Journal Mobile Options
Table of Contents
Vol. 50, No. 6, 2004
Issue release date: November–December 2004
Gerontology 2004;50:411–416
(DOI:10.1159/000080180)

Fall Incidence in Frail Older Women after Individualized Visual Feedback-Based Balance Training

Sihvonen S. · Sipilä S. · Taskinen S. · Era P.
Departments of aHealth Sciences and bMathematics and Statistics, University of Jyväskylä, and cLIKES-Research Center, Jyväskylä; dBrain Research and Rehabilitation Center Neuron, Kuopio, Finland

Individual Users: Register with Karger Login Information

Please create your User ID & Password





Contact Information











I have read the Karger Terms and Conditions and agree.

To view the fulltext, please log in

To view the pdf, please log in

Abstract

Background: The knowledge concerning balance training actually lowering fall rates among frail older persons is limited. Objective: The aim of this study was to examine the effects of a 4-week individualized visual feedback-based balance training on the fall incidence during 1-year follow-up among frail older women living in residential care. Methods: Twenty-seven older women from 2 residential care homes were randomized into exercise (n = 20) and control (n = 7) groups. Balance measurements were carried out before and after a 4-week training period and falls were monitored by monthly diaries for 1 year. An interview about fear of falling and physical activity was completed before and after the intervention and after the 1-year follow-up. Results: A positive effect of balance training on fall incidence was found. A dynamic Poisson regression model showed that during the follow-up the monthly risk of falling was decreased in the exercise group compared to controls (risk ratio 0.398, 95% CI 0.174–0.911, p = 0.029). In addition, the exercise group reported a reduced fear of falling and increased physical activity after a training period but these changes declined during the follow-up period. Conclusion: Individualized visual feedback-based balance training was shown to be a promising method for fall prevention among frail older women. High compliance (97.5%) with the training program showed that carefully targeted training programs can be carried out among older people with health limitations.



Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

References

  1. Luukinen H, Koski K, Hiltunen L, Kivelä SL: Incidence rate of falls in an aged population in northern Finland. J Clin Epidemiol 1994;47:843–850.
  2. Tinetti ME: Factors associated with serious injury during falls by ambulatory nursing home residents. J Am Geriatr Soc 1987;35:644–648.
  3. Kallin K, Lundin-Olsson L, Jensen J, Nyberg L, Gustafson Y: Predisposing factors and precipitating factors for falls among older people in residential care. Public Health 2002;116:263–271.
  4. Lipsitz LA, Jonsson PV, Kelley MM, Koestner JS: Causes and correlates of recurrent falls in ambulatory frail elderly. J Gerontol 1991;46:M114–M122.
  5. Studenski S, Duncan PW, Chandler J, et al: Predicting falls: The role of mobility and nonphysical factors. J Am Geriatr Soc 1994;42:297–302.
  6. Tinetti M, Baker D, McAvay G, et al: A multifactorial intervention to reduce the risk of falling among elderly people living in the community. N Engl J Med 1994;331:821–827.
  7. Myers AH, Young Y, Langlois JA: Prevention of falls in the elderly. Bone 1996;18(suppl):S87–S101.
  8. Stalenhoef PA, Diederiks JPM, Knottnerus JA, Kester ADM, Crebolder HFJ: A risk model for the prediction of recurrent falls in community-dwelling elderly: A prospective cohort study. J Clin Epidemiol 2002;55:1088–1094.
  9. Ray WA, Taylor JA, Meador KG, et al: A randomized trial of a consultation service to reduce falls in nursing homes. JAMA 1997;278:557–562.
  10. Close J, Ellis M, Hooper R, Glucksman E, Jackson S, Swift C: Prevention of falls in the elderly trial (PROFET): A randomized controlled trial. Lancet 1999;353:93–97.
  11. Jensen J, Lundin-Olsson L, Nyberg L, Gustafson Y: Fall and injury prevention in older people living in residential care facilities. A cluster randomized trial. Ann Intern Med 2002;136:733–741.

