Download or read book Implementing a Modified Otago Exercise Program for Fall Prevention Using the Health Belief Model for Communty dwelling Seniors in the Senior Center Setting written by Theodora Barenholtz and published by . This book was released on 2018 with total page 92 pages. Available in PDF, EPUB and Kindle. Book excerpt: In this study, the implementation of a fall prevention exercise program for community-dwelling seniors based on a behavior change component using the Health Belief Model (HBM) was studied. The Otago Exercise Program (OEP) was administered to groups of seniors in three senior center settings for five sessions over eight weeks with a follow-up at 12 weeks. The study design was a quasi-experimental, nonrandomized control group with blinded pre-test and post-test. The primary outcome was balance ability, measured using the Berg Balance Scale (BBS). The secondary outcomes were attitudes toward fall prevention using a survey based on the HBM constructs. The study hypothesis was that the OEP with behavior change based on the HBM would yield a more significant increase in the BBS score than the OEP group without the behavior change component. The results retained the null hypothesis, and there was not a significant difference between the groups. Both the OEP group and the OEP + HBM group experienced a significant improvement in balance as measured by the BBS. There was no significant change in attitudes as measured by the survey for the intervention group. The clinical importance of this study was the investigation of a novel approach to implementing a fall prevention exercise program. The study indicates that as few as five sessions of group fall prevention exercises can achieve significant improvements in balance for community-dwelling seniors.

Download or read book Understanding Current Fall Prevention Program Design in Community based Exercise Programs for Older Adults in Canada written by Alexie Touchette and published by . This book was released on 2019 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Background: Falls - events by which an individual inadvertently comes to rest on the ground, floor, or lower level - present a major public health concern as they have potential to cause serious injury, admission to long-term care, and even death. Research has shown that training balance through exercise is effective at reducing falls in community-dwelling older adults. Specifically, evidence-based fall prevention exercise recommendations include at least three hours of high challenge balance exercise per week, on an ongoing basis. Community exercise programs are a potential delivery mode for implementing effective fall prevention exercises, however, little is known regarding current practice and whether they include effective fall prevention exercise recommendations. Objective: To describe characteristics of fall prevention and balance training community exercise programs for adults aged 50 years and older in Canada and determine whether the programs include the evidence-based exercise recommendations. To determine instructor and program characteristics associated with the inclusion of evidence-based recommendations. Methods: Instructors of fall prevention community exercise programs completed an electronic self-report questionnaire following a modified Dillman recruitment strategy. Questions explored program design, exercise content, target population, and demographic information. Exercises were coded for balance challenge using a previous coding scheme based on existing recommendations. Analysis followed stated objectives using descriptive statistics and multiple logistic regression. Results: 140 completed eligible responses were analyzed. One program (0.7%) included all recommendations for effective fall prevention exercise. 59 programs (42%) were offered on an ongoing basis, 1 program (0.7%) conducted at least three hours of balance exercises a week, and 133 programs (95%) prescribed mostly moderate or high challenge balance exercises. Based on descriptive statistics of programs including the recommendations, exploratory multiple logistic regression was conducted to determine instructor and/program characteristics associated with program duration. Instructor educational background in a related field and the prescription of home exercises were significantly associated with program duration. Conclusions: Most programs included at least one recommendation for effective fall prevention exercise, with only one program included all three. Future studies should focus on barriers and facilitators influencing design and delivery of community fall prevention exercise programs.

Download or read book Evidence Based Practices to Reduce Falls and Fall Related Injuries Among Older Adults written by Cassandra W. Frieson and published by Frontiers Media SA. This book was released on 2018-09-20 with total page 198 pages. Available in PDF, EPUB and Kindle. Book excerpt: Falls and fall-related injuries among older adults have emerged as serious global health concerns, which place a burden on individuals, their families, and greater society. As fall incidence rates increase alongside our globally aging population, fall-related mortality, hospitalizations, and costs are reaching never seen before heights. Because falls occur in clinical and community settings, additional efforts are needed to understand the intrinsic and extrinsic factors that cause falls among older adults; effective strategies to reduce fall-related risk; and the role of various professionals in interventions and efforts to prevent falls (e.g., nurses, physicians, physical therapists, occupational therapists, health educators, social workers, economists, policy makers). As such, this Research Topic sought articles that described interventions at the clinical, community, and/or policy level to prevent falls and related risk factors. Preference was given to articles related to multi-factorial, evidence-based interventions in clinical (e.g., hospitals, long-term care facilities, skilled nursing facilities, residential facilities) and community (e.g., senior centers, recreation facilities, faith-based organizations) settings. However, articles related to public health indicators and social determinants related to falls were also included based on their direct implications for evidence-based interventions and best practices.

