (2008). "Falls in individuals with stroke". Journal of Rehabilitation Research and Development. 45 (8): 1195–213. doi:10.1682/JRRD.2007.09.0145 (inactive 1 November 2024). hdl:2066/70270. PMID 19235120. ProQuest 215286948.{{cite journal}}: CS1 maint: DOI inactive as of November 2024 (link)
  58. ^ Tsur A, Segal Z (April 2010). "Falls in stroke patients: risk factors and risk management". The Israel Medical Association Journal. 12 (4): 216–9. PMID 20803880.
  59. ^ Yang YR, Chen YC, Lee CS, Cheng SJ, Wang RY (February 2007). "Dual-task-related gait changes in individuals with stroke". Gait & Posture. 25 (2): 185–90. doi:10.1016/j.gaitpost.2006.03.007. PMID 16650766.
  60. ^ Allen NE, Schwarzel AK, Canning CG (5 March 2013). "Recurrent falls in Parkinson's disease: a systematic review". Parkinson's Disease. 2013: 906274. doi:10.1155/2013/906274. PMC 3606768. PMID 23533953.
  61. ^ Wood BH, Bilclough JA, Bowron A, Walker RW (June 2002). "Incidence and prediction of falls in Parkinson's disease: a prospective multidisciplinary study". Journal of Neurology, Neurosurgery, and Psychiatry. 72 (6): 721–5. doi:10.1136/jnnp.72.6.721. PMC 1737913. PMID 12023412. S2CID 18378056.
  62. ^ Koller WC, Silver DE, Lieberman A (December 1994). "An algorithm for the management of Parkinson's disease". Neurology. 44 (12 Suppl 10): S1-52. PMID 7854513.
  63. ^ Finlayson ML, Peterson EW, Cho CC (September 2006). "Risk factors for falling among people aged 45 to 90 years with multiple sclerosis". Archives of Physical Medicine and Rehabilitation. 87 (9): 1274–9, quiz 1287. doi:10.1016/j.apmr.2006.06.002. PMID 16935067.
  64. ^ Socie MJ, Sosnoff JJ (2013). "Gait variability and multiple sclerosis". Multiple Sclerosis International. 2013: 645197. doi:10.1155/2013/645197. PMC 3603667. PMID 23533759.
  65. ^ Severini G, Manca M, Ferraresi G, Caniatti LM, Cosma M, Baldasso F, et al. (June 2017). "Evaluation of Clinical Gait Analysis parameters in patients affected by Multiple Sclerosis: Analysis of kinematics". Clinical Biomechanics. 45: 1–8. doi:10.1016/j.clinbiomech.2017.04.001. PMID 28390935. S2CID 24378620.
  66. ^ Cattaneo D, De Nuzzo C, Fascia T, Macalli M, Pisoni I, Cardini R (June 2002). "Risks of falls in subjects with multiple sclerosis". Archives of Physical Medicine and Rehabilitation. 83 (6): 864–7. doi:10.1053/apmr.2002.32825. PMID 12048669.
  67. ^ Krupp LB, Christodoulou C (May 2001). "Fatigue in multiple sclerosis". Current Neurology and Neuroscience Reports. 1 (3): 294–8. doi:10.1007/s11910-001-0033-7. PMID 11898532. S2CID 28222172.
  68. ^ van Dijk PT, Meulenberg OG, van de Sande HJ, Habbema JD (April 1993). "Falls in dementia patients". The Gerontologist. 33 (2): 200–4. doi:10.1093/geront/33.2.200. PMID 8468012.
  69. ^ Shaw FE (2003). "Falls in older people with dementia" (PDF). Great Aging. 6 (7): 37–40. Archived (PDF) from the original on 2020-12-05. Retrieved 2020-12-27.
  70. ^ Olesen J (10 February 2014). "Fear of Falling Phobia - Basiphobia". FEAROF.NET. Archived from the original on 30 November 2020. Retrieved 3 December 2020.
  71. ^ Chen, Wei-Cheng; Li, Yang-Tzu; Tung, Tao-Hsin; Chen, Chieh; Tsai, Ching-Yao (2021-07-02). "The relationship between falling and fear of falling among community-dwelling elderly". Medicine. 100 (26): e26492. doi:10.1097/MD.0000000000026492. PMC 8257838. PMID 34190176.
  72. ^ Souza, Larissa Franciny de; Canever, Jaquelini Betta; Moreira, Bruno de Souza; Danielewicz, Ana Lúcia; Avelar, Núbia Carelli Pereira de (2022-02-09). "Association Between Fear of Falling and Frailty in Community-Dwelling Older Adults: A Systematic Review". Clinical Interventions in Aging. 17: 129–140. doi:10.2147/CIA.S328423. PMC 8843349. PMID 35173427.
  73. ^ Camerlingo, Claudia (2023-05-15). "The complexity of basophobia and aging: covariates and consequences". European Review. Retrieved 2024-11-07.
  74. ^ a b Talbot LA, Musiol RJ, Witham EK, Metter EJ (August 2005). "Falls in young, middle-aged and older community dwelling adults: perceived cause, environmental factors and injury". BMC Public Health. 5 (1): 86. doi:10.1186/1471-2458-5-86. PMC 1208908. PMID 16109159.

Further reading

[edit]
  • Lord SR, Sherrington C, Menz HB, Close JC (March 2007). Falls in Older People: Risk Factors and Strategies for Prevention. Cambridge University Press. ISBN 978-0-521-68099-8.
[edit]
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