Application of fall prevention and management strategies based on patient participation and Internet plus in elderly inpatients / 中国实用护理杂志

Objective:To explore the effectiveness of patient participation and Internet plus in fall prevention management strategies of elderly inpatients and analyze the causes of falls, so as to provide a basis for continuous improvement in fall prevention to investigate their continuous improvement.Methods:A pre- and post-control study was conducted. Totally 8 480 elderly inpatients hospitalized in the Department of Internal Medicine from 1 June 2020 to 31 May 2021 in Chenzhou NO. 1 People′s Hospital were selected by convenient sampling as the control group, and 8 662 elderly inpatients hospitalized in the Department of Internal Medicine from 1 June 2021 to 31 May 2022 were in the experimental group. The routine fall prevention measures were used in the control group, and on this basis, the experimental group formulated and implemented fall prevention management strategies involving patients based on the patient participation framework "informing, participating, empowering, cooperating, and electronic information support" and introduced Internet plus. Then the differences between the two groups in terms of the incidence of falls and the satisfaction rate of nursing care were compared.Results:The experimental group included 8 662 cases (5 110 males and 3 552 females) with (73.96 ± 8.78) years old, while the control group included 8 480 cases (4 918 males and 3 562 females) with (74.11 ± 8.59) years old. The incidence of falls in experimental group (0.092%, 8/8 662) was lower than that in control group (0.224%, 19/8 480), and the difference was statistically significant ( χ 2=4.71, P<0.05); the nursing care satisfaction rate of experimental group (98.880%, 8 565/8 662) was higher than that of control group (96.450%, 8 179/8 480), and the difference also was statistically significant ( χ 2=106.50, P<0.01); the analysis of the fall causes of the patients revealed that the toilet squatting commode was an important hidden risk of falls in elderly patients. Conclusions:Fall prevention management strategies based on patient participation can reduce the incidence of falls in elderly patients and improve the satisfaction rate of nursing care. Patient participation introduced "Internet plus" can prevent patient falls. The root causes of patient falls will continue to change, and care managers should continually track real-time changes in the root causes of falls to identify problems, develop and adjust prevention strategies accordingly, and pay attention to the importance of infrastructure in the safety of older patients.

Estudo de avaliabilidade do Programa Fall TIPS Brasil / Evaluability study of the Fall TIPS Brazil Program

Resumo: Esta tese compõe o projeto de pesquisa e desenvolvimento tecnológico "Difusão e adoção do Programa Fall TIPS: engajamento de pacientes, profissionais e liderança clínica para a prevenção de quedas em ambiente hospitalar. Está ligada à linha de Pesquisa de Gerenciamento de Serviços de Saúde e Enfermagem do Programa de Pós-Graduação em Enfermagem (PPGENF) da UFPR e teve por objetivo elaborar e validar um modelo teórico, modelo lógico e matriz de análise e julgamento do Programa Fall TIPS, em sua adaptação pioneira ao cenário brasileiro. O programa,baseado em evidências, está implantado em mais de 125 instituições de saúde no mundo, e é sustentado por mais de uma década de pesquisas. Ao utilizar-se de estratégias multimodais para a prevenção de quedas hospitalares, consiste em um conjunto de ferramentas e instrumentos. Seu diferencial está no engajamento de profissionais de saúde, pacientes e acompanhantes no desenvolvimento e execução, em conjunto, de um plano personalizado para prevenção de quedas entre pacientes internados. Trata-se de um estudo de avaliabilidade (EA), realizado em um hospital público e de ensino, na cidade de Curitiba, no Paraná, no período de 2021 a 2023. Utilizou-se o referencial de Trevisan e Walser mediante componentes como: definição do foco do estudo de avaliabilidade; desenvolvimento de uma teoria inicial do programa; coleta de feedback sobre a teoria do programa; e considerações sobre os usos do estudo de avaliabilidade. Contou com uma etapa documental e outra participativa. Na etapa documental foram analisadas legislações, diretrizes e publicações sobre segurança do paciente, prevenção de quedas e sobre o Programa Fall TIPS. A etapa participativa foi resultante de oficinas, junto a 15 profissionais de saúde ligados a um hospital público e de ensino, indicados pela gestão hospitalar. Posteriormente, os construtos provenientes foram validados, em oficinas, por três enfermeiras ligadas à docência e assistência, convidadas por suas atuações em avaliação, segurança do paciente e gestão de riscos assistenciais, além de conhecimentos prévios sobre o Programa Fall TIPS. Os dados da etapa documental foram analisados à luz de pontos-chave sobre o programa e sobre o problema que se propõe a enfrentar. Os dados oriundos das oficinas junto a profissionais de saúde e informantes-chave foram analisados por Análise de Conteúdo, mediante categorias de análise previamente definidas: contextos interno e externo à instituição hospitalar, recursos, objetivos, atividades, produtos, resultados, impacto, metas e questões ligadas à execução do programa em instituições de saúde. O estudo possibilitou melhor conhecimento do programa e da temática prevenção de quedas hospitalares. Ainda, ao ser disponibilizado em website brasileiro do programa, isso contribuirá para a disseminação do programa, adoção por profissionais de saúde e instituições de saúde interessadas e condução de processos avaliativos.

