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Latest & greatest articles for falls
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Falls and fractures: applying All Our Health Falls: applying All Our Health - GOV.UK Tell us whether you accept cookies We use about how you use GOV.UK. We use this information to make the website work as well as possible and improve government services. Accept all cookies You’ve accepted all cookies. You can at any time. Hide Search Guidance Falls: applying All Our Health Evidence and guidance for healthcare professionals to assess risks, advise patients and families and prevent falls (...) . Published 1 April 2015 Last updated 18 December 2019 — From: Documents HTML Details Examples to inform healthcare professionals in assessing risks and preventing falls. Published 1 April 2015 Last updated 18 December 2019 18 December 2019 Added links to new professional resources and tools. 24 July 2019 Updated information on falls and fractures with new advice and resources. 14 June 2018 Updated guidance references and added 2017 NICE quality standards. 4 August 2017 Updated measuring outcomes section
Meta-analysis and GRADE profiles of exercise interventions for falls prevention in long-term care facilities To provide a comprehensive collection of evidence on the effectiveness of exercise interventions to prevent falls and support clinical decision-making.A systematic literature review and meta-analysis of randomized controlled trails were performed by combining trials from published systematic reviews and more recent ones from a separate literature search.The literature search (...) was performed using PubMed, CINAHL, Cochrane Databases, and Google Scholar dating January 2007 - March 2018.Comparable studies were pooled using the random-effects model. The GRADE approach was used to judge the evidence.Exercises with a balance component or with technical devices reduced falls significantly, however, with low confidence in the evidence. The evidence indicated that exercises conducted longer than 6 months were beneficial. In frail residents, exercise interventions seemed to have
Fall Prevention Guidelines for Patients in Wheelchairs or Patients with Delirium: A Review of Evidence-Based Guidelines Fall Prevention Guidelines for Patients in Wheelchairs or Patients with Delirium: A Review of Evidence-Based Guidelines | CADTH.ca Find the information you need Fall Prevention Guidelines for Patients in Wheelchairs or Patients with Delirium: A Review of Evidence-Based Guidelines Fall Prevention Guidelines for Patients in Wheelchairs or Patients with Delirium: A Review (...) of Evidence-Based Guidelines Last updated: July 19, 2019 Project Number: RC1159-000 Product Line: Research Type: Devices and Systems Report Type: Summary with Critical Appraisal Result type: Report Question What are the evidence based guidelines to prevent falls for older adults requiring wheelchairs in institutionalized care? What are the evidence based guidelines to prevent falls for adult patients with delirium in institutionalized care? Key Message One evidence-based guideline was included
Walkers with Wheels Versus Walkers Without Wheels for Fall Prevention in Older Adults: A Review of the Comparative Clinical Effectiveness Walkers with Wheels Versus Walkers Without Wheels for Fall Prevention in Older Adults: A Review of the Comparative Clinical Effectiveness | CADTH.ca Find the information you need Walkers with Wheels Versus Walkers Without Wheels for Fall Prevention in Older Adults: A Review of the Comparative Clinical Effectiveness Walkers with Wheels Versus Walkers Without (...) Wheels for Fall Prevention in Older Adults: A Review of the Comparative Clinical Effectiveness Last updated: July 22, 2019 Project Number: RC1160-000 Product Line: Research Type: Devices and Systems Report Type: Summary with Critical Appraisal Result type: Report Question What is the comparative clinical effectiveness of preventing falls in older adults using walkers with wheels versus walkers without wheels? Key Message One systematic review was identified regarding the comparative effectiveness
Vitamin D Supplementation for the Prevention of Falls and Fractures in Residents of Long-Term Care Facilities: A Review of Clinical Effectiveness, Cost-Effectiveness, and Guidelines Vitamin D Supplementation for the Prevention of Falls and Fractures in Residents of Long-Term Care Facilities: A Review of Clinical Effectiveness, Cost-Effectiveness, and Guidelines | CADTH.ca Find the information you need Vitamin D Supplementation for the Prevention of Falls and Fractures in Residents of Long-Term (...) Care Facilities: A Review of Clinical Effectiveness, Cost-Effectiveness, and Guidelines Vitamin D Supplementation for the Prevention of Falls and Fractures in Residents of Long-Term Care Facilities: A Review of Clinical Effectiveness, Cost-Effectiveness, and Guidelines Last updated: April 30, 2019 Project Number: RC1105-000 Product Line: Research Type: Drug Report Type: Summary with Critical Appraisal Result type: Report Question What is the clinical effectiveness of vitamin D supplementation
