• Journal of Korean Academy of Nursing
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• v.45 no.4
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• pp.469-482
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• 2015

Purpose: The purpose of this study was to identify which nursing interventions are the most effective in fall prevention for hospitalized patients. Methods: From 3,675 papers searched, 34 were selected for inclusion in the meta-analysis. Number of fallers, falls, falls per 1,000 hospital-days, and injurious falls, fall protection activity, knowledge related to falls, and self-efficacy about falls were evaluated as outcome variables. Data were analyzed using the Comprehensive Meta Analysis (CMA) 2.2 Version program and the effect sizes were shown as the Odd Ratio (OR) and Hedges's g. Results: Overall effect size of nursing interventions for fall prevention was OR=0.64 (95% CI: 0.57~0.73, p <.05) and Hedges's g= - 0.24. The effect sizes (OR) of each intervention ranged from 0.34 to 0.93, and the most effective nursing intervention was the education & environment intervention (OR=0.34, 95% CI: 0.28~0.42, p<.001), followed by education intervention (OR=0.57, 95% CI: 0.50~0.67, p=.001). Subgroup analyses showed that multifaceted interventions (OR=0.76, 95% CI: 0.73~0.79, p<.001) were more effective than unifactorial interventions, and that activities for prevention of falls (OR=0.08, 95% CI: 0.05~0.15, p<.001) showed the largest effect size among outcome variables. Conclusion: Falls in hospitalized patients can be effectively prevented using the nursing interventions identified in this study. These findings provide scientific evidence for developing and using effective nursing interventions to improve the safety of hospitalized patients.

• Physical Therapy Korea
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• v.28 no.2
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• pp.123-131
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• 2021

Background: Only 2% of falls in older adults result in serious injuries (i.e., hip fracture). Therefore, it is important to differentiate injurious versus non-injurious falls, which is critical to develop effective interventions for injury prevention. Objects: The purpose of this study was to a. extract the best features of surface electromyography (sEMG) for classification of injurious falls, and b. find a best model provided by data mining techniques using the extracted features. Methods: Twenty young adults self-initiated falls and landed sideways. Falling trials were consisted of three initial fall directions (forward, sideways, or backward) and three knee positions at the time of hip impact (the impacting-side knee contacted the other knee ("knee together") or the mat ("knee on mat"), or neither the other knee nor the mat was contacted by the impacting-side knee ("free knee"). Falls involved "backward initial fall direction" or "free knee" were defined as "injurious falls" as suggested from previous studies. Nine features were extracted from sEMG signals of four hip muscles during a fall, including integral of absolute value (IAV), Wilson amplitude (WAMP), zero crossing (ZC), number of turns (NT), mean of amplitude (MA), root mean square (RMS), average amplitude change (AAC), difference absolute standard deviation value (DASDV). The decision tree and support vector machine (SVM) were used to classify the injurious falls. Results: For the initial fall direction, accuracy of the best model (SVM with a DASDV) was 48%. For the knee position, accuracy of the best model (SVM with an AAC) was 49%. Furthermore, there was no model that has sensitivity and specificity of 80% or greater. Conclusion: Our results suggest that the classification model built upon the sEMG features of the four hip muscles are not effective to classify injurious falls. Future studies should consider other data mining techniques with different muscles.

• Journal of muscle and joint health
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• v.13 no.1
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• pp.7-19
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• 2006

Falls are a major sources of death and injury in elderly people. Aged-related changes in the physiological systems which contribute to the maintenance of balance are well documented in older adults. These changes coupled with age-related changes in muscle and bone are likely to contribute to an increased risk of falls in this population. Regular exercise may be one way of preventing falls and fall-related fractures. However, the optimal exercise prescription to prevent falls has not yet been defined. On the literature review of exercise intervention for fall prevention in the elderly, exercise appeared to be a useful tool in fall prevention by improving fall risk factors. The optimum exercise prescription; moderate intensity frequency of 3-4 times per week, duration of 30-60minutes can contribute to decreased hazards and number of fall. Fall prevention protocol should include safety, falling effect, enjoyment, and easiness to follow for older people. Effective exercise programs suggested for fall prevention were such as weight-bearing exercise, resistance exercise, lower muscle strength with elastic band, swiss ball exercise walking, tai chi, and yoga.

• Journal of Korean Clinical Nursing Research
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• v.16 no.1
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• pp.27-37
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• 2010

Purpose: This study was conducted to determine the effects of a fall prevention program on gait, balance and falls efficacy in stroke patients Methods: The study utilized a non-equivalent control group pretest and post test design. Subjects were contacted at the oriental medicine ward of D hospital in B city for strokes. The subjects were 25 in the experimental group and 25 in the control group. The fall prevention program consists of fall related exercises and fall related education. Collected data were analyzed using a t-test, Chi-Square test, Fisher's exact test by SPSS 14.0 Win program. Results: The fall prevention program with exercises and education used in this study was found to be very effective in increasing gait, balance and falls efficacy in patients with stroke. Conclusion: The fall prevention program used in this study seems appropriate for stroke patients. Thus, further research to refine the efficacy and application of this program is warranted.

