Intensive Exercise Reduces the Fear of Additional Falls in Elderly People: Findings from the Korea Falls Prevention Study
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Background/Aims: Falls among older people are a major public health problem and may result in fracture, medical complications that require hospitalization, and fear of additional falls. Given the prevalence and impact of the fear of falling again, reducing the incidence of falls is important to prevent additional falls. This study analyzed whether exercise programs decrease the fear of future falls in elderly patients who have fallen previously. Methods: A randomized controlled study was performed that included 65 elderly community-dwelling subjects who had fallen in the previous year. Subjects were randomized into two groups: an exercise group (EG, n = 36) and a control group (CG, n = 29). The EG participated in three exercise sessions per week for 12 weeks. Muscle strength, balance, agility, flexibility, and muscular endurance were measured at baseline and after 12 weeks. Results: After the 12-week exercise program, the subjects in the EG demonstrated remarkable improvement in their walking speed, balance (p = 0.003), back strength (p = 0.08), lower extremity strength (p = 0.004), and flexibility (p < 0.001). When asked whether they were afraid of falling, more participants in the EG than in the CG responded “not at all” or “a little.”Conclusions: The 12-week exercise program described here reduced the fear of falling (p = 0.02). It also improved the balance, flexibility, and muscle strength of the participants and was associated with improved quality of life.
Abstract
Background/Aims: Falls among older people are a major public health problem and may result in fracture, medical complications that require hospitalization, and fear of additional falls. Given the prevalence and impact of the fear of falling again, reducing the incidence of falls is important to prevent additional falls. This study analyzed whether exercise programs decrease the fear of future falls in elderly patients who have fallen previously. Methods: A randomized controlled study was performed that included 65 elderly community-dwelling subjects who had fallen in the previous year. Subjects were randomized into two groups: an exercise group (EG, n = 36) and a control group (CG, n = 29). The EG participated in three exercise sessions per week for 12 weeks. Muscle strength, balance, agility, flexibility, and muscular endurance were measured at baseline and after 12 weeks. Results: After the 12-week exercise program, the subjects in the EG demonstrated remarkable improvement in their walking speed, balance (p = 0.003), back strength (p = 0.08), lower extremity strength (p = 0.004), and flexibility (p < 0.001). When asked whether they were afraid of falling, more participants in the EG than in the CG responded “not at all” or “a little.”Conclusions: The 12-week exercise program described here reduced the fear of falling (p = 0.02). It also improved the balance, flexibility, and muscle strength of the participants and was associated with improved quality of life.
참고문헌 (39)
- Oliver D, "Risk factors and risk assessment tools for falls in hospital in-patients: a systematic review", Age Ageing, 33, pp.122~130 (2004)
- Kannus P, "Prevention of falls and consequent injuries in elderly people", Lancet, 366, pp.1885~1893 (2005)
- Tinetti ME, "Risk factors for falls among elderly persons living in the community", N Engl J Med, 319, pp.1701~1707 (1988)
- Lord SR, "Falls in Older People: Risk Factors and Strategies for Prevention. 2nd ed" (2001), Cambridge University Press
- Bergeron E, "A simple fall in the elderly: not so simple", J Trauma, 60, pp.268~273 (2006)
- Nachreiner NM, "Circumstances and consequences of falls in community-dwelling older women", J Womens Health, 16, pp.1437~1446 (2007)
- Akyol AD, "Falls in the elderly: what can be done?", Int Nurs Rev, 54, pp.191~196 (2007)
- Lachman ME, "Fear of falling and activity restriction: the survey of activities and fear of falling in the elderly (SAFE)", J Gerontol B Psychol Sci Soc Sci, 53, pp.P43~P50 (1998)
- Scheffer AC, "Fear of falling: measurement strategy, prevalence, risk factors and consequences among older persons", Age Ageing, 37, pp.19~24 (2008)
- Howland J, "Covariates of fear of falling and associated activity curtailment", Gerontologist, 38, pp.549~555 (1998)
- Friedman SM, "Falls and fear of falling: which comes first? A longitudinal prediction model suggests strategies for primary and secondary prevention", J Am Geriatr Soc, 50, pp.1329~1335 (2002)
