Falls


Effects of Single-Task Versus Dual-Task Training on Balance Performance in Older Adults: A Double-Blind, Randomized Controlled Trial

Patima Silsupadol, PT, PhD, Anne Shumway-Cook, PT, PhD, Vipul Lugade, MS, Paul van Donkelaar, PhD,
Li-Shan Chou, PhD, Ulrich Mayr, PhD, Marjorie H. Woollacott, PhD

Summary:
Dual-task training is effective in improving gait speed under dual-task conditions in elderly participants with balance impairment. Training balance under single-task conditions may not generalize to balance control during dual- task contexts. Explicit instruction regarding attentional focus is an important factor contributing to the rate of learning and the retention of the dual-task training effect.

Year study was published: 2009

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Association of Dance-Based Mind-Motor Activities With Falls and Physical Function Among Healthy Older Adults A Systematic Review and Meta-analysis

Michèle Mattle, MSc, MPH; Patricia O. Chocano-Bedoya, MD, PhD; Melanie Fischbacher, MSc; Ursina Meyer, PhD; Lauren A. Abderhalden, PhD; Wei Lang, PhD; Richard Mansky, MD; Reto W. Kressig, MD; Johann Steurer, MD; E. John Orav, PhD; Heike A. Bischoff-Ferrari, MD, DrPH

Summary:
Are dance-based mind-motor activities associated with benefits for fall prevention and better physical functions, such as balance, mobility, and strength, in healthy adults 65 years and older? This systematic review and meta-analysis of 29 randomized clinical trials found that dance based mind-motor interventions were associated with a statistically significant reduction (37%) in fall risk and a statistically significant reduced rate (31%) of falls. There was a statistically significant association between favorable physical function outcomes and dance-based mind-motor activities for participants in the dance-based mind-motor intervention groups compared with those in the control groups.

Dance-based mind-motor activities may help fall prevention efforts in healthy older adults.

Year study was published: 2020

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Dual-task exercises in older adults: A structured review of current literature

Luz A. Varela-Vásquez, Eduard Minobes-Molina, Javier Jerez-Roig


Summary:

Considerable attention has recently focused on the role of dual-task exercises (DT) in the older adult. The aim was to conduct a review to describe the dual-task exercises that have been shown to be effective in improving balance and other physical characteristics such as decreased falling and walking speed in older adults. Review of intervention studies, in the Pubmed, PEDro, CINAHL and Web of Science databases. The search produced 498 references, 11 of which were identified with the description of the dual-task exercises, finding a wide variety of exercises, as well as great variability of outcome measures, discovering that the dual task is predominantly used for balance and walking speed training. All studies presented at least one group performing a double cognitive-motor task, some studies used the fixed priority modality in one group and variable in another, finding greater improvements in variable prioritisation. It can be said that dual-task training in older adults can improve balance and walking speed, which in turn reduces the risk of falling only if the planned dual-task training meets certain characteristics, such as training in specific concepts crucial in motor learning and dual-task training modalities.


Year study was published: 2020

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Disseminating Tai Chi in the Community: Promoting Home Practice and Improving Balance

Betty Chewning, PhD, Dale Wilson, MA, Jane E Mahoney, MD, Kristine M Hallisy, PT, DSc, Nisaratana Sangasubana, PhD, Ronald Gangnon, PhD 

Summary:

Falls among older adults is a pressing public health challenge. Considerable research documents that longer tai chi courses can reduce falls and improve balance. However, longer courses can be challenging to implement. Our goal was to evaluate whether a short 6-week modified tai chi course could be effective at reducing falls risk if older adults designed a personal home practice plan to receive a greater tai chi “dose” during the 6 weeks.

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The Association Between Timed Up and Go Test and History of Falls: The Tromsø Study

Gyrd Thrane, Ragnar M Joakimsen and Eline Thornquist

Summary:

A relationship between TUG time and history of falls in men but not in women was determined. However, the clinical relevance of this associated is limited due to the relatively small statistical significance found between the results male fallers and non-fallers as well as the inconsistent results of falls questionnaires. The conclusion of the research was the TUG may not be used as a test of fall risk in an ambulatory elderly population.

Year study was published: 2018

Mean age of participants in study: 74-89 years

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Otago Exercise Program in the United States: Comparison of 2 Implementation Models

Tiffany E. Shubert, Matthew L. Smith, Lavina Goto, Luohua Jiang, Marcia G. Ory

Summary:

Otago Exercise Program (OEP) is a fall prevention program that consists of 5 warm-up exercises and 17 strength and balance exercises, which are progressed over the course of the program. This program can be administered by a PT or other healthcare professional in a home health or outpatient setting (US OEP) or in a community based setting (community OEP). This study reports significant improvements in physical and self-reported measures in both US and community OEP. There were no significant differences in improvements of outcomes measures (TUG, 30-second chair rise test, and four-stage balance test) between community and US OEP; therefore, the less costly community OEP can achieve results similar to those achieved with US OEP – especially with Timed “Up & Go” as concluded by this study.

Year study was published: 2017

Mean age of participants in study: 80 years old

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Balance Confidence and Fear of Falling Avoidance Behavior Are Most Predictive of Falling in Older Adults: Prospective Analysis

Merrill R. Landers, Sarrie Oscar, Jessica Sasaoka, Kyle Vaughn

Summary:

Physical-based measures (Berg Balance Scale, Sensory Organization Test, Timed “Up & Go”, and Dynamic Gait Index) as well as psychological-based measures (Falls Efficacy Scale, Activity Specific Balance Confidence Scale, and Fear of Falling Avoidance Behavior Questionnaire) were assessed during this study to determine which variable(s) were most predictive of falls in older adults. The results of this study concluded that balance confidence was the best predictor of falling, followed by fear of falling avoidance behavior, and the Time “Up & Go” (TUG). Fall history, presence of pathology, and physical tests did not predict falling. The study also concluded that psychological factors (balance confidence and fear avoidance) were stronger predictors of future falls than physical factors (gait, balance, visual acuity, etc.)