Abstract: This thesis entails the project of research and technological development "Dissemination and adoption of the Fall TIPS Program": engagement of patients, professionals and clinical leadership for fall prevention within hospital settings". It is connected with the line of research of Health and Nursing Services Management of the Postgraduation Program in Nursing at the Federal University of Paraná (PPGENF- UFPR). It aimed to elaborate and validate a theoretical model, logic model and matrix of analysis and judgement of the Fall TIPS Program in its pioneer adaptation to the Brazilian setting. The evidence-based program has been implemented in over 125 health institutions worldwide, and it is supported by over a decade of research. It consists of a set of tools and instruments by using multimodal strategies for hospital fall prevention. Its differential lies in the engagement of health professionals, patients and their companions in the joint development and execution of a personalized fall prevention plan among hospitalized patients. It is an availability study (AS) conducted in a public teaching hospital in the city of Curitiba, Paraná State ­ Brazil from 2021 to 2023. Trevisan and Walser's theoretical framework was used by means of components as follows: definition of the focus of the availability study; development of an initial theory of the program; feedback collection on the program theory; and considerations on the use of the availability study. It comprised documentary and participating steps. In the documentary step, legislations, guidelines and publications on patient safety, fall prevention, and on the Fall TIPS Program were analyzed. The participating step resulted from workshops with 15 health professionals from the public teaching hospital, appointed by the hospital management. Subsequently, the resulting constructs were validated, during the workshops, by three teaching and health care nurses, invited by their performance in assessment, patient's safety and management of health care hazards, in addition to their previous knowledge on the Fall TIPS Program. The data from the documentary step were analyzed in light of the key points on the program and on the aimed problem. The data gathered from the workshops with the health professionals and key informants were analyzed by the Content Analysis, by means of previously defined analysis categories, as follows: internal and external contexts to the hospital institution; resources, objectives, activities, products, results, impact, goals and questions related to the program execution within health institutions. The study enabled better knowledge of the program and the thematics of hospital fall prevention. In addition, the release of the program in its Brazilian website will contribute to the dissemination and adoption of the program by health professionals and interested health institutions, with the execution of evaluation processes.

Awareness in general population about the home modifications which are necessary to prevent falls in community dwelling elderly

Background: Falls are considered to be one of the “geriatric giants”. The living room, bathroom, bedroom and staircase are common areas where falls occur within home. Many elderlies who fall even if they remain uninjured, become apprehensive causing them to cut down on their activities of daily living and becoming less active, weaker, further increasing their chances of falling. Therefore, it’s of paramount importance to scrutinize the awareness about the home modifications. The study was conducted to examine if the general population is aware of the home modifications necessary to prevent falls in community dwelling elderly. Methods: A cross sectional study was conducted in 300people between 30 to 50 years old who were not medical professionals. Convenience sampling was used. A self-structured questionnaire was prepared and clearance of ethical committee was obtained. After taking people’s consent they were asked to fill the questionnaire. Results: Results show that out of 300 participants people are aware of non-slippery floors (70%), railings at the staircase (62%). People are least aware of the following modifications: glare free paints (20%), door knobs can be replaced with lever handle (40%), install adhesive strips on the staircase (30%). Conclusions: Results show that out of 300 participants people are aware of non-slippery floors (70%), railings at the staircase (62%). People are least aware of the following modifications: glare free paints (20%), door knobs can be replaced with lever handle (40%), install adhesive strips on the staircase (30%).

