Fall Prevention Programs Research Articles

Fall prevention programmes for older adults in the community: impact on rate of falls.

Fall prevention programmes for older adults in the community: impact on rate of falls.

Can two multimodal psychomotor exercise programs improve attention, affordance perception, and balance in community dwellings at risk of falling? A randomized controlled trial

BackgroundFalls are associated with cognitive and physical function deterioration. Attention decline, inaccurate affordance perception, and balance impairment are considered to be risk factors for falls. Furthermore, few studies have reported psychomotor intervention as a fall prevention program. This study aimed to investigate the effects of two multimodal programs on attention, perceptual and stepping-forward boundaries, and balance in community-dwelling older adults at risk of falling.MethodsFifty-one community-dwelling older adults were recruited to participate in a 24-week randomized controlled trial. Participants (75.4 ± 5.6 years) were randomly assigned to one of three groups: the 1) multimodal psychomotor program [EG1], 2) combined program (multimodal psychomotor program + whole-body vibration program) [EG2], and 3) control group. Participants were assessed at baseline, at post-intervention, and after a 12-week no-intervention follow-up period.ResultsThe within-group comparisons showed significant improvements in attention and balance in EG1 and EG2 after the intervention (p < 0.05). The magnitudes of the treatment effects were similar in both EGs, ranging from medium to large. Decreases in the fall rate were also observed in EG1 (− 44.2%) and EG2 (− 63.0%) (p < 0.05). During the follow-up period, these improvements in attention were maintained, while those in balance were reversed in both EGs. No significant differences between groups were found.ConclusionsThese study results suggest that both multimodal exercise programs were effective for fall prevention and were well tolerated by the participants. Specifically, EG1 and EG2 showed identical improvements in attention, and EG2 presented a slightly larger enhancement in balance and a larger decrease in the fall rate. Our findings demonstrate the benefits of maintaining the psychomotor intervention program by itself or in combination with the whole-body vibration program to prevent cognitive and physical function deterioration.Trial registrationClinicalTrials.gov Identifier:NCT03446352. Date of registration: February 26, 2018.

Statistical analysis plan for the coaching for healthy AGEing trial – a cluster-randomised controlled trial to enhance physical activity and prevent falls in community-dwelling older people

BackgroundThis statistical analysis plan details the Coaching for Healthy AGEing (CHAnGE) trial analysis methodology. ObjectiveTo investigate the effect of a combined physical activity and fall prevention program on physical activity and falls compared to a healthy eating among people aged 60 years and over. MethodsThe CHAnGE trial is a pragmatic parallel-group cluster-randomised controlled trial with allocation concealment and blinded assessors. Clusters are allocated to either (1) a physical activity and fall prevention intervention or (2) to a healthy eating intervention. The primary outcomes are: objectively measured physical activity at 12 months post-randomisation, and self-reported falls throughout the 12-month trial period. Secondary outcomes include the proportion of participants reporting a fall, the proportion of participants meeting the Australian physical activity guidelines, body mass index, eating habits, mobility goal attainment, mobility-related confidence, quality of life, fear of falling, risk-taking behaviour, mood, well-being, self-reported physical activity, disability, and use of health and community services. AnalysisWe will follow the intention-to-treat principle. All analysis will allow for cluster randomisation using a generalised estimating equation approach. The between-group difference in the number of falls per person-year will be analysed using negative binomial regression models. For the continuously scored primary and secondary outcome measures, linear regression models adjusted for corresponding baseline scores will assess the effect of group allocation. Analyses will take into account cluster randomisation and will be adjusted for baseline scores. A subgroup analysis will assess differential effects of the intervention by baseline physical activity levels and history of falls.

Falls in Post-Polio Patients: Prevalence and Risk Factors.

