Community-Based Fall Prevention and Exercise Programs for Older Adults

Sustainability of fall prevention exercise programmes for community-dwelling older adults: a scoping review protocol

INTRODUCTION

Falls have financial, emotional and physical implications for ageing individuals and the healthcare system. Evidence-based exercise programmes have been one of the most effective ways of preventing falls in community dwellings for older adults. However, more research is needed to understand how to sustain these programmes. This scoping review protocol describes our plan to investigate the factors influencing the sustainability of community-based fall prevention exercise programmes.

METHODS AND ANALYSIS

Our scoping review will use the Joanna Briggs Institute methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews framework. The studies will have no restrictions, including publication date, language or geographic location. Key search terms concerning programme sustainability and exercise falls prevention will be conducted in Medline, EMBASE, Cumulative Index to Nursing and Allied Health Literature, Academic Search Premier, APA PsycINFO and SPORTDiscus in consultation with an experienced librarian. Once duplicates have been removed, two independent reviewers will conduct title and abstract screening, full-text screening and data extraction. Data from eligible articles will be collated and charted to summarise data into three categories: (1) study description, including publication date, author(s), study location, paper's aim/purpose, study participants, study design and conclusion; (2) data regarding the type of exercise programme will be used using the 16-point checklist Consensus on Exercise Reporting Template; and (3) data regarding sustainability will be organised using domains from the Program Sustainability Assessment Tool. Our results will be charted through the use of Covidence to identify patterns across the studies. Additionally, narrative synthesis will be employed to articulate the study findings.

ETHICS AND DISSEMINATION

As this is a scoping review, we do not require ethics approval. We intend to share our report findings with scientists, healthcare professionals and decision-makers. We will publish our results in reputable scientific journals and present them at relevant conferences.

Frailty Markers and Falls Among US Clergy

Studies examining frailty, physical performance, and falls among the clergy are limited. The objective of the study was to analyze sociodemographic profiles, gait, strength, and falls between diocesan and religious clergy. Participants included eighty-eight male Catholic clergy primarily in the northeast United States. Participants completed a demographic profile and gait velocity and strength measures. Results noted that more diocesan priests were retired (p = .02). Participants with a fall history demonstrated slower gait (p = .001) and weaker grip strength (p = .017) and were more likely to have a fear of falling (p = .009). Findings underscore the importance of fall screening among clergy.

Addressing Biomechanical Errors in the Back Squat for Older Adults: A Clinical Perspective for Maintaining Neutral Spine and Knee Alignment

Background/Objectives: Falls pose a significant health risk for older adults, often due to balance disorders and decreased mobility. Methods: The ability to perform sit-to-stand transfers, which involve squatting, is crucial for daily independence. Incorporating squats into exercise routines can enhance lower body strength, reduce fall risk, and improve overall quality of life. Results: While the back squat is beneficial, proper form is essential to avoid biomechanical errors, like lumbar hyperlordosis and knee valgus. Conclusions: Health and fitness professionals, such as physical therapists and/or clinical exercise physiologists, should carefully guide older adults in performing the back squat, addressing any functional deficits, and ensuring proper technique to minimize the risk of injury and maximize the benefits.

A Process Evaluation of a Fall Prevention Intervention Using the RE-AIM Framework

BACKGROUND

Home hazard removal programs are effective in reducing falls among older adults, but delivery in the United States is limited.

OBJECTIVES

We completed a process evaluation of the Home Hazard Removal Program (HARP), an intervention delivered by occupational therapists.

METHODS

Using the RE-AIM framework (reach, effectiveness, adoption, implementation, maintenance), we examined outcomes using descriptive statistics and frequency distribution. We examined differences between covariates using Pearson correlation coefficients and two-sample t tests.

RESULTS

79.1% of eligible older adults participated (reach); they experienced a 38% reduction in fall rates (effectiveness). Ninety percent of recommended strategies were completed (adoption), 99% of intervention elements were delivered (implementation), and 91% of strategies were still used at 12 months (maintenance). Participants received an average of 258.6 minutes of occupational therapy. An average of US$765.83 was spent per participant to deliver the intervention.

CONCLUSIONS

HARP has good reach, effectiveness, adherence, implementation, and maintenance and is a low-cost intervention.

Student coaching in a rural community fall prevention program: An exploratory study

Falls are a significant cause of disability internationally. The purpose of this exploratory study was to examine the effectiveness of a community fall prevention program, Stepping On (SO), using nine student physical therapists and program faculty in a rural setting. A mixed-methods design was utilized. Students partnered with older adults to master exercises, demonstrate floor recovery techniques, and manage community navigation in line with program fidelity. A descriptive survey assessed program outcomes. Students participated in a follow-up focus group to discuss perspectives on their role in the program. One hundred and seventeen community-dwelling older adults (mean age: 75.2 ± 8.5) completed the program. Participants who lived alone were likely to limit their activities because of fear of falling (p = .045). Following SO most subjects (87.7%) described having a better understanding of falls and their causes, with a plan to arise from the floor (82.6%). Focus group themes underscored students' opportunity to facilitate, reinforce safety during mobility activities, and motivate participants. Furthermore, an increased awareness of other professions' contribution to fall prevention was noted. Following a community fall prevention program, older adults have a better understanding of fall prevention and plan for floor recovery. In turn, student coaching skills are reinforced.

Effectiveness of Olympic Combat Sports on Balance, Fall Risk or Falls in Older Adults: A Systematic Review

Simple Summary

The regular practice of physical activity has achieved greater diffusion in recent years as a strategy for fall prevention and improving or maintaining the general health status of older adults, which contributes to an active and healthy lifestyle. The strategies to promote active and healthy aging need to be reassessed due to the COVID-19 pandemic to promote the safe practice of physical activity among older adults, considering, among other measures, practicing social distancing or training at home. Such a scenario could provide the opportunity to promote physical activity that requires a limited number of participants in reduced spaces for its practice, such as Olympic combat sports. In this review, an overview of the effects of Olympic combat sports on balance, fall risk, or falls in older adults is presented. From 1496 records, eight studies were included, involving 322 older adults (64% female; mean age = 71.1 years). The available evidence does not allow a definitive recommendation for or against Olympic combat sports interventions as an effective strategy to improve balance and reduce the fall risk or falls in older adults. Therefore, more high-quality studies are required to draw definitive conclusions.

Abstract

This systematic review and meta-analysis aimed to assess the available body of published peer-reviewed articles related to the effects of Olympic combat sports (OCS), compared with active/passive controls, on balance, fall risk, or falls in older adults. The TESTEX and GRADE scales assessed the methodological quality and certainty of the evidence. The protocol was registered in PROSPERO (code: CRD42020204034). From 1496 records, eight studies were included, involving 322 older adults (64% female; mean age = 71.1 years). The TESTEX scale revealed all studies with a score ≥ 60% (moderate-high quality). The GRADE scale indicated all studies with at least some concerns, up to a high risk of bias (i.e., was rated very low). Meta-analyses were planned, although the reduced number of studies precluded its incorporation in the final manuscript. Only two from six studies that assessed balance found improvements after OCS compared to controls. No differences were found between OCS vs. control groups for fall risk or falls. The available evidence does not allow a definitive recommendation for or against OCS interventions as an effective strategy to improve balance and reduce the fall risk or falls in older adults. Therefore, more high-quality studies are required to draw definitive conclusions.