Physical Therapy Rehabilitation Science

  • 제10권2호
  • /
  • Pages.185-196
  • /
  • 2021
  • /
  • 2287-7576(pISSN)
  • /
  • 2287-7584(eISSN)
물리치료재활과학회 (korean Academy of Physical Therapy Rehabilitation Science)
권호 표지
DOI QR코드

DOI QR Code

Relationship between Postural Balance Training and Fall Risks for Elderly: a Systematic Review of Randomized Controlled Trials

  • Kim, Heesuk (Department of Physical Therapy, Graduate school of Health and Welfare, Baekseok University) ;
  • Hwang, Sujin (Department of Physical Therapy, Division of Health Science, Baekseok University)
  • 투고 : 2021.06.09
  • 심사 : 2021.06.18
  • 발행 : 2021.06.30
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Objective: Falling is one of main accident to facilitate the physical injuries in order adults. The purpose of the systematic review was to determine the effects of postural balance training whether the recovery of falls in elderly with normal physical function or not throughout summing the selected studies quantitatively. Design: A systematic review Methods: MEDLINE and other four databases were searched up to April 20, 2021 and randomized controlled trials (RCTs) evaluating postural balance approaches on fall risks in elderly. The researched studies excluded the double studies, titles and abstract, and finally full-reported study. The selected RCTs studies were extracted characteristics of the studies and summary of results based on PICOS-SD (population, intervention, comparison, outcomes, and setting- study design) model to synthesize the papers qualitatively. Results: The review involved 22 RCT reports with 4,847 community older adults aged 65 years or over. Nineteen of the selected RCT studies reported dual or multimodal exercises show the beneficial effect for older adults compared to one-type treatment or no intervention. All of selected showed low risk in the selection, attrition, and reporting bias. However, detection bias showed low risk at 75% records of the involved RCTs and performance bias was low risk at only three records. Conclusions: The results of the systematic review propose that a standardized therapeutic approach and the intensity are needed for improving risk of falls in older adults.