Download or read book Fall Reduction Program for Seniors written by Julianna Whitehead and published by . This book was released on 2014 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Based on documented studies older adults/elderly falls are a major concern. Approximately 1/3 of community dwelling adults will fall in a year (Dickson and others, 2012). Falls can lead to mobility deficits, broken bones, loss of independence and death. In addition falls are the main cause for fatal injury in older adults. The financial burden of falls will be $67.7 billion by 2020 (CDC 2014). Research has shown that community dwelling seniors are at a high risk for falls. Implementing a free community based fall prevention program with education on intrinsic and extrinsic factors including activity of daily living (ADL's) and balance techniques the program can reduce potential for falls by 24.86% (Kittipimpanon, Amnatusatsue, Kerdmangkol, Jarupat- Maruo, and Nityasuddhi, 2012). This project would include a multidisciplinary team with classes to be held once a month. The program will start with introductions and a handout to assess the participant's knowledge of fall risk and fall prevention. The program will cover who, what, where, when and why falls occur with a power point presentation. Instructions will be given for safety in the home and community. Exercise basics will be taught to help improve balance and strength. Handouts will be provided to offer guidance in making one's environment safer as well as information on adaptive equipment to assist with reaching and bending, instructions on medications and ways to prevent orthostatic hypotension and dizziness. A survey at the end of the class will be given to assess for an increase in knowledge, option for a home evaluation and a follow up phone interview 6 months later to assess how the patient did and if any falls have occurred. A fall reduction program would benefit participants by raising awareness about falls and it would benefit the host facility because participants would be more likely to return to their facility when in need of care. When looking at the physical, emotional and financial toll falls have on an individual, their family and community, implementation of a fall reduction program will benefit stakeholder and participants.

Download or read book EVIDENCE BASED GUIDELINES OF F written by Man-Wai Law and published by Open Dissertation Press. This book was released on 2017-01-26 with total page 84 pages. Available in PDF, EPUB and Kindle. Book excerpt: This dissertation, "Evidence-based Guidelines of Fall Prevention Programme for Hospitalized Older Patients" by Man-wai, Law, 羅敏慧, was obtained from The University of Hong Kong (Pokfulam, Hong Kong) and is being sold pursuant to Creative Commons: Attribution 3.0 Hong Kong License. The content of this dissertation has not been altered in any way. We have altered the formatting in order to facilitate the ease of printing and reading of the dissertation. All rights not granted by the above license are retained by the author. Abstract: Background: Falls are one of the most common and serious problems facing the elderly and are known to be associated with significant mortality, morbidity, decreased functioning and premature institutionalization. In Hong Kong, the prevalence of falls among community-dwelling older adults is 19.3%. Moreover, the incidence of falls among older people in institutions is almost three times the fall rates for the community-dwelling elderly. Institutional falls are regarded as common adverse events in hospitalized older patients. Significant mortality, morbidity and healthcare costs associated with institutional falls led institutions to recognize falls as a high-priority safety risk for hospitalized patients. This demonstrated the significance of providing the health care providers with an evidenced-based practice guideline of an effective multifactorial fall prevention programme in order to prevent in-patient falls. Objectives: The objectives of the study are to systematically review and present the best evidence for the effectiveness of multifactorial fall prevention interventions in reducing falls in hospitals, to translate the reviewed evidence and to develop evidence-based practice guidelines for the multifactorial fall prevention programme as well as to develop a plan for implementing and evaluating the multifactorial fall prevention programme. Methods: The relevant literature was searched by several electronic databases. The related literature was then retrieved, reviewed and synthesized. The quality assessment of the studies was performed according to the methodological checklist for controlled trials designed by the Scottish intercollegiate Guideline Network (SIGN). Evidenced-based practice guidelines for the multifactorial fall prevention programme were then synthesized according to the findings of the reviewed literature, while the implementation potential being assessed in terms of transferability, feasibility and the cost-benefit ratio. Results: Five studies were identified according to the inclusion and exclusion criteria set. "Evidence-based guidelines of fall prevention programme for hospitalized older patients" were formulated based on the review of the selected studies. Fourteen recommendations of the evidence-based guidelines are formulated and graded according to the grading system of Scottish Intercollegiate Guidelines Network (SIGN). The evidence-based recommendations can offer nurses and other health care professionals the standards and strategies required for implementing multifactorial fall risk assessment and multifactorial fall prevention interventions, including environmental modifications, knowledge, medication reviews and exercise. A communication plan for various parties in hospitals including a pilot test for determining the feasibility of the innovation and an evaluation plan to determine the effectiveness of the fall prevention programme were subsequently developed. Conclusion: This study reviewed evidence for the effectiveness of the multifactorial fall prevention programme in reducing the incidence of falls, translated the reviewed evidence and developed evidence-based guidelines for a multifactorial fall prevention programme, which can provide the health care practitioners with an evidence-based approach in fall risk assessment and management so as to prevent in-patient falls. DOI: 10.5353/th_b5088408 Subjects: Fa