Simple SummaryPeople with post-polio syndrome (PPS) suffer frequent falls due to muscle weakness and problems with their balance. In order for a rehabilitation clinician to fit the patient with the optimal treatment plan to prevent imbalance and falls, we performed a simple 10-min walking test with 50 PPS patients. We also asked the patients how many falls they had experienced in the last year and they filled out a questionnaire regarding their balance confidence. We found that we can predict the occurrence of falls in PPS patients based on the consistency of their walking pattern. Since it is very easy to measure the walking pattern, our results may help rehabilitation clinicians to identify individuals at risk of fall and reduce the occurrence of falls in this population. Individuals with post-polio syndrome (PPS) suffer from falls and secondary damage. Aim: To (i) analyze the correlation between spatio-temporal gait data and fall measures (fear and frequency of falls) and to (ii) test whether the gait parameters are predictors of fall measures in PPS patients. Methods: Spatio-temporal gait data of 50 individuals with PPS (25 males; age 65.9 ± 8.0) were acquired during gait and while performing the Timed Up-and-Go test. Subjects filled the Activities-specific Balance Confidence Scale (ABC Scale) and reported number of falls during the past year. Results: ABC scores and number of falls correlated with the Timed Up-and-Go, and gait cadence and velocity. The number of falls also correlated with the swing duration symmetry index and the step length variability. Four gait variability parameters explained 33.2% of the variance of the report of falls (p = 0.006). The gait velocity was the best predictor of the ABC score and explained 24.8% of its variance (p = 0.001). Conclusion: Gait variability, easily measured by wearables or pressure-sensing mats, is an important predictor of falls in PPS population. Therefore, gait variability might be an efficient tool before devising a patient-specific fall prevention program for the PPS patient.

Risk Factors Associated with Fall Awareness, Falls, and Quality of Life Among Ethnic Minority Older Adults in Upper Northern Thailand.

BackgroundFalls are a major public health issue and one of the leading causes of morbidity and mortality among the older adults in many countries. Falls and their consequences have an impact on people’s quality of life, particularly the older adults. However, there have been very few studies on falls among ethnic minority groups living in rural areas. The aim of this study was to examine factors related to fall awareness, falls, and quality of life among ethnic minority older adults living in northern Thailand.MethodsA cross-sectional study was conducted among 462 older adults from ethnic minority groups living in rural communities in Phayao and Lamphun provinces of northern Thailand using a multi-stage sampling technique. The data were collected through face-to-face interviews, with structured questionnaires covering health information, fall awareness, and quality of life (WHOQOL-OLD). The factors were determined using simple linear regression and binary logistic regression.ResultsThe mean age of the participants was 68.2, Karen (35.5%), Mien (24.2%), indigenous (20.8%), and Hmong (19.5%). In the previous 12 months, 20.6% of elders had experienced a fall, and 4.5% of them had experienced multiple falls. More than half of the elders had moderate fall awareness and quality of life (71.6% and 68.6%, respectively). Univariate analysis revealed that minority group, sociodemographic characteristics, sleep duration, and fear of falling were all found to be associated with fall awareness, falls, and quality of life score (p<0.001). There was a significant relationship among fall awareness, falls, and quality of life score (p<0.001). Compared to those who had not fallen in the previous year, the quality of life of the older adults who had fallen was about 11 points lower.ConclusionSeveral independent variables were discovered to be fall risk factors and quality of life indicators. It is critical to recognize the risk factors to promote fall prevention programs that are appropriate for the older adults among ethnic minorities. Therefore, public health agencies and local government should be aware of the problem and initiate an implementation program and policy to prevent falls and improve the quality of life among ethnic minority older adults.

Using Patient Simulation to Promote Best Practices in Fall Prevention and Postfall Assessment in Nursing Homes.

Background:Fall-related injuries rise with age and are of particular concern for frail populations living in nursing homes.Local Problem:The Perley and Rideau Veterans' Health Centre is a large nursing home in Ontario, Canada. In 2019, we conducted internal audits of our Falls Prevention Program and identified notable variations in staff's response to a resident fall.Interventions:We developed an in situ patient simulation program of a resident fall.Methods:This was a mixed-methods evaluation of participants' perspectives of a simulation-based interprofessional education program for fall prevention.Results:Participants indicated high-level support for simulation-based learning, with more than 80% of the participants expressing that they will apply these skills in the future when caring for a resident who falls.Conclusions:Our findings indicate that simulation-based training is well received by frontline workers in a nursing home setting and can be conducted as part of a typical shift with minimal disruption to resident care.