Interventions for preventing falls in people after stroke. Falls are one of the most common complications after stroke, with a reported incidence ranging between 7% in the first week and 73% in the first year post stroke. This is an updated version of the original Cochrane Review published in 2013.To evaluate the effectiveness of interventions aimed at preventing falls in people after stroke. Our primary objective was to determine the effect of interventions on the rate of falls (number (...) of falls per person-year) and the number of fallers. Our secondary objectives were to determine the effects of interventions aimed at preventing falls on 1) the number of fall-related fractures; 2) the number of fall-related hospital admissions; 3) near-fall events; 4) economic evaluation; 5) quality of life; and 6) adverse effects of the interventions.We searched the trials registers of the Cochrane Stroke Group (September 2018) and the Cochrane Bone, Joint and Muscle Trauma Group (October 2018
Rate or Rhythm Control in Older Atrial Fibrillation Patients: Risk of Fall-Related Injuries and Syncope Management of atrial fibrillation (AF) with rate and/or rhythm control could lead to fall-related injuries and syncope, especially in the older AF population. We aimed to determine the association of rate and/or rhythm control with fall-related injuries and syncope in a real-world older AF cohort.A retrospective cohort study.Danish nationwide administrative registries from 2000 to 2015 (...) .A total of 100 935 patients with AF aged 65 years or older claiming prescription of rate-lowering drugs (RLDs) and/or anti-arrhythmic drugs (AADs) were included. We compared the use of rate-lowering monotherapy with rate-lowering dual therapy, AAD monotherapy, and AAD combined with rate-lowering therapy.Outcomes were fall-related injuries and syncope as a composite end point (primary) or separate end point (secondary).In this population, the median age was 78 years (interquartile range [IQR] = 72-84 y
Effect of Vitamin K2 on Postural Sway in Older People Who Fall: A Randomized Controlled Trial Vitamin K is thought to be involved in both bone health and maintenance of neuromuscular function. We tested the effect of vitamin K2 supplementation on postural sway, falls, healthcare costs, and indices of physical function in older people at risk of falls.Parallel-group double-blind randomized placebo-controlled trial.Fourteen primary care practices in Scotland, UK.A total of 95 community-dwelling (...) participants aged 65 and older with at least two falls, or one injurious fall, in the previous year.Once/day placebo, 200 μg or 400 μg of oral vitamin K2 for 1 year.The primary outcome was anteroposterior sway measured using sway plates at 12 months, adjusted for baseline. Secondary outcomes included the Short Physical Performance Battery, Berg Balance Scale, Timed Up & Go Test, quality of life, health and social care costs, falls, and adverse events.Mean participant age was 75 (standard deviation [SD] = 7
Effect of a Home-Based Exercise Program on Subsequent Falls Among Community-Dwelling High-Risk Older Adults After a Fall: A Randomized Clinical Trial. Whether exercise reduces subsequent falls in high-risk older adults who have already experienced a fall is unknown.To assess the effect of a home-based exercise program as a fall prevention strategy in older adults who were referred to a fall prevention clinic after an index fall.A 12-month, single-blind, randomized clinical trial conducted from (...) April 22, 2009, to June 5, 2018, among adults aged at least 70 years who had a fall within the past 12 months and were recruited from a fall prevention clinic.Participants were randomized to receive usual care plus a home-based strength and balance retraining exercise program delivered by a physical therapist (intervention group; n = 173) or usual care, consisting of fall prevention care provided by a geriatrician (usual care group; n = 172). Both were provided for 12 months.The primary outcome
The rise and fall of aspirin in the primary prevention of cardiovascular disease. Aspirin is one of the most frequently used drugs worldwide and is generally considered effective for the secondary prevention of cardiovascular disease. By contrast, the role of aspirin in primary prevention of cardiovascular disease is controversial. Early trials evaluating aspirin for primary prevention, done before the turn of the millennium, suggested reductions in myocardial infarction and stroke (although
Effectiveness of Tai Ji Quan vs Multimodal and Stretching Exercise Interventions for Reducing Injurious Falls in Older Adults at High Risk of Falling: Follow-up Analysis of a Randomized Clinical Trial Exercise has been shown to reduce injurious falls in older adults. Evidence, however, is lacking regarding the types of intervention that are most effective in preventing injurious falls among older adults at high risk of falling.To determine the longer-term effectiveness of therapeutic tai ji (...) quan intervention vs multimodal exercise and stretching exercise in decreasing injurious falls among older adults at high risk of falling.This trial involves a prespecified analysis with the data analyzed by intent-to-treat. Follow-up analysis of a single-blind randomized trial conducted in community settings of 7 urban and suburban cities in Oregon from February 20, 2015, to September 15, 2018, compared a therapeutic tai ji quan intervention with multimodal exercise and stretching exercise