• PNF and Movement
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• v.11 no.2
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• pp.57-65
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• 2013

Purpose : This purpose of this study was to investigate the effects of elastic band resistance exercise program in the falls prevention of elderly women. Methods : The subjects of this study, 46 people elderly women who participated in the exercise program of Jeollanamdo Y elderly welfare center were chosen as subjects and use the elastic band resistance exercise program for 12 weeks. Results : There was a significant increase on the physical function and fall efficacy of all the subjects in the experimental group and the control one after the experiment. Furthermore, the experimental group showed more meaningful improvement than the control one. Conclusion : Falls Efficacy of the experimental group before the experiment, after the changes in difference was noted. More results from the 12 weeks of using the elastic band resistance exercise program to increase the efficacy of body functions (power of lower extremity, muscle endurance, flexibility, balance, and agility), and falls efficacy of elderly women is considered as an effective fall prevention exercise program.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.14 no.7
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• pp.3383-3389
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• 2013

The purpose of this study is to identify the relationship between falls efficacy, perception of fall risk and fall prevention behavior in frail elderly. The data was collected from 300 elderly through the questionnaire. 1)the mean score of fall efficacy was $34.3{\pm}11.5$, perception of fall risk was $34.3{\pm}11.5$, and fall prevention behavior was $17.7{\pm}2.75$. 2)Fall efficacy was significantly different according to falls experience(t=2.905, p<.05). Perception of fall risk was significantly different according to falls experience (t=2.704, p<.05) and Fall prevention behavior was significantly different according to falls experience (t=2.706, p<.05). 3) It showed the negative relation between fall efficacy and perception of fall risk. It showed the positive relation between falls efficacy and falls prevention behaviors, and falls prevention behaviors and perception of fall risk. According to this study, it showed relation between fall efficacy, perception of fall risk and falls prevention behaviors. Thus it is highly recommended to include reinforce of efficacy and perception of fall risk in an effective fall-prevention program.

• Journal of muscle and joint health
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• v.18 no.1
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• pp.50-62
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• 2011

Purpose: The purpose of this study was to determine the incidence and influencing factors of falls in the institutionalized elderly. Method: A descriptive survey design was used with a convenience sampling of 430 institutionalized elderly. Data were collected using a structured questionnaire. Results: The falls rate after admission in institution was 8.4%. Types of injury after falls were mostly contusion and fracture. Interventions for fall prevention were environmental management and regular evaluation of risk factors for falls. Fall experience was significantly different according to admission periods. Type of falls was significantly different according to state of ADL. Predictors for falls were longer admission periods and dependent state in ADL. Conclusion: Falls is important health related problem in the institutionalized elderly, so effective fall prevention program is needed for their health promotion.

• Physical Therapy Korea
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• v.18 no.3
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• pp.38-48
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• 2011

The aim of the study was to identify which fall-prevention program offered in community settings in Korea is the most effective in strengthening muscles. Muscle weakness is one of the major risk factors causing falls among the elderly. Randomized controlled trials and clinical controlled trials published between 1996 and February 2011 were included in this study. Seventeen of the 69 identified studies met the study's criteria and were included in this meta-analysis. The overall effect size of the program was .822 (95% confidence interval= .717~.927). The general strengthening exercise (1.608), dance sports training (1.538), Thera-band exercise for lower extremities (1.517), Seniorobic exercise (1.146), gait training (.959), balance training (.909), gradual resistive exercise (.888), and multifactorial fall prevention (.842) programs all show positive effects on muscle strengthening. Subgroup analyses found that more relative effects are seen in programs offered to the more elderly. In this study, the effect of increasing muscle strength on the prevention of falls can only be indirectly suggested; there are few available studies that report the frequency or history of falls in Korea. Further studies are needed to examine the direct effect of fall prevention exercise programs among the elderly.

• Journal of Biomedical Engineering Research
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• v.31 no.6
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• pp.438-448
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• 2010

The social activities of the elderly have been increasing as our society progresses toward an aging society. As their activities are increased, the occurrence of falls that could lead to fractures are increased. Falls are serious health hazards to the elderly and we need more thorough understanding of falls including the progress of falls and the impact area in various fall directions. Many of the traditional methods of falls research dealt with voluntary falls by younger subject since older subject can easily get fracture from voluntary falls. So, it has been difficult to get exact data about falls of the elderly. Here, we tried to capture the characteristics of the movements of major joints using three dimensional motion capture system during falls experiments using a moving mattress that can safely induce unexpected falls. Healthy younger subjects participated in the actual falls experiment and the moving mattress was actuated by a pneumatic system. The kinematic parameters such as velocities of major segments were imported to a computer simulation environment and falls to hard surfaces were simulated in a computational environment using a realistic human model of aged persons. The simulation was able to give approximations to contact forces which can occur during actual falls. And we designed impact absorption system to reduce the impact during falls. We can adapt this system to fracture prevention system that we are going to study.

• Journal of the Korea Convergence Society
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• v.9 no.9
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• pp.389-397
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• 2018

This study identified the knowledge, attitude and degree of prevention behaviors on falls of the elderly and analyzed the relationship among them as well as their effects on fall prevention behaviors. This study was targeted at 167 elderly attending senior welfare centers and data collected by interview was analyzed using SPSS 18.0 program. As a result of correlation analysis, positive relations were identified between knowledge and attitude on falls, as well as attitude and prevention behaviors on falls. Factors that had significant effect on fall prevention behaviors were gender and attitude and showed 21.1% of explanatory power (F=8.41, p<.001). The study further suggests intervention programs on fall prevention focusing on the improvement of attitude on falls for enhancing fall prevention behaviors of the elderly to be developed and applied based on the results of this study.