Download or read book Implementing Multifactorial Education Modules with Older Adults written by Salvador Chavez and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Falls are a significant concern for community-dwelling older adults (OAs), with one in four OAs reporting a fall every year. Occupational therapy students collaborated with first responders of the Novato Fire District to identify gaps in fall prevention community outreach programs and found that many interventions lack an interactive or individualized approach. Based on the gap analysis and current literature, seven education modules were developed to address key risk factors including home safety hazards, polypharmacy, fear of falling, and strength and balance exercises. Thirty community-dwelling OAs participated in the education modules that were implemented at two senior community sites in Marin County. Participants were screened via Functional Reach Test (FRT) and completed a survey to determine their personal risk factors for falling, which guided their personalized fall prevention education. Of the participants, 90% rated their experience with the education modules as "very good" or "excellent," and a majority indicated greatest satisfaction with the balance exercises. The interactive 1:1 education modules are an effective and innovative method for fall prevention education and highlight the importance of client-centered treatment.

Download or read book Lifestyle integrated Functional Exercise LiFE program to prevent falls written by Lindy Clemson and published by Sydney University Press. This book was released on 2014-07-12 with total page 102 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Lifestyle-integrated Functional Exercise (LiFE) program is a way of reducing the risk of falls by integrating balance and strength activities into regular daily tasks. Unloading the dishwasher becomes an opportunity to improve strength. Brushing your teeth becomes an opportunity to improve balance. In the LiFE program, every daily task becomes an opportunity to improve balance and strength. This is a different approach to a traditional program where you would be required to complete a series of exercises a certain number of times a day for a set number of days each week. The trainer's manual outlines the principles of the LiFE program and provides a step-by-step guide for therapists and trainers to implement the program with their clients. It should be used in conjunction with the participant's manual so that the program is fully understood from both the trainer's and participant's perspectives.

Download or read book Community dwelling Older Adults Adherence to Fall Prevention Recommendations written by Suzänne Fleming Taylor and published by . This book was released on 2014 with total page 151 pages. Available in PDF, EPUB and Kindle. Book excerpt: Falling among older adults is a leading cause of concern due to the known impacts including physical injury, loss of independence, increased health care costs, and mortality. In efforts to decrease the numbers of falls experienced by older adults, healthcare providers assess individuals' fall risks and provide corresponding fall prevention recommendations. The effectiveness however, of these recommendations, is only as strong as the level of adherence to those recommendations; which has proven low in recent research. Using the theoretical foundation of the Health Belief Model, this study quantified adherence to environmental fall prevention recommendations. Twenty-two community-dwelling older adults participated in this randomized control group study that took place across three home visits, scheduled approximately 30 days apart. Participants were interviewed regarding their recent falls and perceived susceptibility to future falls; then a home evaluation was conducted. Treatment group participants were provided personalized education explaining how and why environmental fall prevention recommendations were important to decrease their risk of falls while control group participants were provided general recommendations. A two-sample t-test for independent groups determined a statistically significant relationship: participants who received personalized education intervention were more likely to follow recommendations than those who received general education intervention. Multiple regressions were conducted to review relationships between an individual's recent falls, and their perceived susceptibility to future falls, with their extent of adherence with fall prevention recommendations. No statistically significant relationship was found. This study suggests that providing personalized education for community-dwelling older adults regarding environmental fall prevention recommendations increases their extent of adherence with such recommendations.

