• Title/Summary/Keyword: Fall risk

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Comparisons of lower extremity strength, cognition, and ankle mobility according to the 8.5seconds cut-off point for the 8-foot up-and-go test in elderly women

  • Kang, Dong-yeon;Kim, Young-mi;Lee, Kyung-soon
    • Journal of the Korean Society of Physical Medicine
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    • v.10 no.3
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    • pp.87-93
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    • 2015
  • PURPOSE: The purpose of this study was to investigate the effects of the 8.5seconds cut-off of the 8-foot up-and-go test as a predictor of falling and a good discriminator of fallers and non-fallers in women in their 60s to 80s. METHODS: The final subjects of this study were 98 elderly women from six senior centers of B metropolitan city. The 8-foot up-and-go test evaluated agility and dynamic balance. The chair-stand test measured the muscle strength for of the lower body. Ankle dorsiflexion and plantar flexion were measured to assess the ankle mobility of the subjects in this study. RESULTS: The below 8.5seconds group showed significantly low values in age and high values in chair-stand (times/30 s), plantar flexion ($^{\circ}$), and K-MMSE (score) compared to the over 8.5seconds group. This group was significantly faster compared to the over 8.5seconds group. In the below 8.5seconds group, only plantar flexion ($^{\circ}$) of all the items showed significantly higher values among those in their 60s compared to those in their 70s and 80s. CONCLUSION: The 8.5seconds cut-off on the 8-foot up-and-go test as a good discriminator and predictor of falling showed differences among fall risk factors (age, lower extremity strength, cognition, and ankle mobility) in women in their 60s to 80s without having regular exercise and a fall experience over the past ones year.

Epidemiology and Outcomes of Traumatic Brain Injury in Elderly Population : A Multicenter Analysis Using Korean Neuro-Trauma Data Bank System 2010-2014

  • Eom, Ki Seong
    • Journal of Korean Neurosurgical Society
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    • v.62 no.2
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    • pp.243-255
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    • 2019
  • Objective : Although traumatic brain injury (TBI) occurs in people of all age groups, the elderly population is at a particular risk. The proportion of elderly population in the society is markedly increasing and Korea is one of the most rapidly aging societies. Here, we analyzed the data from 904 patients older over 65 years who were registered in the Korean Neuro-Trauma Data Bank System (KNTDBS). Methods : The Korean Society of Neurotraumatology recorded data from 20 institutions between September 2010 and March 2014. This retrospective study examined the clinical epidemiology, sex difference, outcome epidemiology, sociodemographic variables, and outcomes in the geriatric population related to TBI based on data from the KNTDBS. Results : The study included 540 men and 364 women. The age distributions in the male and female groups were statistically significantly different. The most common cause of trauma was a fall and diagnosis was acute subdural hematoma. The incidence was the highest in men aged 80-84 years and in women aged 75-79 years. The most common time of arrival to hospital after TBI was within 1 hour and 119 rescue team provided first aid earliest to patients with TBI. The mortality rate stratified according to the cause of trauma was significantly different, with mortality rates of 3.77% in fall and 11.65% in traffic accident. The mortality rates according the severity of brain injury, Glasgow Coma Scale score, and treatment were statistically significant. Conclusion : To our knowledge, this study is the first to focus on elderly patients with TBI in Korea and particularly investigate mortality and characteristics related to TBI-related death based on data from the KNTDBS. Although the study has some limitations, our results may be used to obtain useful information to study targeted prevention and more effective treatment options for older TBI patients and establish novel treatment guidelines and health polish for the geriatric population.

Integrated Analytical-Numerical Approach to Compute the Energy on Rock-fall Protection Fence (해석적-수치해석적 방법을 통한 낙석방지울타리에 작용하는 에너지 분석)

  • Kim, Hee Su;Hwang, Youngcheol;Jang, Hyun-Ick;Ban, Hoki
    • Journal of the Korean GEO-environmental Society
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    • v.20 no.12
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    • pp.57-64
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    • 2019
  • A man-made slope has been increased due to the construction of road. This slope lies at risk of rock falling, induced mostly by heavy rainfall. The MOLIT (Ministry of Land, Infrastructure and Transport) recommends the specific dimension of rockfall protection fence (post, wire-rope, and mesh) which should resist 48~61 kJ. However, the energy absorption capacity of each component of rockfall protection fence is not clearly presented. Hence, this study made an effort to compute the energy absorption capacity of each component in analytical and numerical method, and compared with each other.