    External Resources

  12. Lord S, Ward JA, Williams P, Strudwick M: The effect of 12-month exercise trial on balance, strength, and falls in older women: A randomized controlled trial. J Am Geriatr Soc 1995;43:1198–1206.
  13. Wolf SL, Barnhart HX, Kutner NG, McNeely E, Tingsen X, and the Atlanta FICSIT Group: Reducing frailty and falls in older persons: An investigation of tai chi and computerized balance training. J Am Geriatr Soc 1996;44:489–497.
  14. Campbell AJ, Robertson MC, Gardner MM, Norton RN, Tilyard MW, Buchner DM: Randomised controlled trial of a general practice programme of home based exercise to prevent falls in elderly women. BMJ 1997;315:1065–1069.
  15. Rubenstein LZ, Josephson KR, Trueblood PR, Loy S, Harker JO, Pietruszka FM, Robbins AS: Effects of a group exercise program on strength, mobility, and falls among fall-prone elderly men. J Gerontol A Biol Sci Med Sci 2000;55:M317–M321.
  16. Hauer K, Rost B, Rütschle K, et al: Exercise training for rehabilitation and secondary prevention of falls in geriatric patients with a history of injurious falls. J Am Geriatr Soc 2001;49:10–20.
  17. Gillespie LD, Gillespie WJ, Robertson MC, Lamb SE, Cumming RG, Rowe BH: Interventions for preventing falls in elderly people (Cochrane Review). Cochrane Database Syst Rev 2001;3:CD000340.
  18. Buchner DM, Cress ME, de Lateur BJ, et al: The effect of strength and endurance training on gait, balance, fall risk, and health services use in community-living older adults. J Gerontol A Biol Sci Med Sci 1997;52:M218–M224.
  19. Campbell AJ, Robertson MC, Gardner MM, Norton RN, Buchner DM: Falls prevention over 2 years: A randomized controlled trial in women 80 years and older. Age Ageing 1999;28:513–518.
  20. Day L, Fildes B, Gordon I, Fitzharris M, Flamer H, Lord S: Randomized factorial trial of falls prevention among older people living in their own homes. BMJ 2002;325:128.
  21. Mulrow CD, Gerety MB, Kanten D, Cornell EJ, DeNino LA, Chiodo L, et al: A randomized trial of physical rehabilitation for very frail nursing home residents. JAMA 1994;271:519–524.
  22. McMurdo MET, Millar AM, Daly F: A randomized controlled trial of fall prevention strategies in old peoples’ homes. Gerontology 2000;46:83–87.
  23. Nowalk MP, Prendergast JM, Bayles CM, D’amico FJ, Colvin GC: A randomized trial of exercise programs among older individuals living in two long-term care facilities: The FallsFREE Program. J Am Geriatr Soc 2001;49:859–865.
  24. American Geriatrics Society, British Geriatrics Society, and American Academy of Orthopaedic Surgeons Panel on Fall Prevention: Guideline for the prevention of falls in older persons. J Am Geriatr Soc 2001;49:664–672.
  25. Carter N, Kannus P, Khan K: Exercise in the prevention of falls in older people. A systematic literature review examining the rationale and the evidence. Sports Med 2001;31:427–438.
  26. Lord SR, Ward JA, Williams P: Exercise effect on dynamic stability in older women: A randomized controlled trial. Arch Phys Med Rehabil 1996;77:232–236.
  27. Rose D, Clark S: Can the control of bodily orientation be significantly improved in a group of older adults with a history of falls? J Am Geriatr Soc 2000;48:275–282.
  28. Hu M-H, Woollacott MH, Multisensory training of standing balance in older adults: I. Postural stability and one-leg stance balance. J Gerontol 1994;49:M52–M61.
  29. Hu M-H, Woollacott MH, Multisensory training of standing balance in older adults: II. Kinematic and electromyographic postural responses. J Gerontol 1994;49:M62–M71.
  30. Protas EJ, Wang CY, Harris C: Usefulness of an individualized balance and gait intervention programme based on the problem-oriented assessment of mobility in nursing home residents. Disabil Rehabil 2001;23:192–198.
  31. Wolf B, Feyes H, De Weerdt W, van der Meer J, Noom M, Aufdemkampe G: Effect of a physical therapeutic intervention for balance problems in the elderly: A single-blind, randomized, controlled multicentre trial. Clin Rehabil 2001;15:624–636.

    External Resources

  32. Grimby G: Physical activity and muscle training in the elderly. Acta Med Scand Suppl 1986;711:233–237.
  33. Sihvonen S, Sipilä S, Era P: Changes in postural balance in frail elderly women during a four-week visual feedback training: A randomized controlled trial. Gerontology 2004;50:87–95.
  34. Alho OP, Läärä E, Oja H: How should relative risk estimates for acute otitis media in children under 2 years be perceived? J Clin Epidemiol 1996;49:9–14.
  35. Oja H, Alho OP, Läärä E: Model-based estimation of the excess fraction (attributable fraction): Day care and middle ear infection. Stat Med 1996;15:1519–1534.
  36. Shumway-Cook A, Gruber W, Baldwin M, Liao S: The effect of multidimensional exercises on balance, mobility, and fall-risk in community-dwelling older adults. Phys Ther 1997;77:46–57.
  37. Franzoni S, Rozzini R, Boffelli S, Frisoni GB, Trabucchi M: Fear of falling in nursing home patients. Gerontology 1994;40:38–44.


Pay-per-View Options
Direct payment This item at the regular price: USD 38.00
Payment from account With a Karger Pay-per-View account (down payment USD 150) you profit from a special rate for this and other single items.
This item at the discounted price: USD 26.50