Download or read book The Effect of a Fall Prevention Program on Gait and Balance of Community dwelling Elders written by Naiyana Piphatvanitcha and published by . This book was released on 2006 with total page 400 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Efficacy of a Community and Group based Intervention to Reduce Fall Risk Among Older People written by Patricia Lynn Ritter Ratliff and published by . This book was released on 2011 with total page 88 pages. Available in PDF, EPUB and Kindle. Book excerpt: Background: Systematic reviews and meta-analyses of fall prevention programs support the use of exercise as an effective intervention to improve strength and balance, thus decreasing fall risks. The Arthritis Foundation Exercise Program (AFEP) has not been evaluated for its potential to improve measures of physical functioning relating to falls risk management. Objective: To analyze the effect of an 8-week, 16 session AFEP intervention on performance-based measures of balance, functional fitness and self-rated health-related quality of life measures for senior adults. Design: A quasi-experimental pretest-posttest group design study, with each subject serving as her or his own control. Setting: An Alabama senior residential and wellness facility. Subjects: Forty-five senior volunteers. Methods: Balance and functional fitness measures were assessed using the Berg Balance Scale (BBS) and the Senior Fitness Test (SFT), which consists of six validated performance tests and assessment of Body Mass Index (BMI). Self-reported health-related quality of life was assessed using the RAND 36-Item Health Survey, Version 1.0. Results: Paired-sample t-test analyses identified the AFEP intervention as significantly associated with improvements in BB, SFT measures for arm curl strength, chair sit-and-reach and back scratch flexibility, and six-minute walk distance. There was no significant effect on SFT measures for BMI, 8-foot up-and-go, or any of the RAND-36 subgroups. Conclusion: The AFEP is a potentially effective fall prevention exercise intervention strategies for seniors.

Download or read book Effectiveness of a Fall Prevention Program on Wellbeing of Community dwelling Elders written by Therese Nicole Henning and published by . This book was released on 2017 with total page 370 pages. Available in PDF, EPUB and Kindle. Book excerpt: Falls represent a growing public health concern and can lead to both physical and psychological consequences that challenge the quality of life of community-dwelling elders. The purpose of this retrospective study explores the potential health benefits of participation in a multifaceted fall prevention program. The study enrolled 91 community-dwelling older adults between the ages of 65 and 93 into a six-month program. Participation in the program was voluntary, 69% of participants were female participants and 31% male. Program components include: access to a six-week exercise-based class, a fall prevention workshop, and a home safety assessment. The study measures number of falls, hospitalizations, fall risk, and quality of life using evidence-based assessment tools over the duration of six-months. Significant study findings show an 86% enrollment in the six-week class, 76% improvement in balance and strength, 28% reduction in "at risk" participants, a 33% decrease in number of falls, 87% increase in perceived safety, 82% increase in confidence, and 79% perceived decrease in fall risk. Additionally, the study demonstrates a correlation between quality of life and fall risk. Findings show that among the participants, the 55% that lowered their overall risk of falling experienced an improvement in quality of life. In conclusion, the study demonstrates the potential health benefits of participation in a fall prevention program but also highlights the challenges of recruitment and the importance of understand falls self-efficacy and the stigma of falling prior to launching a program.

Download or read book Preventing Falls in the Community Dwelling Older Adult Population Through Education Exercise and Strategic Partnerships written by Julie Kay Philbrook and published by . This book was released on 2017 with total page 108 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Minnesota Department of Public Health cited unintentional falls as the leading cause of injury-related emergency room visits, hospitalizations, and deaths for Minnesotans aged 65 and older. The purpose of this project was to implement the evidence-based older adult falls prevention program Stepping On for community-dwelling older adults. This was accomplished by creating strategic partnerships between Transcultural Nurse Leaders, Faith Community Nurses, and other community stakeholders. The project was grounded on Rosemarie Parse's Human Becoming Theory. The Older Adult Fall Prevention Sunflower Model illustrates the interrelationships of the core concepts for the project. This active approach is also in alignment with Parse's theory which stresses the value of co-participative and person-centered nursing. Using this theory allows nurses to walk alongside older adults to openly explore all aspect of falls and assist them to create an action plan to prevent them from occurring. Addressing fall prevention for older adults is a nursing challenge that will require a collaborative teamwork approach that is both interdisciplinary and inter-professional. This project advanced nursing by providing the nurse leader with the tools needed to implement the evidence-based injury prevention education program for community-dwelling older adults. It also provides a framework that will facilitate collaboration with other healthcare experts and community-based organizations to form strategic partnerships that will reach older adults and prevent falls.

