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18 Νοεμβρίου 2017, 08:38:07

Αποστολέας Θέμα: Σωματική άσκηση.  (Αναγνώστηκε 11872 φορές)

0 μέλη και 1 επισκέπτης διαβάζουν αυτό το θέμα.

14 Νοεμβρίου 2017, 22:24:29
Απάντηση #15
Αποσυνδεδεμένος

Argirios Argiriou

Moderator
Δεν είναι ορατοί οι σύνδεσμοι (links). Εγγραφή ή Είσοδος
August 13, 2015

[spoiler]Progressive Balance Training Program Prevents Injurious Falls in Older Women

Paul S. Mueller, MD, MPH, FACP reviewing El-Khoury F et al. BMJ 2015.

At 2 years, balance and gait performance had improved significantly.

Randomized trials have shown that exercise programs that emphasize balance training lower risk for falls in community-dwelling elders. However, these trials generally have lacked power to determine whether such programs prevent injurious falls. In this multicenter controlled trial from France, 706 older women (age, 75–85) with diminished balance or gait capacities and living in their own homes were assigned randomly to a 2-year progressive balance training program or no intervention (control group). Balance training consisted of weekly supervised group sessions supplemented by individually prescribed home exercises. All participants received information about fall prevention. Injurious falls were categorized as moderate (e.g., those resulting in bruising, sprains, or abrasions) or severe (e.g., those resulting in fractures, head injury requiring hospital admission, joint dislocation, or lacerations requiring suturing).

Significantly fewer injurious falls occurred in the intervention group than in the control group (305 vs. 397; hazard ratio, 0.8); of severe falls, 68 occurred in the intervention group, and 87 occurred in the control group (HR, 0.8). At 2 years, women in the intervention group performed significantly better on all balance and gait tests and had significantly better perception of their overall physical function than women in the control group.

COMMENT

Injurious falls result in substantial morbidity, functional decline, and premature institutionalization. In this trial, progressive balance training prevented injurious falls and improved physical function in older women at high risk for falls. Elders should be encouraged to engage in such programs.

EDITOR DISCLOSURES AT TIME OF PUBLICATION

Disclosures for Paul S. Mueller, MD, MPH, FACP at time of publication
Consultant / advisory boardBoston Scientific (Patient Safety Advisory Board)
Editorial boardsMedical Knowledge Self-Assessment Program (MKSAP 17 General Internal Medicine Committee); MKSAP 17 General Internal Medicine (author/contributor)
Leadership positions in professional societiesAmerican Osler Society (Vice President)

CITATION(S):

El-Khoury F et al. Effectiveness of two year balance training programme on prevention of fall induced injuries in at risk women aged 75-85 living in community: Ossébo randomised controlled trial. BMJ 2015; 351:h3830. (Δεν είναι ορατοί οι σύνδεσμοι (links). Εγγραφή ή Είσοδος)
[/spoiler]
- See more at: Δεν είναι ορατοί οι σύνδεσμοι (links). Εγγραφή ή Είσοδος

Και ένα σχετικό βίντεο:

Balance Exercises for Seniors - Stronger Seniors Chair Exercise Program


SUMMARY AND COMMENT | GENERAL MEDICINE
November 09, 2017

Meta-Analysis of Strategies to Prevent Injurious Falls in Older Adults

Thomas L. Schwenk, MD reviewing Tricco AC et al. JAMA 2017 Nov 7.

Exercise alone or as part of a multicomponent intervention was effective.

Studies of approaches to prevent falls that result in serious injury in older adults (age, ≥65) have focused mostly on comparing single interventions, as have subsequent meta-analyses. Now, investigators have conducted complex pairwise and network meta-analyses of data from 283 randomized, controlled trials with 160,000 participants (mean age, 78; 74% women) to explore the effects of both single and multicomponent fall-prevention interventions.

The following four single and combined interventions were associated with lower risk for injurious falls, compared with usual care:

Exercise, such as walking and balance training (odds ratio, 0.51)

Exercise combined with vision assessment and treatment (OR, 0.17)

Exercise combined with vision assessment and treatment and environmental assessment and modifications (e.g., installing grab bars, removing throw rugs; OR, 0.30)

Clinic-based quality-improvement strategies (e.g., staff education, assigned case management) combined with multifactorial assessment and treatment (e.g., comprehensive geriatric assessment) and vitamin D and calcium supplementation (OR, 0.12).

COMMENT

The solution to the expensive and clinically serious problem of injurious falls lies in combining home-based and clinic-based interventions. This analysis is a good example of how improving population health requires not only moving out of typical emergency and hospital settings but also making a coordinated commitment of resources by health care systems beyond the level of individual clinicians.

EDITOR DISCLOSURES AT TIME OF PUBLICATION
Disclosures for Thomas L. Schwenk, MD at time of publication

Editorial boards

UpToDate

CITATION(S):
Tricco AC et al. Comparisons of interventions for preventing falls in older adults: A systematic review and meta-analysis. JAMA 2017 Nov 7; 318:1687. (Δεν είναι ορατοί οι σύνδεσμοι (links). Εγγραφή ή Είσοδος)

Larson EB.Evidence supports action to prevent injurious falls in older adults. JAMA 2017 Nov 7; 318:1659. (Δεν είναι ορατοί οι σύνδεσμοι (links). Εγγραφή ή Είσοδος)

Δεν είναι ορατοί οι σύνδεσμοι (links). Εγγραφή ή Είσοδος



Before ordering a test decide what you will do if it is (1) positive, or (2) negative. If both answers are the same, don't do the test. Archie Cochrane.

Λέξεις κλειδιά: σωματική άσκηση υγεία φυσική 
 

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