키워드

참고문헌

  1. Cuevas-Trisan R. Balance problems and fall risks in the elderly. Phys Med Rehabil Clin N Am. 2017;28:727-37. https://doi.org/10.1016/j.pmr.2017.06.006
  2. World Health Organization. Falls. Geneva (Switzerland); 2021.
  3. Cadore EL, Rodriguez-Manas L, Sinclair A, Izquierdo M. Effects of different exercise interventions on risk of falls, gait ability, and balance in physically frail older adults: a systematic review. Rejuvenation Res. 2013;16:105-14. https://doi.org/10.1089/rej.2012.1397
  4. Thomas E, Battaglia G, Patti A, Brusa J, Leonardi V, Palma A, et al. Physical activity programs for balance and fall prevention in elderly: A systematic review. Medicine (Baltimore). 2019;98:e16218. https://doi.org/10.1097/MD.0000000000016218
  5. Osoba MY, Rao AK, Agrawal SK, Lalwani AK. Balance and gait in the elderly: A contemporary review. Laryngoscope InvestigOtolaryngol. 2019;4:143-53.
  6. Alhasan H, Alshehri MA, Wheeler PC, Fong DTP. Effects of Interactive Videogames on Postural Control and Risk of Fall Outcomes in Frail and Pre-frail Older Adults: A Systematic Review and Meta-Analysis. Games Health J. 2021;10:83-94. https://doi.org/10.1089/g4h.2020.0009
  7. Zhang Q, Liu Y, Li D, Jia Y, Zhang W, Chen B, et al. Exercise intervention for the risk of falls in older adults: A protocol for systematic review and meta-analysis. Medicine (Baltimore). 2021;100:e24548. https://doi.org/10.1097/MD.0000000000024548
  8. Jehu DA, Davis JC, Falck RS, Bennett KJ, Tai D, Souza MF, et al. Risk factors for recurrent falls in older adults: A systematic review with meta-analysis. Maturitas. 2021;144:23-8. https://doi.org/10.1016/j.maturitas.2020.10.021
  9. Almeida TL, Alexander NB, Nyquist LV, Montagnini ML, Santos AC, Rodrigues GH, et al. Minimally supervised multimodal exercise to reduce falls risk in economically and educationally disadvantaged older adults. J Aging Phys Act. 2013;21:241-59. https://doi.org/10.1123/japa.21.3.241
  10. Ansai JH, Aurichio TR, Goncalves R, Rebelatto JR. Effects of two physical exercise protocols on physical performance related to falls in the oldest old: A randomized controlled trial. GeriatrGerontol Int. 2016;16:492-9.
  11. Chittrakul J, Siviroj P, Sungkarat S, Sapbamrer R. Multi-System Physical Exercise Intervention for Fall Prevention and Quality of Life in Pre-Frail Older Adults: A Randomized Controlled Trial. Int J Environ Res Public Health. 2020;17.
  12. Delbaere K, Valenzuela T, Lord SR, Clemson L, Zijlstra GAR, Close JCT, et al. E-health Standing Tall balance exercise for fall prevention in older people: results of a two year randomised controlled trial. BMJ. 2021;373:n740.
  13. Freiberger E, Haberle L, Spirduso WW, Zijlstra GA. Long-term effects of three multicomponent exercise interventions on physical performance and fall-related psychological outcomes in community-dwelling older adults: a randomized controlled trial. J Am Geriatr Soc. 2012;60:437-46. https://doi.org/10.1111/j.1532-5415.2011.03859.x
  14. Gallo E, Stelmach M, Frigeri F, Ahn DH. Determining Whether a Dosage-Specific and Individualized Home Exercise Program With Consults Reduces Fall Risk and Falls in Community-Dwelling Older Adults With Difficulty Walking: A Randomized Control Trial. J Geriatr Phys Ther. 2018;41:161-72. https://doi.org/10.1519/JPT.0000000000000114
  15. Gawler S, Skelton DA, Dinan-Young S, Masud T, Morris RW, Griffin M, et al. Reducing falls among older people in general practice: The ProAct65+ exercise intervention trial. Arch Gerontol Geriatr. 2016;67:46-54. https://doi.org/10.1016/j.archger.2016.06.019
  16. Gouveia BR, Goncalves Jardim H, Martins MM, Gouveia ER, de Freitas DL, Maia JA, et al. An evaluation of a nurse-led rehabilitation programme (the Pro Balance Programme) to improve balance and reduce fall risk of community-dwelling older people: A randomised controlled trial. Int J Nurs Stud. 2016;56:1-8. https://doi.org/10.1016/j.ijnurstu.2015.12.004
  17. Halvarsson A, Franzen E, Faren E, Olsson E, Oddsson L, Stahle A. Long-term effects of new progressive group balance training for elderly people with increased risk of falling - a randomized controlled trial. Clin Rehabil. 2013;27:450-8. https://doi.org/10.1177/0269215512462908