Download or read book Falls Prevention Education for Older Patients Designed Using the Health Belief Model written by Anne-Marie Hill and published by . This book was released on 2010 with total page 678 pages. Available in PDF, EPUB and Kindle. Book excerpt: Background Falls in hospital are a substantial problem for older patients and for health care systems. Falls account for more than 40% of reported adverse events in hospitals, and are three times more likely to be injurious than falls among community dwelling people. In-hospital falls are also associated with poorer rehabilitation outcomes, prolonged length of stay, increased health costs and risk of requiring residential care. A small number of randomised controlled trials of multifactorial interventions have produced conflicting results. These interventions had some effect in reducing falls, but are difficult to replicate and the relative effectiveness of each component is unknown. There is limited evidence for preventing falls in high risk cohorts of the older population after hospital discharge and only a few studies have reported rates of falls during this period. Review of the literature indicated two key areas that warranted further investigation. First, the effect of providing patient education to reduce falls in hospital was unknown, although research findings in the community suggested that falls prevention programmes are limited by low levels of patient adherence. Second, there were sparse data about falls rates and falls prevention in the post discharge period. Aims The aim of this thesis was to examine whether falls prevention patient education could be designed and delivered using a theoretical model of health behaviour change, the Health Belief Model (HBM). The studies examine the sustained effect of providing inpatient education on falls rates following discharge and investigate risk factors for falls in the population after discharge. Secondary aims were to investigate whether the constructs of the HBM could be used to explain older people's awareness of and knowledge about falls, and their engagement in falls prevention strategies after hospital discharge. Methods The education materials were evaluated by conducting a randomised trial (n=100) in a population of older hospital patients. The materials were designed and delivered using the constructs of the HBM and principles of adult education. An observational study (n=343) also followed up participants, who were enrolled in a multi-site randomised controlled trial, to examine the effect of inpatient education on rates of falls in the six months after discharge. Risk factors for falls, patients' self-perceived risk of falls, knowledge about falls prevention and engagement in exercise after leaving hospital were investigated. Results The education achieved key changes in participants' awareness, self-perceived risk and knowledge about falls, and their self-efficacy to engage in falls prevention behaviours. However providing inpatient education did not have a sustained effect in reducing falls rates in the six months after discharge. Falls rates in the cohort, including injurious falls rates, were increased for six months following discharge when compared to the general community population. Forty percent of participants fell and over 50% of these sustained an injurious fall. Three protective interactions: receiving assistance with Activities of daily living if a participant had depressed mood at discharge, receiving assistance with Activities of daily living if the participant had fallen in the six months prior to hospital admission and being a male participant with a visual impairment, lowered the risk of falls outcomes. Participants were found to have low levels of knowledge about suitable falls prevention strategies to use after discharge and only 35% were engaging in exercise when surveyed at six months post discharge. Those participants who believed that they were at risk of sustaining a serious injury if they fell were significantly more likely to be engaging in exercise. Discussion This research programme was the first to investigate older patients' response to falls prevention education designed using the HBM. The constructs of the HBM, utilised with adult education principles, were effectively applied to design and delivery of falls prevention education for older patients. The HBM was a suitable model of health behaviour change to explain older people's attitudes towards and knowledge of falls, and engagement in exercise following discharge. The results of the research also demonstrate for the first time that older people are at increased risk of sustaining a fall and falls-related injury in the six months after leaving hospital. Feedback provided by older people in this study suggests that low levels of knowledge and adherence to falls prevention strategies may contribute to falls risk in this population. Identification of risk factors for falls in the post discharge period highlighted that receiving assistance with ADL reduces falls risk and injurious falls risk in high risk cohorts of the post discharge population, including participants who had a history of previous falls. Conclusion An educational intervention designed using the HBM improved older people's awareness and knowledge of falls and falls prevention strategies and enhanced their self-efficacy to engage in falls preventive behaviours. Older people were at increased risk of falls after hospital discharge but had low levels of knowledge about how to reduce falls risk and low levels of engagement in exercise. Future research should develop and evaluate interventions that are specifically targeted to this population.