Review of NCOA Evidence Based Fall Prevention Strategies for the Home Health Setting

<h3>Objective(s)</h3> To evaluate the effectiveness of National Council on Aging (NCOA) evidence based fall prevention programs that can be completed in the home setting. <h3>Data Sources</h3> We conducted searches of PEDRo, CINAHL, PubMed and Scopus using combinations of the following search terms: fall prevention, community, intervention, exercise, physical therapy, evidence based, home. <h3>Study Selection</h3> Criteria were chosen to capture all studies that included NCOA fall prevention programs that can be implemented in the home setting. Inclusion criteria identified studies from peer-reviewed journals including NCOA fall prevention programs with elements allowing for individualized training and implementation. Studies with only community based, group provision were excluded. <h3>Data Extraction</h3> For articles included in this review, the following information was extracted: type of study, methodological quality review, level of evidence, number of subjects, outcome measures used, interventions, primary positive and negative results, and setting. <h3>Data Synthesis</h3> Four NCOA evidence based fall prevention programs were identified as appropriate to be provided in the home setting: CAPABLE, FallScape, FallsTalk and the Otago Exercise Program. Data extracted from included articles demonstrated improvements with falls efficacy, reduction in the number of falls, and increased recognition of fall risk. <h3>Conclusions</h3> Falls are a concern for older adults with expensive medical care and a loss of independence for the individual. With our analysis, 4 NCOA programs can be reasonably provided in the home setting. Only one program (CAPABLE) is specifically designed to be implemented in the home setting. While there is strong evidence of the effectiveness of these programs, more work is recommended to determine the best practices for provision of home programs. This work is relevant with the COVID-19 pandemic limiting community interventions. <h3>Author(s) Disclosures</h3> The authors declare no conflicts of interest.

Self-Monitoring of Balance Performance can Reduce the Rate of Falls Among Older Adults.

Background: 29% of older adults fall annually, resulting in the leading cause of accidental death. Fall prevention programs typically include exercise training and self-monitoring of physical activity has a positive effect on the self-efficacy and self-regulation of exercise behaviors. We assessed if self-monitoring of fall risk, without an intervention, impacts fall rates.Methods: Fifty-three older adults had open access to a balance measuring platform which allowed them to self-monitor their postural stability and fall risk using a simple 1-min standing balance test. 12-month retrospective fall history was collected and a monthly/bimonthly fall log captured prospective falls. Participants had access to self-monitoring for up to 2.2 years. Fall history and fall incidence rate ratios and their confidence intervals were compared between the periods of time with and without access to self-monitoring.Results: A 54% reduction in the number of people who fell and a 74% reduction in the number of falls was observed when participants were able to self-monitor their postural stability and fall risk, after normalizing for participation length. Further, 42.9% of individuals identified as having high fall risk at baseline shifted to a lower risk category at a median 34 days and voluntarily measured themselves for a longer period of time.Discussion: We attribute this reduction in falls to changes in health behaviors achieved through empowerment from improved self-efficacy and self-regulation. Providing older adults with the ability to self-monitor their postural stability and intuit their risk of falling appears to have modified their health behaviors to successfully reduce fall rates.

The Effectiveness of the Stepping-On Fall Prevention Program on the Quality of Life, Fear of Fall, and Fall-Preventive Behaviors Among Community-Dwelling Older Adults: A Randomized Clinical Trial

Background: Along with increasing population of the elderly in various countries, the incidence of falls and respective damages has also increased. Objectives: Given the numerous disagreements regarding the effectiveness of different interventions mentioned in various sources, the present study aimed to examine the effectiveness of the Stepping-On fall preventive program on the quality of life, fear of fall, and fall-preventive behaviors among community-dwelling older adults in Shiraz, Iran. Methods: This study is a single-blinded randomized interventional or clinical trial study conducted on 90 elderly people under the coverage of two large health centers during 2019 - 2020 in Shiraz, Iran. Multi-stage randomized sampling was used to select the participants who were randomly allocated to either of the intervention (n = 45) or control groups (n = 45). Data collection tools were the Fall Efficiency Scale, fall prevention behaviors, and Lipad quality of life questionnaires. The intervention group participated in a 7-session Stepping-On program, while the control group received the same routine care. Collected data were analyzed with SPSS software version 22. Results: The findings indicated that the Stepping-On program was effective on the fear of falling scores (P = 0.008) and the quality of life of the elderly under study (P = 0.019) at follow-up time. However, there was no significant difference immediately after the intervention (P &gt; 0.05). However, the mean score of fall-preventing behaviors increased during the course of the study and reached a significant level immediately after the study was conducted (P = 0.046) and the other two months later (P = 0.028). Conclusions: The Stepping-On program may apparently affect the study variables. Therefore, further research is suggested to confirm the effectiveness of this program so that it can be used across all healthcare centers for the elderly.