  18. Jeon MY, Jeong H, Petrofsky J, Lee H, Yim J. Effects of a randomized controlled recurrent fall prevention program on risk factors for falls in frail elderly living at home in rural communities. Med Sci Monit. 2014;20:2283-91. https://doi.org/10.12659/MSM.890611
  19. Josephs S, Pratt ML, Calk Meadows E, Thurmond S, Wagner A. The effectiveness of Pilates on balance and falls in community dwelling older adults. J Bodyw Mov Ther. 2016;20:815-23. https://doi.org/10.1016/j.jbmt.2016.02.003
  20. LaStayo P, Marcus R, Dibble L, Wong B, Pepper G. Eccentric versus traditional resistance exercise for older adult fallers in the community: a randomized trial within a multi-component fall reduction program. BMC Geriatr. 2017;17:149. https://doi.org/10.1186/s12877-017-0539-8
  21. Lee HC, Chang KC, Tsauo JY, Hung JW, Huang YC, Lin SI, et al. Effects of a multifactorial fall prevention program on fall incidence and physical function in community-dwelling older adults with risk of falls. Arch Phys Med Rehabil. 2013;94:606-15, 15 e1. https://doi.org/10.1016/j.apmr.2012.11.037
  22. Li F, Harmer P, Fitzgerald K, Eckstrom E, Akers L, Chou LS, et al. Effectiveness of a Therapeutic Tai Ji Quan Intervention vs a Multimodal Exercise Intervention to Prevent Falls Among Older Adults at High Risk of Falling: A Randomized Clinical Trial. JAMA Intern Med. 2018;178:1301-10. https://doi.org/10.1001/jamainternmed.2018.3915
  23. Oh DH, Park JE, Lee ES, Oh SW, Cho SI, Jang SN, et al. Intensive exercise reduces the fear of additional falls in elderly people: findings from the Korea falls prevention study. Korean J Intern Med. 2012;27:417-25. https://doi.org/10.3904/kjim.2012.27.4.417
  24. Riva D, Fani M, Benedetti MG, Scarsini A, Rocca F, Mamo C. Effects of High-Frequency Proprioceptive Training on Single Stance Stability in Older Adults: Implications for Fall Prevention. Biomed Res Int. 2019;2019:2382747.
  25. Patil R, Uusi-Rasi K, Tokola K, Karinkanta S, Kannus P, Sievanen H. Effects of a Multimodal Exercise Program on Physical Function, Falls, and Injuries in Older Women: A 2-Year Community-Based, Randomized Controlled Trial. J Am Geriatr Soc. 2015;63:1306-13. https://doi.org/10.1111/jgs.13489
  26. Roaldsen KS, Halvarsson A, Sahlstrom T, Stahle A. Task-specific balance training improves self-assessed function in community-dwelling older adults with balance deficits and fear of falling: a randomized controlled trial. Clin Rehabil. 2014;28:1189-97. https://doi.org/10.1177/0269215514534087
  27. Shahrbanian S, Hashemi A, Hemayattalab R. The comparison of the effects of physical activity and neurofeedback training on postural stability and risk of fall in elderly women: A single-blind randomized controlled trial. Physiother Theory Pract. 2021;37:271-8. https://doi.org/10.1080/09593985.2019.1630877
  28. Yamada M, Higuchi T, Nishiguchi S, Yoshimura K, Kajiwara Y, Aoyama T. Multitarget stepping program in combination with a standardized multicomponent exercise program can prevent falls in community-dwelling older adults: a randomized, controlled trial. J Am Geriatr Soc. 2013;61:1669-75. https://doi.org/10.1111/jgs.12453
  29. Zhao Y, Chung PK, Tong TK. Effectiveness of a Community-Based Exercise Program on Balance Performance and Fear of Falling in Older Nonfallers at Risk for Falling: A Randomized, Controlled Study. J Aging Phys Act. 2016;24:516-24. https://doi.org/10.1123/japa.2015-0224
  30. Zouita S, Zouhal H, Ferchichi H, Paillard T, Dziri C, Hackney AC, et al. Effects of Combined Balance and Strength Training on Measures of Balance and Muscle Strength in Older Women With a History of Falls. Front Physiol. 2020;11:619016. https://doi.org/10.3389/fphys.2020.619016
  31. Merali Z and Wilson JR. Explanatory versus pragramtic trials: an essential concept in study design and interpretation. Clin Spine Surg. 2017;30:404-6. https://doi.org/10.1097/BSD.0000000000000588
  32. Dal-Re R, Janiaud P, Loannidis JPA. Real-world evidence: how pragmatic are randomized controlled tirals labeled as pragmatic? BMC Med. 2018;16:49. https://doi.org/10.1186/s12916-018-1038-2