A five-week exercise program can reduce falls and improve obstacle avoidance in the elderly.
Identifieur interne : 001068 ( Main/Exploration ); précédent : 001067; suivant : 001069A five-week exercise program can reduce falls and improve obstacle avoidance in the elderly.
Auteurs : Vivian Weerdesteyn [Pays-Bas] ; Hennie Rijken ; Alexander C H. Geurts ; Bouwien C M. Smits-Engelsman ; Theo Mulder ; Jacques DuysensSource :
- Gerontology [ 0304-324X ] ; 2006.
Descripteurs français
- KwdFr :
- Analyse et exécution des tâches (MeSH), Auto-efficacité (MeSH), Chutes accidentelles (prévention et contrôle), Exercice physique (MeSH), Femelle (MeSH), Humains (MeSH), Marche à pied (MeSH), Mâle (MeSH), Résultat thérapeutique (MeSH), Sujet âgé (MeSH), Sujet âgé de 80 ans ou plus (MeSH), Équilibre postural (MeSH), Évaluation de programme (MeSH).
- MESH :
English descriptors
- KwdEn :
- MESH :
- prevention & control : Accidental Falls.
- Aged, Aged, 80 and over, Exercise, Female, Humans, Male, Postural Balance, Program Evaluation, Self Efficacy, Task Performance and Analysis, Treatment Outcome, Walking.
Abstract
BACKGROUND
Falls in the elderly are a major health problem. Although exercise programs have been shown to reduce the risk of falls, the optimal exercise components, as well as the working mechanisms that underlie the effectiveness of these programs, have not yet been established.
OBJECTIVE
To test whether the Nijmegen Falls Prevention Program was effective in reducing falls and improving standing balance, balance confidence, and obstacle avoidance performance in community-dwelling elderly people.
METHODS
A total of 113 elderly with a history of falls participated in this study (exercise group, n = 79; control group, n = 28; dropouts before randomization, n = 6). Exercise sessions were held twice weekly for 5 weeks. Pre- and post-intervention fall monitoring and quantitative motor control assessments were performed. The outcome measures were the number of falls, standing balance and obstacle avoidance performance, and balance confidence scores.
RESULTS
The number of falls in the exercise group decreased by 46% (incidence rate ratio (IRR) 0.54, 95% confidence interval (CI) 0.36-0.79) compared to the number of falls during the baseline period and by 46% (IRR 0.54, 95% CI 0.34-0.86) compared to the control group. Obstacle avoidance success rates improved significantly more in the exercise group (on average 12%) compared to the control group (on average 6%). Quiet stance and weight-shifting measures did not show significant effects of exercise. The exercise group also had a 6% increase of balance confidence scores.
CONCLUSION
The Nijmegen Falls Prevention Program was effective in reducing the incidence of falls in otherwise healthy elderly. There was no evidence of improved control of posture as a mechanism underlying this result. In contrast, an obstacle avoidance task indicated that subjects improved their performance. Laboratory obstacle avoidance tests may therefore be better instruments to evaluate future fall prevention studies than posturographic balance assessments.
DOI: 10.1159/000091822
PubMed: 16645293
Affiliations:
Links toward previous steps (curation, corpus...)