CE: Reimagining Injurious Falls and Safe Mobility.

Injurious falls remain among the most common, dangerous, and costly adverse events in hospitals, despite the widespread implementation of fall prevention programs. Many current health care system policies and nursing practices oversimplify fall prevention by focusing on limiting the person's mobility and making the environment safer, or simply documenting a fall risk score. But most falls are caused by factors intrinsic to that individual; merely limiting their mobility can increase preventable hospital complications and readmissions, and still leaves them at risk for falls. This article proposes a new approach to reducing injurious falls in older adults-one grounded in evidence-based protocols known to positively impact the health of older adults. The approach, called by the acronym ERA-Electronic health record integration, Risk factors that matter, Assessment and care plans-allows nurses to use a validated fall risk assessment tool to reframe fall risk factors as part of the comprehensive care plan, and to map modifiable risk factors to interventions that address the underlying causes of falls and promote safer mobility. The ERA approach can help nurses use their time more effectively by focusing on targeted actions that improve patient outcomes, working in coordination with an interprofessional, cross-continuum care team.

Nutritional and Non-Communicable Disease (NCD) Status Association with Fall among Older Persons in Malaysia: Findings from National Health and Morbidity Survey (NHMS) Malaysia 2018

ntroduction Fall is a health problem for older persons. This study investigates the potential factors of concern: the nutritional status of the elderly and non-communicable disease association with incidents of falls. Methods and Materials This study used data from NHMS 2018, a cross-sectional design, applied two-stage stratified cluster sampling. Descriptive statistics such as the percentage of each variable were done. Factors associated with falls were determined at both univariate and multivariable levels using simple logistic regression and multiple logistic regression. The data were presented as standard values for each analysis and adjusted odds ratios with 95% CI with p values (&lt;0.05). Results A total of 3,867 from 3,977 elderly (mean age 68.2+ 6.85) were recruited with the response rate of 97.2%. Factors associated with fall were 70 years old and above (AOR= 1.34, 95% CI: 1.09, 1.64), obesity (AOR=1.55, 95% CI: 1.21, 1.98), undernutrition (AOR=1.59, 95% CI: 1.30, 1.94), persons with 2 NCDs (AOR=1.49, 95% CI: 1.15, 1.92) and persons with 3 NCDs (AOR=1.63, 95% CI: 1.23, 2.16). Discussion and Conclusion Advanced age, malnutrition, obesity, and having two or more NCD are associated with falls in the NHMS 2018 study. In conclusion, falls are prevalent among older persons. There is an urgent need for public health strategies to decrease the incidence and early identification of those at risk. Implementation of fall preventive programs can also significantly reduce falls among the elderly.

A Survey-Based Assessment of "Matter of Balance" Participant Fall-Related Experience.

Falls are a substantial cause of injury in older adults, which can be attributed to progressive lack of physical activity, associated comorbidities, social isolation, and chronic health conditions. Fall prevention courses are designed to educate participants on fall safety and increase activity levels and social engagement. The purpose of this study was to evaluate the perceived effectiveness of a nationally recognized fall prevention course on self-reported fall frequency and lifestyle habits. This was a single-group pretest-posttest study of a convenience sample of older adults enrolled in a group fall prevention program, A Matter of Balance, in a community setting between March 2019 and March 2020. Questionnaires were distributed at the first and final sessions of the course to evaluate participant perceptions of the program and its impact on their fall history, exercise habits, and social engagement. Comparisons were made using Wilcoxon rank sum tests. A total of 40 class members agreed to participate, with 29 (73%) completing both the presurvey and the postsurvey. Responses indicated no change in the number of falls or participants following an established exercise routine. However, of those who fell prior to the course, 75% reported a reduction in falls. In addition, the participants reported an overall increase in weekly exercise frequency. In those who reported fear of falling, 71% reported a reduction in fear following the course. The participants in this study self-reported a decrease in fall rate, a decrease in fear of falling, and an increase in exercise frequency. The course is not fall protective but can be considered an adjunct to fall prevention measures that include medical, medication, visual, and environmental management.