Avaliação de tecnologia educacional digital sobre o programa fall tips brasil de prevenção de quedas

Objetivo: Desenvolver e avaliar uma tecnologia educacional (TE) digital sobre prevenção de quedas para uso por profissionais de saúde durante a implantação do programa Fall TIPS no Brasil. Material e Método: Pesquisa aplicada e de desenvolvimento tecnológico, incluindo as etapas de planejamento, desenvolvimento e avaliação de uma tecnologia educacional baseada na web, sobre prevenção de quedas, a ser utilizada na implementação do programa Fall TIPS no Brasil. A pesquisa foi realizada entre 2020 e 2022 na modalidade de co-produção e incluiu infográficos, podcasts e vídeos para cada um dos stakeholders envolvidos no programa. Resultados: A avaliação consistiu em 19 questões sobre aparência e objetivos e foi respondida por um grupo de 14 enfermeiros líderes de um hospital do sul do Brasil, por meio de um instrumento que atingiu um índice geral de validação de conteúdo de 0,85. Conclusões: A TE visa melhorar a prevenção de quedas estimulando a adesão ao programa FALL TIPS em hospitais brasileiros.

Objective: To develop and evaluate a digital educational technology (ET) on fall prevention to be used by health professionals during the implementation of the Fall TIPS program in Brazil. Material and Method: Applied research and technological development, including the planning, development and evaluation stages of a web-based educational technology on fall prevention to be used in the implementation of the Fall TIPS program in Brazil. The study was conducted from 2020 to 2022 in a co-production format and included infographics, podcasts and videos for each of the stakeholders involved in the program. Results: The evaluation consisted of 19 questions regarding appearance and goals and was answered by a group of 14 nurse leaders from a hospital in the South of Brazil, using an instrument that achieved an overall content validation index of 0.85. Conclusions: The ET aims to improve fall prevention by promoting adherence to the Fall TIPS program in Brazilian hospitals.

Objetivo: Desarrollar y evaluar una tecnología educativa digital (ET) sobre prevención de caídas para uso de los profesionales de la salud durante la implementación del programa Fall TIPS en Brasil. Material y Método: Investigación aplicada y desarrollo de tecnología, incluidas las etapas de planificación, desarrollo y evaluación de una tecnología educativa basada en la web sobre prevención de caídas, para ser utilizada en la implementación del programa FALL TIPS en Brasil. Se realizó entre 2020 y 2022 en la modalidad de coproducción e incluyó infografías, podcasts y videos para cada uno de los actores involucrados en el programa. Resultados: La evaluación incluyó 19 preguntas sobre apariencia y objetivos, y fue respondida por un grupo de 14 enfermeros líderes de un hospital del sur de Brasil, utilizando un instrumento que alcanzó un índice de validación de contenido general de 0,85. Conclusiones: La ET tiene como objetivo mejorar la prevención de caídas fomentando la adherencia al programa Fall TIPS en los hospitales brasileños.

Risk factors for falls in older adults with cognitive impairment

Background: Falls are one of the leading causes of disability among older people. The risk factors of falls widely vary among the older populations, including the different stages of cognitive impairment. We aim to identify the risk factors for falls among cognitively impaired older adults. Materials and Methods: In a cross-sectional study, older adults attending the memory clinic were screened for falls and their risk factors. A total of 112 subjects who satisfied the inclusion criteria and provided informed consent were subjected to a semi?structured interview and comprehensive geriatric assessment. Cognitive impairment was graded by the Clinical Dementia Rating (CDR). Subjects were divided into fallers and nonfallers. A multivariable logistic regression analysis was done to identify the independent risk factors of falls. Results: The prevalence of falls was 39.28% in the study population. Gender (adjusted odds ratio [aOR] [95% confidence interval (CI)]: 2.21 [0.690�117]), body mass index (aOR [95% CI]: 0.89 [0.773�028]), socioeconomic status (middle-class aOR [95% CI]: 0.34 [0.077�526], lower-class aOR [95% CI]: 2.44 [0.349�.160]), multimorbidity (aOR [95% CI]: 19.39 [1.043�0.373]), depression (mild aOR [95% CI]: 2.90 [0.896� 9.429] and moderate aOR [95% CI]: 4.77 [0.967�.597]), and impairment in hobbies and home (aOR [95% CI]: 24.78 [6.251�.294]) part of CDR were the independent predictors of falls. Conclusion: Older adults with cognitive impairment are at high risk of falling with definitive risk factors. Regular screening will help to identify older adults at risk of falls and enable fall prevention to reduce morbidity and dependency.