Le document en format XML
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Geurts</name></author><author><name sortKey="Smits Engelsman, Bouwien C M" sort="Smits Engelsman, Bouwien C M" uniqKey="Smits Engelsman B" first="Bouwien C M" last="Smits-Engelsman">Bouwien C M. Smits-Engelsman</name></author><author><name sortKey="Mulder, Theo" sort="Mulder, Theo" uniqKey="Mulder T" first="Theo" last="Mulder">Theo Mulder</name></author><author><name sortKey="Duysens, Jacques" sort="Duysens, Jacques" uniqKey="Duysens J" first="Jacques" last="Duysens">Jacques Duysens</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2006">2006</date><idno type="RBID">pubmed:16645293</idno><idno type="pmid">16645293</idno><idno type="doi">10.1159/000091822</idno><idno type="wicri:Area/Main/Corpus">001040</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">001040</idno><idno type="wicri:Area/Main/Curation">001040</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Curation">001040</idno><idno type="wicri:Area/Main/Exploration">001040</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">A five-week exercise program can reduce falls and improve obstacle avoidance in the elderly.</title><author><name sortKey="Weerdesteyn, Vivian" sort="Weerdesteyn, Vivian" uniqKey="Weerdesteyn V" first="Vivian" last="Weerdesteyn">Vivian Weerdesteyn</name><affiliation wicri:level="3"><nlm:affiliation>Sint-Maartenskliniek Research, Development and Education, Nijmegen, The Netherlands. v.weerdesteyn@maartenskliniek.nl</nlm:affiliation><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Sint-Maartenskliniek Research, Development and Education, Nijmegen</wicri:regionArea><placeName><settlement type="city">Nimègue</settlement><region type="province" nuts="2">Gueldre</region></placeName></affiliation></author><author><name sortKey="Rijken, Hennie" sort="Rijken, Hennie" uniqKey="Rijken H" first="Hennie" last="Rijken">Hennie Rijken</name></author><author><name sortKey="Geurts, Alexander C H" sort="Geurts, Alexander C H" uniqKey="Geurts A" first="Alexander C H" last="Geurts">Alexander C H. Geurts</name></author><author><name sortKey="Smits Engelsman, Bouwien C M" sort="Smits Engelsman, Bouwien C M" uniqKey="Smits Engelsman B" first="Bouwien C M" last="Smits-Engelsman">Bouwien C M. Smits-Engelsman</name></author><author><name sortKey="Mulder, Theo" sort="Mulder, Theo" uniqKey="Mulder T" first="Theo" last="Mulder">Theo Mulder</name></author><author><name sortKey="Duysens, Jacques" sort="Duysens, Jacques" uniqKey="Duysens J" first="Jacques" last="Duysens">Jacques Duysens</name></author></analytic><series><title level="j">Gerontology</title><idno type="ISSN">0304-324X</idno><imprint><date when="2006" type="published">2006</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Accidental Falls (prevention & control)</term><term>Aged (MeSH)</term><term>Aged, 80 and over (MeSH)</term><term>Exercise (MeSH)</term><term>Female (MeSH)</term><term>Humans (MeSH)</term><term>Male (MeSH)</term><term>Postural Balance (MeSH)</term><term>Program Evaluation (MeSH)</term><term>Self Efficacy (MeSH)</term><term>Task Performance and Analysis (MeSH)</term><term>Treatment Outcome (MeSH)</term><term>Walking (MeSH)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Analyse et exécution des tâches (MeSH)</term><term>Auto-efficacité (MeSH)</term><term>Chutes accidentelles (prévention et contrôle)</term><term>Exercice physique (MeSH)</term><term>Femelle (MeSH)</term><term>Humains (MeSH)</term><term>Marche à pied (MeSH)</term><term>Mâle (MeSH)</term><term>Résultat thérapeutique (MeSH)</term><term>Sujet âgé (MeSH)</term><term>Sujet âgé de 80 ans ou plus (MeSH)</term><term>Équilibre postural (MeSH)</term><term>Évaluation de programme (MeSH)</term></keywords><keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>Accidental Falls</term></keywords><keywords scheme="MESH" qualifier="prévention et contrôle" xml:lang="fr"><term>Chutes accidentelles</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Aged, 80 and over</term><term>Exercise</term><term>Female</term><term>Humans</term><term>Male</term><term>Postural Balance</term><term>Program Evaluation</term><term>Self Efficacy</term><term>Task Performance and Analysis</term><term>Treatment Outcome</term><term>Walking</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Analyse et exécution des tâches</term><term>Auto-efficacité</term><term>Exercice physique</term><term>Femelle</term><term>Humains</term><term>Marche à pied</term><term>Mâle</term><term>Résultat thérapeutique</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Équilibre postural</term><term>Évaluation de programme</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>Falls in the elderly are a major health problem. Although exercise programs have been shown to reduce the risk of falls, the optimal exercise components, as well as the working mechanisms that underlie the effectiveness of these programs, have not yet been established.