Fall prevention education to reduce fall risk among community-dwelling older persons: A systematic review.

ObjectivesThis review aims to identify types of the existing fall prevention education (FPE) and their effectiveness in promoting fall risk awareness, knowledge and preventive fall behaviour change among community‐dwelling older people.BackgroundFPE is a cost‐effective and helpful tool for reducing fall occurrences.EvaluationThis is a systematic review study using electronic searches via EBSCOHost® platform, ScienceDirect, Scopus and Google Scholar in March 2021. The review protocol was registered with PROSPERO (CRD42021232102). The Preferred Reporting Items for Systematic reviews and Meta‐Analyses (PRISMA) statement flow chart guided the search strategy. Articles published from January 2010 to March 2021 were included for quality appraisal using the ‘Transparent Reporting of Evaluations with Non‐randomised Designs’ (TREND) and the ‘Consolidated Standards of Reporting Trials’ (CONSORT) statement for randomised controlled trial studies.Key issuesSix FPE studies selected emphasised on personal health status, exercise and environmental risk factors. These studies reported an increase in fall risk awareness or knowledge and a positive change in fall preventive behaviours. Two studies included nurses as educators in FPE.ConclusionFPE evidently improved awareness or knowledge and preventive fall behaviour change among older adults. Nurses are in great potential in planning and providing FPE for older adults in community settings.Implications for Nursing ManagementExpand nurses' roles in fall prevention programmes in community settings by using high‐quality and evidence‐based educational tools. Highlight the nurse's role and collaborative management in FPE.

A Technological-Based Platform for Risk Assessment, Detection, and Prevention of Falls Among Home-Dwelling Older Adults: Protocol for a Quasi-Experimental Study.

BackgroundAccording to the United Nations, it is estimated that by 2050, the number of people aged 80 years and older will have increased by 3 times. Increased longevity is often accompanied by structural and functional changes that occur throughout an individual’s lifespan. These changes are often aggravated by chronic comorbidities, adopted behaviors or lifestyles, and environmental exposure, among other factors. Some of the related outcomes are loss of muscle strength, decreased balance control, and mobility impairments, which are strongly associated with the occurrence of falls in the elderly. Despite the continued undervaluation of the importance of knowledge on fall prevention among the elderly population by primary care health professionals, several evidence-based (single or multifaceted) fall prevention programs such as the Otago Exercise Program (OEP) have demonstrated a significant reduction in the risk of falls and fall-related injuries in the elderly within community settings. Recent studies have strived to integrate technology into physical exercise programs, which is effective for adherence and overcoming barriers to exercise, as well as improving physical functioning.ObjectiveThis study aims to assess the impact of the OEP on the functionality of home-dwelling elderly using a common technological platform. Particularly, the impact on muscle strength, balance, mobility, risk of falling, the perception of fear of falling, and the perception of the elderly regarding the ease of use of technology are being examined in this study.MethodsA quasi-experimental study (before and after; single group) will be conducted with male and female participants aged 65 years or older living at home in the district of Porto. Participants will be recruited through the network COLABORAR, with a minimum of 30 participants meeting the study inclusion and exclusion criteria. All participants will sign informed consent forms. The data collection instrument consists of sociodemographic and clinical variables (self-reported), functional evaluation variables, and environmental risk variables. The data collection tool integrates primary and secondary outcome variables. The primary outcome is gait (timed-up and go test; normal step). The secondary outcome variables are lower limb strength and muscle resistance (30-second chair stand test), balance (4-stage balance test), frequency of falls, functional capacity (Lawton and Brody - Portuguese version), fear of falling (Falls Efficacy Scale International - Portuguese version), usability of the technology (System Usability Scale - Portuguese version), and environmental risk variables (home fall prevention checklist for older adults). Technological solutions, such as the FallSensing Home application and Kallisto wearable device, will be used, which will allow the detection and prevention of falls. The intervention is characterized by conducting the OEP through a common technological platform 3 times a week for 8 weeks. Throughout these weeks, the participants will be followed up in person or by telephone contact by the rehabilitation nurse. Considering the COVID-19 outbreak, all guidelines from the National Health Service will be followed. The project was funded by InnoStars, in collaboration with the Local EIT Health Regional Innovation Scheme Hub of the University of Porto.ResultsThis study was approved on October 9, 2020 by the Ethics Committee of Escola Superior de Enfermagem do Porto (ESEP). The recruitment process was meant to start in October, but due to the COVID-19 pandemic, it was suspended. We expect to restart the study by the beginning of the third quarter of 2021.ConclusionsThe findings of this study protocol will contribute to the design and development of future robust studies for technological tests in a clinical context.Trial RegistrationISRCTN 15895163; https://www.isrctn.com/ISRCTN15895163International Registered Report Identifier (IRRID)PRR1-10.2196/25781