Development of an fall prevention early warning bracelet based on red dot indication system and evaluation of its clinical application / 中国实用护理杂志

Objective:to provide a new type of fall prevention early warning bracelet and share the feedback of clinical preliminary application data in order to reduce the incidence of falls in inpatients.Methods:The convenience sampling method was used to select the inpatients who were hospitalized in the Department of Geriatrics of Hunan Provincial People ′s Hospital from January to February 2021. The 30 patients who did not use bracelets in November 2020 were taken as the routine group and 30 patients who used bracelets in December 2020 were taken as the experimental group. The two groups were monitored during hospitalization and 2 weeks after discharge. The patients in the routine group were given routine anti-fall signs and health education, while the patients in the experimental group were given the use and health education of early warning bracelets on the basis of routine. The incidence of fall was recorded. The inpatients ′ nursing job satisfaction scale and the self-designed bracelet use feedback questionnaire (experimental group) were used to evaluate the application effect. Results:No fall occurred in the experimental group, but 4 patients fell in the routine group (13.3%). The incidence of fall in the experimental group was significantly lower than that in the routine group ( χ2=4.29, P=0.038). The scores of all dimensions of nursing satisfaction in the experimental group were also higher than those in the routine group ( t values were -8.20--4.05, all P<0.05). Another 26.7% (8/30) of patients said that wearing a bracelet would have a certain impact on hand movement or rest, but all the 30 patients surveyed indicated that they were willing to continue to wear the bracelet. Three nurses said it would not necessarily reduce the incidence of falls, but all the 10 nurses involved said the shift was more convenient. Conclusions:The preliminary clinical trial feedback of the bracelet is good, and the patients and their families have high recognition, which is helpful for the patients and their families to participate in the fall prevention activities and improve the self-management of the patients.

Use of the patient fall prevention reminder checklist to increase health care provider awareness at the Philippine Children's Medical Center

@#<p><strong>BACKGROUND:</strong> Falls in the hospital are preventable. Prevention of fall requires cooperation from the health care provider, caregivers, as well as the hospital administration. This study was done to utilize standard reminders for fall to increase the awareness of health care providers of a tertiary hospital for children. <br /> <br /><strong>OBJECTIVES:</strong> To determine the effectiveness of the Patient Fall Prevention Reminder Checklist in increasing the awareness of health care providers of patients admitted at the Philippine Children's Medical Center. <br /> <br /><strong>METHODOLOGY:</strong> After obtaining permission to use an established Patient Fall Prevention Reminder checklist from the Intermountain Health Care (USA), participants were recruited after giving their informed consent. A pre-test was conducted to gauge the awareness and practices of the participants in preventing falls in the hospital. After the pre-test, the tool was introduced and discussed by the author to the participants. After 7 days, the participantswere followed up to take the post-test. Data collected were encoded then analyzed throughdescriptive statistics. <br /> <br /><strong>RESULTS:</strong> There were one hundred twenty-one (121) respondents with 42 males and 79 females. There is an increase in awareness in fall prevention amongthe residents and nurses, based on their pre and post-test examination results. The midwives had previous awareness in preventing falls even prior to the study. <br /> <br /><strong>CONCLUSIONS AND RECOMMENDATIONS:</strong> The checklist served as an effective tool in increasing the awareness of most study participants. We recommend the establishment of an institutionalized Fall Prevention Reminder Checklist at the Philippine Children's Medical Center for use by health care personnel.</p>

Carers' concern for older people falling at home: an integrative review

Falls, the leading cause of injury and death among older people, can have a significant psychosocial impact on carers. Carers play a crucial role in caring for older persons at home and in fall prevention. This review, which included 15 studies, aimed to identify carers' concern about older people falling and its impact. We identified that most carers had concerns about repeated falls in older people, unknown consequences of falls and care recipients' non-adherence to fall prevention advice. These concerns, in turn, affect carers' physical and psychological health, lifestyle, caregiving burden and use of fall prevention strategies. This paper highlights the importance of recognising carers' fall concern so as to identify carers' needs and awareness of fall prevention in older people living at home. Greater insight into carers' fall concern could facilitate the implementation of new strategies to manage older people's fall risk as well as improve carers' well-being.