Download or read book Adapting the Lifestyle integrated Functional Exercise Program for Medically Underserved Older Adults written by Yi-Ling Hu and published by . This book was released on 2019 with total page 132 pages. Available in PDF, EPUB and Kindle. Book excerpt: Falls are a growing public health problem among the aging population. Structured exercise programs are effective in preventing falls, and many have been implemented for community-dwelling older adults in the U.S. However, low adherence rates for structured exercise are reported consistently for this population. The need to translate alternative evidence-based exercise programs the diverse older adult population is important. One promising alternative program, the Lifestyle-integrated Functional Exercise Program (LiFE), can significantly reduce falls but has not yet been implemented for diverse older adults residing in the US. To initiate the translation of LiFE, we targeted older adults residing in medically underserved (MU) areas, who traditionally have less access to health prevention programs and have the lowest adherence rates for structured exercise programs.First (Chapter 2), we used a scoping review to map the nature and extent of research conducted on exercise and physical activity (PA) participation, interventions and components of effective programs for MU older adults. We found that few exercise-based fall-prevention programs were available specifically for older adults, and adapted materials should be tailored to specific subgroups. This study confirmed the need for translating LiFE for MU older adults, and identified the crucial direction for the next phase of this dissertation study.Second (Chapter 3), we developed an adapted LiFE program, Diverse Older Adults doing LiFE (DO LiFE), using a two-stage mixed method study. In the first stage, perspectives from local MU older adults and occupational therapy (OT) service providers were incorporated to develop a manual for new users. In the second stage, preliminary feasibility was established for DO LiFE in a single-group pilot study. We also developed critical insights for the next stage of the study, including using new recruitment strategies, refined inclusion criteria and measurements.Last, we conducted a randomized feasibility study with attention control (flexibility exercise) to evaluate process outcomes of DO LiFE in preparation for larger studies. For diverse older adults residing in MU areas, DO LiFE has demonstrated good feasibility with high reach, adherence, fidelity, and acceptance, but a revision is needed that addresses barriers before proceeding to larger-scale translational studies.Together, the results indicate that DO LiFE is feasible for further investigation in larger trials among diverse older adults residing in MU areas. The significance of this study is to accelerate translation of an evidence-based fall-prevention program for the in-need, diverse aging population into real-world settings.

Download or read book A CDC Compendium of Effective Fall Interventions written by Judy A. Stevens and published by . This book was released on 2010 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Older adults value their independence and a fall can significantly limit their ability to remain self-sufficient. More than one-third of people aged 65 and older fall each year, and those who fall once are two to three times more likely to fall again. Fall injuries are responsible for significant disability, loss of independence, and reduced quality of life. In 2000, direct medical costs for fall injuries totaled $19 billion. However, we know that falls are not an inevitable result of aging. In recent years, systematic reviews of fall intervention studies have established that prevention interventions can reduce falls. The Centers for Disease Control and Prevention (CDC) developed the CDC Compendium of Effective Fall Interventions to help public health practitioners use the best scientific evidence to effectively address the problem of falls. The Compendium includes 22 specific interventions for community-dwelling older adults that have rigorous scientific evidence of effectiveness, and provides relevant information about these interventions to public health practitioners, aging service providers, and others who wish to implement fall prevention programs.