- Huang TT, "Reducing the fear of falling among community-dwelling elderly adults through cognitive-behavioural strategies and intense Tai Chi exercise: a randomized controlled trial", J Adv Nurs, 67, pp.961~971 (2011)
- Murphy SL, "Characteristics associated with fear of falling and activity restriction in community-living older persons", J Am Geriatr Soc, 50, pp.516~520 (2002)
- Bruce DG, "Recreational physical activity levels in healthy older women: the importance of fear of falling", J Am Geriatr Soc, 50, pp.84~89 (2002)
- Tinetti ME, "A multifactorial intervention to reduce the risk of falling among elderly people living in the community", N Engl J Med, 331, pp.821~827 (1994)
- Chang JT, "Interventions for the prevention of falls in older adults: systematic review and meta-analysis of randomised clinical trials", BMJ, 328, pp.680~ (2004)
- Campbell AJ, "Rethinking individual and community fall prevention strategies: a meta-regression comparing single and multifactorial interventions", Age Ageing, 36, pp.656~662 (2007)
- Gates S, "Multifactorial assessment and targeted intervention for preventing falls and injuries among older people in community and emergency care settings: systematic review and meta-analysis", BMJ, 336, pp.130~133 (2008)
- Gillespie LD, "Interventions for preventing falls in older people living in the community", Cochrane Database Syst Rev, (2), pp.CD007146~ (2009)
- Powell LE, "The activities-specific balance confidence (ABC) scale", J Gerontol A Biol Sci Med Sci, 50A, pp.M28~M34 (1995)
- Mahoney FI, "Functional evaluation: the Barthel index", Md State Med J, 14, pp.61~65 (1965)
- Lawton MP, "Assessment of older people: self-maintaining and instrumental activities of daily living", Gerontologist, 9, pp.179~186 (1969)
- Development of Instrument of Function and QOL for the Disabled: Service Report of National Rehabilitation Center and Local Community Health Research Center, "Shin YJ", Hanyang University Institute for Community Health, ~ (2001)
- Lord SR, "Physiologic, psychologic, and health predictors of 6-minute walk performance in older people", Arch Phys Med Rehabil, 83, pp.907~911 (2002)
- Rao SS, "Prevention of falls in older patients", Am Fam Physician, 72, pp.81~88 (2005)
- Day L, "Randomised factorial trial of falls prevention among older people living in their own homes", BMJ, 325, pp.128~ (2002)
- Schlicht J, "Effect of intense strength training on standing balance, walking speed, and sit-to-stand performance in older adults", J Gerontol A Biol Sci Med Sci, 56, pp.M281~M286 (2001)
- Campbell AJ, "Psychotropic medication withdrawal and a home-based exercise program to prevent falls: a randomized, controlled trial", J Am Geriatr Soc, 47, pp.850~853 (1999)
- Kressig RW, "Associations of demographic, functional, and behavioral characteristics with activity-related fear of falling among older adults transitioning to frailty", J Am Geriatr Soc, 49, pp.1456~1462 (2001)
- Stel VS, "Balance and mobility performance as treatable risk factors for recurrent falling in older persons", J Clin Epidemiol, 56, pp.659~668 (2003)
- Steadman J, "A randomized controlled trial of an enhanced balance training program to improve mobility and reduce falls in elderly patients", J Am Geriatr Soc, 51, pp.847~852 (2003)
- Serra-Rexach JA, "Short-term, light- to moderate-intensity exercise training improves leg muscle strength in the oldest old: a randomized controlled trial", J Am Geriatr Soc, 59, pp.594~602 (2011)
- Stewart AL, "Evaluating the efficacy of physical activity for influencing quality-of-life outcomes in older adults", Ann Behav Med, 13, pp.108~116 (1991)
- Donald IP, "The prognosis of falls in elderly people living at home", Age Ageing, 28, pp.121~125 (1999)
- Hauer K, "Exercise training for rehabilitation and secondary prevention of falls in geriatric patients with a history of injurious falls", J Am Geriatr Soc, 49, pp.10~20 (2001)
- Falls (CG21): The Assessment and Prevention of Falls in Older People, "National Institute of Clinical Excellence", National Institute of Clinical Excellence, ~ (2004)
- Panel on Prevention of Falls in Older Persons, American Geriatrics Society and British Geriatrics Society, "Summary of the updated American Geriatrics Society", British Geriatrics Society clinical practice guideline for prevention of falls in older persons, 2011, pp.59, 148~157
- de Rekeneire N, "Is a fall just a fall: correlates of falling in healthy older persons. The Health, Aging and Body Composition Study", J Am Geriatr Soc, 51, pp.841~846 (2003)
- Stevens JA, "Gender differences for non-fatal unintentional fall related injuries among older adults", Inj Prev, 11, pp.115~119 (2005)