Prevenindo quedas na velhice: Atuação do enfermeiro na Atenção Primária à Saúde / Preventing falls in old age: Nurse's role in Primary Health Care / Prevención de caídas en la vejez: el papel de la enfermera en la Atención Primaria de Salud

Este artigo teve como objetivo analisar a percepção do idoso sobre a atenção prestada pelo enfermeiro referente à prevenção de quedas. Foi realizado um estudo exploratório, descritivo, de natureza qualitativa. O estudou evidenciou que atenção prestada pelo enfermeiro é insuficiente, visto que apenas 15% dos idosos receberam orientações desse profissional sobre quedas que lhes podem ocorrer no cotidiano de suas vidas. Ainda, muitos dos entrevistados expressaram medo desse acidente da queda, tendo eles demonstrado boa disposição para receberem orientações em saúde.

This article aimed to analyze the perception of the elderly about the care provided by the nurse regarding the prevention of falls. An exploratory descriptive study of a qualitative nature was carried out. The study showed that the attention given by nurses is insufficient since only 15% of the elderly received guidance from this professional about falls that can occur to them in their daily lives. Still, many of the interviewees expressed fear of this fall accident, and they showed a willingness to receive health guidance.

Este artículo tuvo como objetivo analizar la percepción de los ancianos sobre la atención prestada por las enfermeras con respecto a la prevención de caídas. Se realizó un estudio exploratorio, descriptivo, cualitativo. El estudio demostró que la atención brindada por las enfermeras es insuficiente ya que solo el 15% de los ancianos recibió orientación de este profesional sobre las caídas que pueden ocurrir en su vida diaria. Aún así, muchos de los entrevistados expresaron temor por este accidente de otoño y mostraron su disposición a recibir orientación sobre salud.

Fall concern about older persons shifts to carers as changing health policy focuses on family, home-based care

With the Singaporean population ageing at an exponential rate, home carers are increasingly becoming essential partners in fall prevention and care delivery for older persons living at home and in the community. Singapore, like other Asian countries, regards the family as the main support structure for the older person, and national policies have been implemented to support this cultural expectation. Family carers experience similar concerns as older persons with regard to fall risk, and identifying and addressing these concerns can potentially lower fall risk and improve fall prevention for older persons. It is timely to remind ourselves - as concern about falls in older persons begins to shift to carers - to incorporate the influence of Asian cultural values and unique family dynamics of outsourcing family caregiving, in the management of older persons' fall risk in the community.

Effects of family-centered educational intervention on fall prevention knowledge, attitudes, compliance and the incidence of falls of elderly inpatients / 现代临床护理

Objective To evaluate the effectiveness of family-centered educational intervention on fall prevention knowledge and attitude,compliance and fall incidence of elderly inpatients. Methods A total of 300 elderly inpatients were selected in a first-class grade A hospital in Beijing and divided into the experiment group and the control group equally.The intervention group was given family-centered educational intervention for 6 months,while the control group was given conventional treatment and care in ward.The knowledge and attitude,compliance and the incidence of falls of elderly inpatients were evaluated at discharge and 3 months,6 months after discharge. Results The knowledge and attitude, compliance of elderly inpatients in the intervention group were significantly better than that in the control group (P<0.05).The incidence of falls in the intervention group was significantly lower than that in the control group at discharge and 3 months,6 months after discharge (P<0.05). Conclusions The family-centered educational intervention can enhance the fall prevention knowledge, attitude and compliance of elderly inpatients effectively and reduce the incidence rate of falls.The long-term effect is relatively obvious.

Interruptions, Unreasonable Tasks, and Quality-Threatening Time Pressure in Home Care: Linked to Attention Deficits and Slips, Trips, and Falls

BACKGROUND: In industrial countries, home care of community dwelling elderly people is rapidly growing. Frequent injuries in home caregivers result from slips, trips, and falls (STFs). The current study tests attentional cognitive failure to mediate the association between work stressors and STFs. METHODS: A sample of 125 home caregivers participated in a questionnaire study and reported work interruptions, unreasonable tasks, quality-threatening time pressure, conscientiousness, attentional cognitive failures, and STFs. RESULTS: In structural equation modeling, the mediation model was shown to fit empirical data. Indirect paths with attentional cognitive failures as the link between work stressors and STF were all significant in bootstrapping tests. An alternative accident-prone person model, that suggests individual differences in conscientiousness to predict attentional cognitive failures that predict more frequent work stressors and STFs, showed no significant paths between work conditions and STFs. CONCLUSION: To prevent occupational injury, work should be redesigned to reduce work interruptions, unreasonable tasks, and quality-threatening time pressure in home care.