Year study was published: 2018

Mean age of participants in study: 72.2 years

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The Effectiveness of a Community-Based Program for Reducing the Incidence of Falls in the Elderly: A Randomized Trial

Lindy Clemson, BAppSc(OT), MAppSc(OT), PhD, Robert G. Cumming, MBBS, MPH, PhD,zk Hal and Kendig, Kirsty Taylor, MPI, PhD, BA(Psych), Megan Swann, BAppSc(OT),z Robert Heard, BA(Hons), PhD,w

Summary: This 14 month randomized trial concluded Stepping On (a multifaceted community-based program using a small-group learning environment which aims to improve fall self-efficacy, encourage behavioral change, and reduce falls all together) was effective for reducing falls in communityresiding elderly people. This was demonstrated by the Stepping On group experienced a 31% reduction in falls. The Stepping On program was determined to be especially effective for men.

Year study was published: 2004

Mean age of participants in study: 78 years old

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Effects of Dancing on the Risk of Falling Related Factors of Healthy Older Adults: A Systematic Review

Esther Lopez Fernandez-Arguelles, Juan Rodriguez-Mansilla, Luis Espejo Antunez,  Elisa Maria Garrido-Ardila, Rafael Perez Munoz

Summary:

This article compiled data from 7 articles to determine the therapeutic effects of dancing as a physical exercise modality on balance, flexibility, gait, muscle strength, and physical performance in older adults. These studies did show positive effects on reducing the risk of falls in relation to improved balance, gait and dynamic mobility, strength and flexibility; however, they were unable to confirm that dance has significant benefits on the aforementioned factors based on scientific evidence due to problems with study designs.

Year study was published: 2015

Mean age of participants in study: 72 years old

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Evidence-Based Exercise Prescription for Balance and Falls Prevention: A Current Review of the Literature

by Tiffany E. Shubert, MPT, PhD

Summary:

The current best practices for physical therapists to effectively improve balance and manage fall risk in patients are those that incorporate a structured, progressing, individually tailored exercise program that meets the optimal exercise dose. These interventions need to continue even after discharge from physical therapy and therefore a continuum of care approach is needed in order to maintain progress, continue to improve upon their abilities, sustain meaningful and permanent changes in risk factors, and ultimately reduce falls risk.

Year study was published: 2011

Mean age of participants in study: N/A

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Exercise to Prevent Falls in Older Adults: An Updated Meta-Analysis and Best Practice Recommendations

by Catherine Sherrington, Anne Tiedemann, Nicola Fairhall, Jacqueline C.T. Close and Stephen R. Lord

Summary:

This updated systematic review compiled data from 99 comparisons from 88 randomized controlled trials, totaling 19,478 participants, looking at exercise as a single intervention to prevent falls. They concluded that exercise for falls prevention at least three (3) hours per week showed the greatest effects and should be targeted at both the general community as well as those at high risk of falls and may occur in both a group or home-based setting. The exercise programs should include: moderate to high challenges to balance as well as strength training, a sufficient dose of exercise, exercise needs to be ongoing, and should include a brisk walking training, unless they are a high risk falls individual.

Year study was published: 2017

Mean age of participants in study: 65+ years old

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Can Social Dancing Prevent Falls in Older Adults? A Protocol of the Dance, Aging, Cognition, Economics (DAnCE) Fall Prevention Randomized Controlled Trial

by Dafna Merom, Robert Cumming, Erin Mathieu, Kaarin J Anstey, Chris Rissel, Judy M Simpson, Rachael L Morton, Ester Cerin, Catherine Sherrington and Stephen R Lord

Summary:

In this Australian study they are determining whether participation in social dancing will: reduce the number of falls and improve cognitive functions associated with fall risk in older people. Participants in the study completed 80 hours of dance classes (either Folk or ballroom dancing) during a 12 month period – classes were an hour long and met twice a week. The researchers concluded dance offers a novel approach to balance training and offers greater social engagement, which is a major contribution to healthy aging.

Year study was published: 2013

Mean age of participants in study: ??

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Balance Confidence and Fear of Falling Avoidance Behavior Are Most Predictive of Falling in Older Adults

by Merrill R. Landers, Sarrie Oscar, Jessica Sasoka & Kyle Vaughn

Summary:

Physical-based measures (Berg Balance Scale, Sensory Organization Test, Timed “Up & Go”, and Dynamic Gait Index) as well as psychological-based measures (Falls Efficacy Scale, Activity Specific Balance Confidence Scale, and Fear of Falling Avoidance Behavior Questionnaire) were assessed during this study to determine which variable(s) were most predictive of falls in older adults. The results of this study concluded that balance confidence was the best predictor of falling, followed by fear of falling avoidance behavior, and the Time “Up & Go” (TUG). Fall history, presence of pathology, and physical tests did not predict falling. The study also concluded that psychological factors (balance confidence and fear avoidance) were stronger predictors of future falls than physical factors (gait, balance, visual acuity, etc.)

Year study was published: 2018

Mean age of participants in study: 72.2 years

Click here to read the full article