The effects of the Otago Exercise Programme on actual and perceived balance in older adults: A meta-analysis

ObjectiveFalls are serious issues in older populations. Balance problems are a major cause of falls and may lead to fear of falling and decreased balance confidence. The Otago Exercise Programme (OEP) is an effective fall prevention program that benefits balance function and fear of falling. The primary aim of the meta-analysis was to investigate the effectiveness of the OEP intervention on actual balance performance (i.e., static, dynamic, proactive or reactive balance) and perceived balance ability (i.e., balance confidence or fear of falling) for older adults; the secondary aim was to examine which OEP protocol most improves balance in older adults.MethodsA systematic electronic review search was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines to identify randomized controlled trials (RCTs) investigating the effects of the OEP on actual balance performance and perceived balance ability in healthy older adults, and examining which OEP training protocol and intervention format most improves balance.ResultsA total of 12 RCTs were included in the analyses. The OEP exerted significant effects on static balance (Hedges’s g = 0.388; 95% confidence interval [CI] = 0.131 to 0.645), dynamic balance (g = -0.228; 95% CI = -0.352 to -0.1.4), proactive balance (g = 0.239; 95% CI = 0.061 to 0.416) and perceived balance (g = -0.184; 95% CI = -0.320 to -0.048) in older adults. Subgroup analysis indicated that the group format for the OEP was more effective for improving static (p = 0.008), dynamic (p = 0.004) and perceived balance (p = 0.004) than was the individual format. Sessions of >30 minutes were more effective in improving static (p = 0.007) and perceived balance (p = 0.014) than were sessions of ≤30 minutes. However, the effects of the OEP on balance were unrelated to the types of control group, training frequency and training period.DiscussionThe OEP is helpful for improving actual balance including static, dynamic, and proactive balance; enhancing confidence in balance control; and reducing fear of falling in older adults. In particular, administrating the OEP in a group setting in >30-minute sessions may be the most appropriate and effective exercise protocol for improving balance.

Comparison of forward and backward gait in males with and without intellectual disabilities.

Intellectual disabilities (ID) affect both cognitive and motor functions. The backward gait is a daily activity and its assessment is used for fall risk estimation and training in the general population. For proper use of backward gait as a rehabilitation tool and in fall prevention programmes for people with ID, it is necessary to determine the backward gait characteristics in the ID population. The aim of this study was to compare the differences between forward and backward gait in persons with nonsyndromic mild and moderate ID, persons with Down syndrome (DS) and a control group of healthy adults. Fifty males divided into four groups (mild ID: n=15, moderate ID: n=19, DS: n=6, controls: n=10) participated in this study. All participants were asked to walk both forward and backward, barefooted and at their natural velocity on a Zebris FDM platform. The Kruskal-Wallis H test was used to compare differences between the analysed groups in forward and backward gait. The Mann-Whitney U test was used to compare the differences between forward and backward gait within each group. The velocity was significantly slower in moderate ID and DS compared to controls in forward and backward gait. When comparing forward and backward gait within each group, the gait velocity decreased in backward gait compared with forward gait by 21.80% in controls, by 33.89% in mild ID, by 34.45% in moderate ID, and by 40.32% in DS. In both moderate ID and DS, the mean backward velocity was slower than 2.16km/h, the velocity used to identify elderly fallers in the general population. Gait velocity was especially affected in DS and moderate ID compared with controls. In both mentioned groups, the backward gait velocity suggests an increased risk of falling. Future studies are necessary to examine the possibility of improving balance control and leg muscle strength by backward walking training in the ID population.