The Influence of Health Belief on Fall Prevention Behavior among Patients Who Experienced Abdominal Surgeries / 기본간호학회지

PURPOSE: The purpose of this study was to identify the influences of health beliefs on fall prevention behavior among adult patients who had abdominal surgery. METHODS: Data were collected from 136 patients who had undergone an abdominal surgery within the past 5 days. The data collection period was from September 21 to October 25, 2017. The health belief measurement tool, modified and reviewed by experts, and the fall prevention guideline developed by the Korean Nurses Association and revised by Park were used. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation and stepwise multiple regression analysis. RESULTS: The Health Belief Model explained 45.7% of the variance in fall prevention behavior among adult patients who had abdominal surgery. Perceived susceptibility and perceived benefits had significant influence on fall-prevention behavior. CONCLUSION: Tailored educational programs which put emphasis on the perceived susceptibility and perceived benefits of fall prevention need to be developed.

Establishment and application effect of fall prevention and control information system in elderly community / 中国应用生理学杂志

OBJECTIVES@#To investigate establishing, applying and evaluating the fall prevention and control information system in elderly community.@*METHODS@#Relying on internet technology and informatization means, the fall comprehensive prevention and control strategy of elderly was guided into online from offline. The fall prevention and control information system which was a collection of risk assessment, remote education and feedback was established. One hundred and twenty-six elderly (over 60 years old) in community were screened in this study and 84 high-risk elders who were involved in the remote continuous comprehensive intervention were screened out. Intervening measures included distributing propaganda album, making mission slides and video used to play with the interpretation remotely. Then fall related situation before and after intervention was analyzed and the effectiveness of system evaluated.@*RESULTS@#After remote intervention, the fall incidence of high-risk group decreased from 21.43% to 4.76%(<0.01). The body balance and gait stability improved clearly(<0. 01). The rate of taking proper prevention and control behavior significantly improved(<0.01). They believed in themselves not to fall down with more confidence when taking complex behaviors(<0.01). The security of environment at home significantly enhanced(<0. 01).@*CONCLUSIONS@#Fall prevention and control information system in elderly community was innovative and convenient. The system could roundly assess the status related to fall and accurately screen out high-risk group. The system could implement the remote continuous comprehensive intervention so that the incident of fall was decrease. In conclusion, the system is stable and effective, can be further popularization and application as a successful pilot.

Effects of a Fall Prevention Program on Physical Fitness, Fall Efficacy and Fall Prevention Behavior among Community-dwelling Older Adults / 재활간호학회지

PURPOSE: This research was conducted to determine the effects of fall prevention exercise and education on physical fitness, fall efficacy, and fall prevention behavior among community-dwelling older adults. METHODS: This study applied nonequivalent control group pretest-posttest design. Data were collected from January 8th to March 4th, 2015. There were 24 subjects in the experimental group and 21 in the control group from two different senior citizen center in B city. The fall prevention program consisted of exercise, education, and telephone coaching was developed using self-efficacy theory: ‘Performance accomplishment’, ‘Vicarious experience’, ‘Verbal persuasion’, ‘Emotional arousal’. Then, it was conducted once a week for 8 weeks. Data were analyzed with χ² test and t-test using the SPSS program. RESULTS: The findings indicated that fall prevention program conducted on older adults is good for improving their muscular strength in lower extremities (t=6.25, p<.001), physical balance (t=2.66, p=.014), physical flexibility (t=2.88, p<.001) and fall prevention behavior (t=6.19, p<.001). CONCLUSION: The fall prevention program can be used for community-dwelling older adults as a nursing intervention that enables older adults to enhance their self-care continuously. It is necessary to conduct a follow-up study to see if a self-help meeting could improve self-efficacy.