</p></div><div type="abstract" xml:lang="en"><p><b>OBJECTIVE</b></p><p>To test whether the Nijmegen Falls Prevention Program was effective in reducing falls and improving standing balance, balance confidence, and obstacle avoidance performance in community-dwelling elderly people.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>A total of 113 elderly with a history of falls participated in this study (exercise group, n = 79; control group, n = 28; dropouts before randomization, n = 6). Exercise sessions were held twice weekly for 5 weeks. Pre- and post-intervention fall monitoring and quantitative motor control assessments were performed. The outcome measures were the number of falls, standing balance and obstacle avoidance performance, and balance confidence scores.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>The number of falls in the exercise group decreased by 46% (incidence rate ratio (IRR) 0.54, 95% confidence interval (CI) 0.36-0.79) compared to the number of falls during the baseline period and by 46% (IRR 0.54, 95% CI 0.34-0.86) compared to the control group. Obstacle avoidance success rates improved significantly more in the exercise group (on average 12%) compared to the control group (on average 6%). Quiet stance and weight-shifting measures did not show significant effects of exercise. The exercise group also had a 6% increase of balance confidence scores.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSION</b></p><p>The Nijmegen Falls Prevention Program was effective in reducing the incidence of falls in otherwise healthy elderly. There was no evidence of improved control of posture as a mechanism underlying this result. In contrast, an obstacle avoidance task indicated that subjects improved their performance. Laboratory obstacle avoidance tests may therefore be better instruments to evaluate future fall prevention studies than posturographic balance assessments.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">16645293</PMID><DateCompleted><Year>2006</Year><Month>10</Month><Day>20</Day></DateCompleted><DateRevised><Year>2008</Year><Month>11</Month><Day>21</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Print">0304-324X</ISSN><JournalIssue CitedMedium="Print"><Volume>52</Volume><Issue>3</Issue><PubDate><Year>2006</Year></PubDate></JournalIssue><Title>Gerontology</Title><ISOAbbreviation>Gerontology</ISOAbbreviation></Journal><ArticleTitle>A five-week exercise program can reduce falls and improve obstacle avoidance in the elderly.</ArticleTitle><Pagination><MedlinePgn>131-41</MedlinePgn></Pagination><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Falls in the elderly are a major health problem. Although exercise programs have been shown to reduce the risk of falls, the optimal exercise components, as well as the working mechanisms that underlie the effectiveness of these programs, have not yet been established.</AbstractText><AbstractText Label="OBJECTIVE" NlmCategory="OBJECTIVE">To test whether the Nijmegen Falls Prevention Program was effective in reducing falls and improving standing balance, balance confidence, and obstacle avoidance performance in community-dwelling elderly people.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">A total of 113 elderly with a history of falls participated in this study (exercise group, n = 79; control group, n = 28; dropouts before randomization, n = 6). Exercise sessions were held twice weekly for 5 weeks. Pre- and post-intervention fall monitoring and quantitative motor control assessments were performed. The outcome measures were the number of falls, standing balance and obstacle avoidance performance, and balance confidence scores.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">The number of falls in the exercise group decreased by 46% (incidence rate ratio (IRR) 0.54, 95% confidence interval (CI) 0.36-0.79) compared to the number of falls during the baseline period and by 46% (IRR 0.54, 95% CI 0.34-0.86) compared to the control group. Obstacle avoidance success rates improved significantly more in the exercise group (on average 12%) compared to the control group (on average 6%). Quiet stance and weight-shifting measures did not show significant effects of exercise. The exercise group also had a 6% increase of balance confidence scores.