Development of Performance Measures Based on the Nursing Process for Prevention and Management of Pressure Ulcers, Falls and Pain (욕창, 낙상예방 및 통증간호의 간호과정 적용 평가도구 개발)

  • Kim, Keum Soon;Kim, Jin A;Kim, Moon Sook;Kim, Yu Jeong;Kim, Eul Soon;Park, Kwang Ok;Song, Mal Soon;Yi, Young Hee;Lee, In Ok;Jung, Yoen Yi;Choi, Yun Kyoung
    • Journal of Korean Clinical Nursing Research
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    • v.15 no.1
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    • pp.133-147
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    • 2009
  • Purpose: This study was conducted to construct evidence based clinical guidelines and to develop nursing process based performance measures for prevention and management of pressure ulcers, falls and pain. Method: Clinical guidelines were drafted through a comprehensive review of relevant literature, national guidelines and hospital protocols. The proposed guidelines were reviewed by a panel of experts and 90 hospital nurses, and refined on the basis of their suggestions. Nursing process based performance measures were developed based on the clinical guidelines and content validity was examined by surveys from 90 hospital nurses. Results: All items, except timetable for position change and pressure ulcer nursing record, in the guidelines for prevention and management of pressure ulcer were appropriate. Most items, except fall risk assessment tools, were appropriate for the guidelines of fall prevention. All other items, except the purpose of pain management, were appropriate for the guidelines of pain management. Performance measures developed in this study were acceptable as a tool to evaluate quality of nursing care. Conclusion: Nursing process based performance measures provide important indicators to monitor whether necessary nursing care is implemented and can be used as the primary resources to improve quality of nursing services.

The Relationship between Stroke Risk Factors, Stroke Subtypes and Diagnostic Pattern in Korean Medicine of Acute Stroke - Multi Center Trials (급성기 중풍 환자들의 위험요인 및 중풍유형과 변증분형의 관련성 연구)

  • Shin, Ae-Sook;Lee, In-Whan;Gwak, Ja-Young;Cho, Seung-Yeon;Park, Seong-Uk;Park, Jung-Mi;Ko, Chang-Nam;Cho, Ki-Ho;Bae, Hyung-Sup
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.9 no.1
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    • pp.19-24
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    • 2008
  • Objectives : This study was conducted as part of the national project to standardize stroke diagnosis in Korean medicine. In this study, we assessed what categories of stroke diagnosis these three most common risk factors of cerebro-vascular attack(CVA), hypertension(HTN), diabetes mellitus(DM) and hyperlipidemia(HL) fall into. Also we looked into stroke subtypes and its diagnosis in Korean medicine. Methods : 806 patients with acute stroke from 5 universities(Kyung-Hee University oriental medical center, Kyung-Hee University East-West Neo Medical Center, Kyungwon university Incheon oriental medical center, Kyungwon university Songpa oriental medical center and DongGuk university Ilsan oriental medical center) across the country were involved from April, 2007 til August, 2008. We had data of 482 patients to be analyzed and diagnosed by a Korean medicine training doctor and a professor. Results : All three major stroke risk factors were diagnosed as being dampness-phlegm pattern, but no significant difference was observed except in hyperlipidemia patients. Stroke subtypes such as hemorrhage and infarction showed no significant difference in this study. Conclusions : This study provides evidence that hyperlipidemia can be diagnosed as dampness-phlegm by Korean medicine. Further studies with various subtypes of stroke patients are required to prove solid evidence with other stroke risk factors.

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Effect of Visual Biofeedback Simulation Training for Balance in Patients with Incomplete Spinal Cord Injury (시각적 바이오피드백 시뮬레이션훈련이 불완전 척수손상환자의 균형에 미치는 효과)

  • Park, Chang-Sik;Kang, Kwon-Young
    • The Journal of the Korea Contents Association
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    • v.11 no.11
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    • pp.194-203
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    • 2011
  • This study investigated the effectiveness of visual biofeedback simulation training for patients with incomplete spinal cord injuries. Fifteen people with an ASIA impairment scale of C and D, according to the intervention method, were studied. They were randomly divided into two groups, seven people in the experimental group and eight people in the control group. They were studied three times a week for six weeks using a Tetrax Interactive Balance System, for a total of eighteen times, and each test took fifteen minutes. Paired t-tests were used to evaluate the changes before and after intervention. The difference between the groups was compared using an independent t-test. The experimental group showed significantly increased general stability, fall risk index, weight distribution (A, C, D, LEFT, HEEL) and weight distribution index, except for synchronization AC, BD. However, the control group only showed significantly increased weight distribution (A, C, LEFT). In a variation, experimental and control groups showed significantly increased weight distribution (A, B, C, HEEL), general stability, fall risk index and synchronization AD. Consequently, it was found that visual biofeedback simulation training was effective for the balance ability of incomplete spinal cord injury patients, and further studies are required.

Biomechanical Analysis of Elderly Fall Related Risk Factors using Downhill Walking on Treadmill (트레드밀 내리막 보행을 이용한 노인 낙상관련 위험요인의 운동역학적 분석)

  • Woo, Jeong-Hyun;Park, Sang-Kyoon
    • 한국체육학회지인문사회과학편
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    • v.55 no.2
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    • pp.643-655
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    • 2016
  • The purpose of this study was to investigate biomechanical differences between young and old adults during downhill walking on a treadmill in order to understand the mechanisms of elderly falls. Eighteen healthy young females(YG: yrs: 21.17±1.5) and eighteen healthy old females(OG: yrs: 66.67±1.33) participated in this study. They were asked to walk at their preferred speed on a treadmill at level, 7.5° and 15° decline. OG walked more wobbly in the medial and lateral directions than YG(p<.05). As slope got steeper, OG had smaller ROM(range of motion) of ankle and knee joints compared with YG. However, there was no difference in ROM of the hip between OG and YG, but maximum extension angle of OG was smaller compared with YG(p<.05). Smaller extensor moment was generated on OG during downhill walking(p<.05). It was hypothesized that more risk factors would be found on older people compared to young people during downhill. However, older people actually walks with a safer strategy compared to young people during downhill. Finally, current findings about biomechanical characteristics of elderly walking would provide useful fundamental information for a follow-up study regarding the prevention of elderly fall during their daily life.