Quality improvement strategies to prevent falls in older adults: a systematic review and network meta-analysis Falls are a common occurrence and the most effective quality improvement (QI) strategies remain unclear.We conducted a systematic review and network meta-analysis (NMA) to elucidate effective quality improvement (QI) strategies for falls prevention. Multiple databases were searched (inception-April 2017). We included randomised controlled trials (RCTs) of falls prevention QI strategies (...) for participants aged ≥65 years. Two investigators screened titles and abstracts, full-text articles, conducted data abstraction and appraised risk of bias independently.A total of 126 RCTs including 84,307 participants were included after screening 10,650 titles and abstracts and 1210 full-text articles. NMA including 29 RCTs and 26,326 patients found that team changes was statistically superior in reducing the risk of injurious falls relative to usual care (odds ratio [OR] 0.57 [0.33 to 0.99]; absolute risk
Vitamin D and Falls in Older African American Women: The PODA Randomized Clinical Trial Limited information is available on the influence of vitamin D on falls in older high-functioning black American women. Endocrine Society guidelines propose serum 25(OH)D levels over 30 ng/mL.To determine if maintenance of serum 25(OH)D above 30 ng/mL protects against falls.The Physical Performance, Osteoporosis and Vitamin D in African American Women (PODA) trial had a prospective, randomized, placebo (...) -controlled, double-dummy design with two arms: one with placebo and one with vitamin D3 adjusted to maintain serum 25(OH)D above 30 ng/mL. The primary outcomes were the prevention of bone loss and the decline in physical performance.The target population was healthy black women older than 60 years with serum 25(OH)D between 8 and 26 ng/mL. The trial was 3 years in duration with a falls questionnaire administered every 3 months. A total of 260 women entered the study, and 184 completed the 3 years. Mean
Risk factors for in hospital falls Rapid Literature Review – Risk Factors for Falls in hospital. 1 Risk factors for in hospital falls Citation Fiona Clay, Gillian Yap and Angela Melder. 2018. Risk factors for in hospital falls: Evidence Review. Centre for Clinical Effectiveness, Monash Health, Melbourne, Australia Contact CCE@monashhealth.org Executive Summary Background The Falls Committee has requested CCE provide a review of the evidence on risk factors for falls sustained in hospital (...) . The high prevalence of falls and injury rate co-occur with substantial healthcare costs.  Moreover, older adults often experience a decline in functional status and social activities after a fall and report a reduced quality of life.  The purpose of this is review is to better understand drivers for the increasing falls rate at Monash Health. Objective To identify the risk factors associated with an increased risk of falls in the hospital setting. Search Strategy Scientific and grey literature
Decreasing Fear of Falling in Chronic Stroke Survivors Through Cognitive Behavior Therapy and Task-Oriented Training Background and Purpose- Research has shown that balance training is effective for reducing the fear of falling in individuals with a history of stroke. In this study, we evaluated (1) whether cognitive behavior therapy could augment the beneficial effects of task-oriented balance training (TOBT) in reducing the fear of falling in chronic stroke survivors and (2) whether it could (...) , in turn, reduce fear-avoidance behavior and improve related health outcomes. Methods- Eighty-nine cognitively intact subjects with mildly impaired balance ability were randomized into the following 2 groups that underwent 90-minutes interventions 2 days per week for 8 weeks: (1) cognitive behavior therapy + TOBT or (2) general health education + TOBT (control). The primary outcome was the fear of falling, and the secondary outcomes were fear-avoidance behavior, balance, fall risk, independent daily
Dual-Task Exercise Reduces Cognitive-Motor Interference in Walking and Falls After Stroke Background and Purpose- Functional community ambulation requires the ability to perform mobility and cognitive task simultaneously (dual-tasking). This single-blinded randomized controlled study aimed to examine the effects of dual-task exercise in chronic stroke patients. Methods- Eighty-four chronic stroke patients (24 women; age, 61.2±6.4 years; time since stroke onset, 75.3±64.9 months) with mild (...) during serial-3-subtractions and verbal fluency task. Secondary outcomes included the Activities-specific Balance Confidence Scale, Frenchay Activities Index, and Stroke-specific Quality of Life Scale. The above outcomes were measured at baseline, immediately after, and 8 weeks after training. Fall incidence was recorded for a 6-month period posttraining. Results- Only the dual-task group exhibited reduced dual-task interference in walking time posttraining (forward walking combined with verbal
Association of Long-term Exercise Training With Risk of Falls, Fractures, Hospitalizations, and Mortality in Older Adults: A Systematic Review and Meta-analysis Long-term exercise benefits on prevalent adverse events in older populations, such as falls, fractures, or hospitalizations, are not yet established or known.To systematically review and investigate the association of long-term exercise interventions (≥1 year) with the risk of falls, injurious falls, multiple falls, fractures (...) method).Six binary outcomes for the risk of falls, injurious falls, multiple falls (≥2 falls), fractures, hospitalization, and mortality.Forty-six studies (22 709 participants) were included in the review and 40 (21 868 participants) in the meta-analyses (mean [SD] age, 73.1 [7.1] years; 15 054 [66.3%] of participants were women). The most used exercise was a multicomponent training (eg, aerobic plus strength plus balance); mean frequency was 3 times per week, about 50 minutes per session