</AbstractText><AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">The Nijmegen Falls Prevention Program was effective in reducing the incidence of falls in otherwise healthy elderly. There was no evidence of improved control of posture as a mechanism underlying this result. In contrast, an obstacle avoidance task indicated that subjects improved their performance. Laboratory obstacle avoidance tests may therefore be better instruments to evaluate future fall prevention studies than posturographic balance assessments.</AbstractText><CopyrightInformation>Copyright (c) 2006 S. Karger AG, Basel.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Weerdesteyn</LastName><ForeName>Vivian</ForeName><Initials>V</Initials><AffiliationInfo><Affiliation>Sint-Maartenskliniek Research, Development and Education, Nijmegen, The Netherlands. v.weerdesteyn@maartenskliniek.nl</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Rijken</LastName><ForeName>Hennie</ForeName><Initials>H</Initials></Author><Author ValidYN="Y"><LastName>Geurts</LastName><ForeName>Alexander C H</ForeName><Initials>AC</Initials></Author><Author ValidYN="Y"><LastName>Smits-Engelsman</LastName><ForeName>Bouwien C M</ForeName><Initials>BC</Initials></Author><Author ValidYN="Y"><LastName>Mulder</LastName><ForeName>Theo</ForeName><Initials>T</Initials></Author><Author ValidYN="Y"><LastName>Duysens</LastName><ForeName>Jacques</ForeName><Initials>J</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D016449">Randomized Controlled Trial</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>Switzerland</Country><MedlineTA>Gerontology</MedlineTA><NlmUniqueID>7601655</NlmUniqueID><ISSNLinking>0304-324X</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000058" MajorTopicYN="N">Accidental Falls</DescriptorName><QualifierName UI="Q000517" MajorTopicYN="Y">prevention & control</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000369" MajorTopicYN="N">Aged, 80 and over</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D015444" MajorTopicYN="Y">Exercise</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D004856" MajorTopicYN="N">Postural Balance</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D015397" MajorTopicYN="N">Program Evaluation</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D020377" MajorTopicYN="N">Self Efficacy</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D013647" MajorTopicYN="N">Task Performance and Analysis</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016896" MajorTopicYN="N">Treatment Outcome</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016138" MajorTopicYN="N">Walking</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2005</Year><Month>08</Month><Day>08</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2005</Year><Month>11</Month><Day>27</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2006</Year><Month>4</Month><Day>29</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2006</Year><Month>10</Month><Day>21</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2006</Year><Month>4</Month><Day>29</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">16645293</ArticleId><ArticleId IdType="pii">91822</ArticleId><ArticleId IdType="doi">10.1159/000091822</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Pays-Bas</li></country><region><li>Gueldre</li></region><settlement><li>Nimègue</li></settlement></list><tree><noCountry><name sortKey="Duysens, Jacques" sort="Duysens, Jacques" uniqKey="Duysens J" first="Jacques" last="Duysens">Jacques Duysens</name><name sortKey="Geurts, Alexander C H" sort="Geurts, Alexander C H" uniqKey="Geurts A" first="Alexander C H" last="Geurts">Alexander C H. Geurts</name><name sortKey="Mulder, Theo" sort="Mulder, Theo" uniqKey="Mulder T" first="Theo" last="Mulder">Theo Mulder</name><name sortKey="Rijken, Hennie" sort="Rijken, Hennie" uniqKey="Rijken H" first="Hennie" last="Rijken">Hennie Rijken</name><name sortKey="Smits Engelsman, Bouwien C M" sort="Smits Engelsman, Bouwien C M" uniqKey="Smits Engelsman B" first="Bouwien C M" last="Smits-Engelsman">Bouwien C M. Smits-Engelsman</name></noCountry><country name="Pays-Bas"><region name="Gueldre"><name sortKey="Weerdesteyn, Vivian" sort="Weerdesteyn, Vivian" uniqKey="Weerdesteyn V" first="Vivian" last="Weerdesteyn">Vivian Weerdesteyn</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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