Meta-analysis of the Effects of Untact Convergence Exercise Programs on Balance, Gait, and Falls Efficacy of Parkinson's Disease Patients (비대면 방식을 융합한 운동 프로그램이 파킨슨 환자의 균형, 보행, 낙상 효능감에 미치는 효과에 관한 메타분석)

  • Roh, Hyo-Lyun;Jang, Se-Hyun
    • Journal of the Korea Convergence Society
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    • v.12 no.5
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    • pp.39-50
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    • 2021
  • In this study, a meta-analysis was conducted to find out the effects of convergent "untact" exercise programs on the balance, gait, and falls efficacy of Parkinson's patients. In this study, the PICO were Parkinson's disease, virtual reality program and an e-exercise program intervention, a comparative intervention with the contact interventions applied, and without any interventions applied, outcomes were balance, gait, and fall efficacy. The survey period was between January and February 2021, and five papers were selected and subjected to meta-analysis. Risk of bias, a tool commonly used for randomized control trial studies, was used. Furthermore, RevMan program was used to investigate effect size of untact exercise programs. The result of the meta-analysis showed that the effect size of balance of the untact exercise program group was 1.27 (SMD=1.27; 95% CI 0.72 to 1.83) (Z=4.51, p<0.001), the effect size of fall efficacy was 0.52 (SMD=0.52; 95% CI -0.000 to 1.03) (Z=1.96, p=0.05), and the effect size of gait was -0.40 (SMD=-0.40; 95% CI -1.00 to 0.10)(Z=1.32, p>0.05). A total of 5 literature analysis showed that untact exercise program is more effective in improving balance and falls efficacy than contact exercise program, but no difference in effectiveness was shown on gait.

Development of community-based intensive health care program for the community dwelling elderly (재가노인을 위한 지역사회 중심의 집중건강관리프로그램의 개발과 적용)

  • Song, Mi-Sook;Song, Hyun Jong
    • 한국노년학
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    • v.29 no.1
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    • pp.37-50
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    • 2009
  • The purpose of the present study was to develop a community-based intensive health care program for the community dwelling elderly to strength their functional status and to verify the effect on their geriatric syndrome. A one-group pretest-posttest design was used for the study. A total of 69 frail elderly, who lived in the area within 20 minutes by car, were committed themselves to the day care center(Sangikjae), and had the ability of verbal communication were selected from G city in Kyunggi province. The participants completed a set of questionnaires to measure the sub-score of frailty, fall, urinary incontinence, malnutrition, and mild cognitive disorder domain, using the Otasha-Kensin through the physical examinations and interviews. After 4 weeks of intervention, the outcome was measured to evaluate the effects of the program, and the data obtained were analyzed using descriptive statistics, paired t-test and McNemar test. The results showed that the sub-score of frailty, fall, urinary incontinence, and malnutrition domain were statistically significantly decreased after intervention except those of urinary incontinence and mild cognitive disorder domain, implying that the risk of frailty, fall, and malnutrition was decreased. These findings indicated that community-based the intensive health care program is effective for relieving geriatric syndrome of the community dwelling elderly.

Effects of Balance Control and Functional Activities During Gym Ball Exercises in Elderly People (노인의 공 운동치료가 균형과 기능적인 활동에 미치는 효과)

  • Hwang, Su-Jin;Lee, Su-Young
    • Physical Therapy Korea
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    • v.11 no.3
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    • pp.25-32
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    • 2004
  • The use of a gym ball is becoming more popular for dynamic balance exercises. However, little is known about the effects of the dynamic ball exercises in the elderly. The purpose of this study was to compare balance and functional mobility after dynamic balance exercises using a gym ball to reduce the risk factorfor falls. All of the 15 subjects were women between the ages of 68 and 91 (mean age=79.9 yrs, SD=5.87) at anursing home in Wonju. Seven of fifteen subjects were placed in the experimental group and the others in the control group. Three clinical tests were used to determine the degree of balance and functional mobility before beginning the exercise program, after 4 weeks of gym ball exercise, and after 8 weeks of gym ball exercise. These three tests included Timed Up & Go (TUG), Berg Balance Scale (BBS) and the Functional Independence Measure (FIM). Dynamic ball exercises training for 8 weeks (5 days per week) included side stretching, prone walking, bridging, marching and opposite arm and leg lifting. There were significant differences found before the gym ball exercise program began and after 4 weeks and then 8 weeks in the experimental group (p<.05). Significant differences between the groups were shown for TUG and BBS (p<.05). No significant difference was noted between the groups for FIM. Therefore, gym ball exercises can improve dynamic balance and may be recommended to include in a therapeutic program to help the elderly reduce their risk of a fall.

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