Download or read book Effect of Exercise on Fall Prevention of Community Dwelling Elderly written by Wai-Ming Priscilla Lui and published by Open Dissertation Press. This book was released on 2017-01-26 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: This dissertation, "Effect of Exercise on Fall Prevention of Community-dwelling Elderly" by Wai-ming, Priscilla, Lui, 雷慧明, was obtained from The University of Hong Kong (Pokfulam, Hong Kong) and is being sold pursuant to Creative Commons: Attribution 3.0 Hong Kong License. The content of this dissertation has not been altered in any way. We have altered the formatting in order to facilitate the ease of printing and reading of the dissertation. All rights not granted by the above license are retained by the author. Abstract: Objective: To evaluate the effectiveness of exercises on fall prevention among community-dwelling elderly. Design: Systematic review of randomized controlled trials. Method: The literature search of articles was conducted through the electronic databases of PubMed, Medline and EMBASE and manual search, and was confined to articles in English language with full text and publications from 2002 to 2012. Randomized controlled trials with exercise as the only intervention which aimed at reducing falls in older people aged 60 or above in community i.e. community-dwelling elderly were included. The primary outcomes were number of fallers, fall rate, time to the first and subsequent falls. Data Extraction: A total of 145 articles were retrieved through the electronic data bases (137 articles) and manual search (8 articles) of which 10 were selected after applying the inclusion criteria. According to the checklist developed by National Institute for Health and Clinical Excellence (NICE) for randomized controlled trials, the overall methodological quality of the 10 studies was rated as good as they had fulfilled 79%-93% of the assessment criteria in the NICE checklist. Results: The studies involved a sample size of 3,138 at the median age of 69 to 83. All the subjects were ambulatory and able to mobilize independently. The duration of exercise interventions ranged from 1.5 months to 12 months at a total of 11-156 hours. Eight studies showed that exercises were effective in fall prevention whereas two studies found no evidence of such effectiveness. The effect of exercises on fall prevention was multifactorial including the duration, frequency and continuity of the exercise programs, the health status of the target population and the individuals' adherence to the exercise programs. Shorter exercise programs and make-up class arrangement resulted in higher adherence rate. Tailor-made (based on the functional capabilities of the subjects) and progressive (gradual increase of the intensity and challenge of the exercises during the intervention period) nature of the exercise programs also enhanced their effectiveness on the elderly. For the studies in which exercise did not have any positive effect on fall prevention, the subjects were generally older (median age at 81) and frailer (with 3-7 frail attributes). Conclusions: This review suggests exercise may be an effective intervention for fall prevention among community-dwelling elderly. Different types of exercise including strengthening, balance, endurance and weight-bearing exercises as well as Tai Chi may prevent falls. The elderly's age and health status must be taken into consideration when designing exercise intervention programs for the elderly. Further researches are recommended to determine the optimal type, intensity, frequency and duration of exercises in fall prevention. Observations from the studies provide insights for future researches, such as the fall prevention effect of group and home exercises, tailor-made and progressive exercise programs. In Hong Kong, no randomized controlled trial studies have been conducted to examine different intervention programs on fall prevention. To achieve generalizabilty of the studies in the review, further local researches, particularly well designed and powered randomized controlled trials have to be conducted to assess the effect of different kinds of exercise interventions on fal

Download or read book The Gift of Caring written by Marcy Cottrell Houle and published by Rowman & Littlefield. This book was released on 2015-07-01 with total page 321 pages. Available in PDF, EPUB and Kindle. Book excerpt: The desire to help our elders navigate health issues is clear and universal—how to assure proper care and a good ending is not. Combining adroit storytelling skills with expert advice, The Gift of Caring: Saving Our Parents from the Perils of Modern Healthcare brings the reader into all-too-familiar scenarios facing our aging parents and offers answers to questions we may not know to ask until it’s too late. Author and biologist Marcy Houle shares her personal journey of caring for her father, a surgeon, who developed Alzheimer’s, and later her mother, who succumbed to other medical conditions. Like many children of aging parents, Marcy often felt powerless traveling this sad trajectory—watching them fall through the cracks of a fragmented and confusing healthcare system, where professionals often wrote off their symptoms as “just old age.” Not having the understanding of the changes that come with aging, she was led to believe there was nothing she could do to help. The tragic secret? According to coauthor and geriatrics physician Elizabeth Eckstrom, these symptoms frequently are not “just old age.” Rather, the problem is that the current healthcare delivery model for older people is ill-equipped to provide the comprehensive, person-centered care seniors need. Today, thousands of aging people face unnecessary suffering, hospitalizations, nursing home stays, and even death due to complications that could have been prevented or treated. Even more troubling, many healthcare professionals have had little or no training in the care of older adults. The Gift of Caring reveals these pitfalls and provides families with tools they can use to avoid them. Interspersed with every few chapters of Marcy’s riveting story, Dr. Eckstrom shares professional medical insights, compiled from the latest research, into what Marcy could have done to safeguard her parents. She shows us how to navigate the system, how we can become our loved one’s best advocate, and what we need to know to achieve healthy aging and meaningful, compassionate final years. Honest, at times humorous, and ultimately uplifting, The Gift of Caring sheds new light on aging from twin perspectives: a story of a daughter desperately seeking help for the parents she loves, and a geriatrician who gives us the knowledge we need to insist upon a better way.