Novel approaches to reduce the risk of falling in community dwellings: effects of two multimodal programs in lower-body strength—a pilot study

Abstract Background Muscle weakness is a key risk factor for falls and strength exercises should be included in fall prevention programs. A psychomotor intervention promoting motor stimulation and the whole-body vibration (WBV) providing muscle contractions may reduce the incidence of falls. Our hypothesis relies on the greater benefits of a combined program. This study aimed to evaluate the effectiveness and the feasibility of two 12-week multimodal programs in lower-body strength in community dwellings fallers or with balance impairment. Methods Thirty-seven participants (34 women; mean age 74.3 ± 5.2 years) were allocated into: experimental group 1 [EG1] (psychomotor intervention), or experimental group 2 [EG2] (combined program: psychomotor intervention plus WBV), 3x/week. Maximal strength of knee extensors and flexors was assessed by an isokinetic dynamometer at 60°/s. Wilcoxon and Mann-Whitney tests were performed. Results The overall adherence rate was high (86.3%), with a level intensity in the rating of perceived exertion of 12.1 ± 0.3 points, in EG1, and 12.5 ± 0.4 points, in EG2. Significant changes between the pre-post intervention were observed exclusively in EG2, in the variables ‘Peak torque extension’ (71.7 ± 28.6 Nm vs. 79.2 ± 23.5 Nm, P = 0.042) and ‘Agonist/Antagonist ratio’ (60.2 ± 13.0 vs. 53.5 ± 8.6, P = 0.013). The effect size (r) in both variables was medium. No significant changes between groups were detected. Conclusions This pilot results indicate that both programs were feasible and well-tolerated. The combined program demonstrates larger effectiveness, since the WBV may positively influence the lower-body strength, reducing the risk of falls. Trial Registration: ClinicalTrials.gov Identifier: NCT03446352. Funding: This pilot was granted by the ESACA Project (Grant ALT20-03-0145-FEDER-000007) and by FCT (SFRH/BD/147398/2019).

A cost-effectiveness evaluation of Dance to Health: a dance-based falls prevention exercise programme in England

ObjectivesThis study aimed to evaluate whether the falls prevention programme Dance to Health provides the health system with an effective and cost-effective means to address the issue of older people's falls. Study designThis study used a pre-post design; that is, the same assessment measures were used both before and after the programme. MethodsAnalysis and modelling were conducted using monitoring data (frequencies including session attendance, falls, general practitioner (GP) and hospital visits), comprehensive financial information (including all costs related to the delivery of Dance to Health), and the Public Health England economic model: ‘A return on investment tool for falls prevention programmes in older people based in the community’. ResultsFindings from the research show that under the suggested health intervention, there was a 58% reduction in the number of falls. Furthermore, the results also demonstrate that Dance to Health offers a potential cost saving of more than £196m over a 2-year period, of which £158m is a potential cost saving for the NHS. ConclusionsThe evidence outlines that Dance to Health offers the health system a cost-effective means to address the issue of older people's falls and most importantly a method that produces strong results in terms of falls prevention.

Causes, Consequences, and Fall Prevention Preferences for Adults in Mid-Life

Abstract Date Presented 04/20/21 Most research studying fall experiences and fall prevention program preferences focuses on older adults, overlooking the falls that occur in midlife. This pilot study gathered preliminary data on fall experiences, consequences, and fall prevention preferences of adults in midlife. Almost all participants experienced functional consequences from their fall and had interest in learning about fall prevention, suggesting that fall prevention programs could be beneficial for middle-aged adults. Primary Author and Speaker: Meredith H. Lee Additional Authors and Speakers: Rachel Reed Contributing Authors: Samantha Grant, Jodi Thomas, and Roy St. Laurent

The Stroll Safe Outdoor Fall Prevention Program: Feasibility and Future Directions

Abstract Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. Using a quasi-experimental design, the feasibility of the Stroll Safe outdoor fall prevention program was examined. Process, scientific, management, and resource assessments were conducted. Results reveal that the program is feasible to implement among active, community-dwelling older adults. Further study using an efficacy trial is warranted. This study helps to build the body of knowledge in outdoor fall prevention, an area of research and practice that is critical to productive aging. Primary Author and Speaker: Tracy Chippendale