Relationship between dynamic postural control ability and abdominal area in middle-aged people / 体力科学

Dynamic postural control ability is necessary for fall prevention in our daily lives. It has been suggested that dynamic postural control ability is highly related to the muscles in the trunk as well as the lower limbs for the keep and move of the body. In this study, we reveal relationship between dynamic postural control ability and abdominal area. Subjects including 31 middle-aged people consist of 12 men and 19 women (mean age 60.0±7.6 years). We measured visceral fat area and cross-sectional area of the trunk muscle using abdominal computed tomography scan. The unstable tilt board is used for measuring dynamic postural control ability. Through multiple regression analysis, it is possible to relate dynamic postural control ability from gender, visceral fat, and deep trunk muscle such as psoas major muscle on abdominal computed tomography scan. It is considered that dynamic postural control ability involved not only increasing the volume of deep trunk muscle but also decreasing the amount of visceral fat.

Analysis of static and dynamic balance in healthy elderly practitioners of Tai Chi Chuan versus ballroom dancing

OBJECTIVE: To determine whether Tai Chi Chuan or ballroom dancing promotes better performance with respect to postural balance, gait, and postural transfer among elderly people. METHODS: We evaluated 76 elderly individuals who were divided into two groups: the Tai Chi Chuan Group and the Dance Group. The subjects were tested using the NeuroCom Balance Master¯ force platform system with the following protocols: static balance tests (the Modified Clinical Tests of Sensory Interaction on Balance and Unilateral Stance) and dynamic balance tests (the Walk Across Test and Sit-to-stand Transfer Test). RESULTS: In the Modified Clinical Test of Sensory Interaction on Balance, the Tai Chi Chuan Group presented a lower sway velocity on a firm surface with open and closed eyes, as well as on a foam surface with closed eyes. In the Modified Clinical Test of Sensory Interaction on Unilateral Stance, the Tai Chi Chuan Group presented a lower sway velocity with open eyes, whereas the Dance Group presented a lower sway velocity with closed eyes. In the Walk Across Test, the Tai Chi Chuan Group presented faster walking speeds than those of the Dance Group. In the Sit-to-stand Transfer Test, the Tai Chi Chuan Group presented shorter transfer times from the sitting to the standing position, with less sway in the final standing position. CONCLUSION: The elderly individuals who practiced Tai Chi Chuan had better bilateral balance with eyes open on both types of surfaces compared with the Dance Group. The Dance Group had better unilateral postural balance with eyes closed. The Tai Chi Chuan Group had faster walking speeds, shorter transfer times, and better postural balance in the final standing position during the Sit-to-stand Test. .

The Prevention of Falls

Performing a fall-related multifactorial assessment combined with a multifactorial intervention is likely to reduce the rate of falls and risk of falling. For a high risk group, a more comprehensive assessment is required. Multifactoral intervention means the adjusted subset of interventions that target the risk factors that have been identified through a fall risk assessment. Overall, current evidence shows that they reduce the rate of falls in older people living in the community. Exercise programs are effective in reducing the rate of falls. Especially, programs including balance training are more beneficial. Exercise duration needs to be long enough to obtain its benefit. Patients who have fallen should have their medication reviewed and for older individuals, a reduction or withdrawal of the medication should be considered. An 800 IU vitamin D daily supplement is recommended for all older adults at risk of falls. Environmental hazard assessment and modification, managing vision impairment, postural hypertension, heart rate and rhythm abnormalities, foot and footwear problems and the use of assistive devices are also beneficial and recommended.

Effects of a Fall Prevention Program on Physical Functions and Psychological Functions in Rural Elderly Women / 재활간호학회지

PURPOSE: The purpose of this study was to determine the effects of a fall prevention program on gait ability, one leg standing-right, one leg standing-left, fear of falling, fall efficacy, and depression in the elderly. METHODS: A fall prevention program was consisted of fall preventing exercise with laughter therapy. Quasi-experimental design with one group pre- and post-test was used. Twenty-two elderly were participated in this study from a community health center located in a rural area, South Korea. SPSS/WIN 18.0 was used for descriptive analysis and paired t-test. RESULTS: After 12 weeks with a fall prevention program, gait ability (t=3.44, p=.002), one leg standing-right (t=-3.73, p=.001), one leg standing-left (t=-4.17, p<.001) and fear of falling (t=2.12, p=.046) in the elderly were significantly improved. CONCLUSION: A fall prevention program was effective on physical and psychological functions. This study suggested that control groups and a larger sample should be included in order to validate the effects of a fall prevention program for the elderly.