Research status and prospect of exercise-based fall prevention in the elderly_West China Medical Journal

Authors：

LIU Zuoyan ¹ , XIANG Xiaona ² ,  HE Hongchen ¹

1. Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. West China School of Medicine, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

HE Hongchen, Email: 66362265@qq.com

Keywords：

Exercise; Elderly; Fall; Prevention

DOI：

10.7507/1002-0179.201904016

Video：

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Under the new era background of actively advocating the " active health” in the elderly, the prevention methods of falls not only include environmental modification, reasonable drugs, emotional support, disease prevention and control, etc., but exercise should also be integrated into them. Exercise training can significantly improve muscle strength, balance, and mobility in the elderly, thereby reducing the risk of falls. This paper reviews the biomechanical causes of falls in the elderly, the sports training prescriptions for fall prevention in the elderly, and the research prospects of sports training for fall prevention in the elderly. It is hoped that the elderly population could establish an active healthy lifestyle based on sports training, elevate the physical fitness continuously, reduce the fall injury, and improve the quality of life through strength, balance, and endurance training.

Citation： LIU Zuoyan, XIANG Xiaona, HE Hongchen. Research status and prospect of exercise-based fall prevention in the elderly. West China Medical Journal, 2019, 34(6): 712-715. doi: 10.7507/1002-0179.201904016 Copy

1.	Jones TS, Ghosh TS, Horn K, et al. Primary care physicians perceptions and practices regarding fall prevention in adult’s 65 years and over. Accid Anal Prev, 2011, 43(5): 1605-1609.
2.	Rubenstein LZ. Falls in older people: epidemiology, risk factors and strategies for prevention. Age Ageing, 2006, 35(Suppl 2): ii37-ii41.
3.	Lacroix A, Kressig RW, Muehlbauer T, et al. Effects of a supervised versus an uniupervised combined balance and strength training program on balance and muscle power in healthy older adults: a randomized controlled trial. Gerontology, 2016, 62(3): 275-288.
4.	李立, 陳玉娟, 翟鳳鳴, 等. 長期從事太極拳運動老年人足底壓力分布特征及平衡能力研究. 中國康復醫學雜志, 2016, 31(9): 984-988.
5.	Masud T, Morris RO. Epidemiology of falls. Age Ageing, 2001, 30(Suppl 4): 3-7.
6.	Means KM, Rodell DE, O’Sullivan PS. Balance, mobility, and falls among community-dwelling elderly persons: effects of a rehabilitation exercise program. Am J Phys Med Rehabil, 2005, 84(4): 238-250.
7.	Kim H, Suzuki T, Saito K, et al. Long-term effects of exercise and amino acid supplementation on muscle mass, physical function and falls in community-dwelling elderly Japanese sarcopenic women: a 4-year follow-up study. Geriatr Gerontol Int, 2016, 16(2): 175-181.
8.	Dadgari A, Aizan Hamid T, Hakim MN, et al. Randomized control trials on otago exercise program (OEP) to reduce falls among elderly community dwellers in shahroud, Iran. Iran Red Crescent Med J, 2016, 18(5): e26340.
9.	胡秀英. 老年護理手冊. 2版. 北京: 科學出版社, 2015: 424-437.
10.	袁春香. 八段錦鍛煉對預防老年人跌倒的研究. 臨床醫藥文獻雜志, 2017, 4(35): 6929-6930.
11.	Thomas EE, De Vito G, Macaluso A. Speed training with body weight unloading improves walking energy cost and maximal speed in 75-to 85 year-old healthy women. J Appl Physiol(1985), 2007, 103(5): 1598-1603.
12.	Auvinet B, Touzard C, Montestruc F, et al. Gait disorders in the elderly and dual task gait analysis: a new approach for identifying motor phenotypes. J Neuroeng Rehabil, 2017, 14(1): 7.
13.	鄒曉峰, 李萍, 劉巍. 老年人步態與平衡的生物力學研究進展. 中國老年學雜志, 2010, 30(18): 2706-2708.
14.	Wang J, Chen Z, Song Y. Falls in aged people of the Chinese mainland: epidemiology, risk factors and clinical strategies. Ageing Res Rev, 2010(Suppl 1): S13-S17.
15.	Donath L, van Die?n J, Faude O. Exercise-based fall prevention in the elderly: what about agility?. Sports Med, 2016, 46(2): 143-149.
16.	Lee J, Yoo HN, Lee BH. Effects of augmented reality-based Otago exercise on balance, gait, and physical factors in elderly women to prevent falls: a randomized controlled trial. J Phys Ther Sci, 2017, 29(9): 1586-1589.
17.	Granacher U, Muehlbauer T, Zahner L, et al. Comparison of traditional and recent approaches in the promotion of balance and strength in older adults. Sports Med, 2011, 41(5): 377-400.
18.	王連成, 張祎, 章禮勤, 等. 老年跌倒患者下肢肌肉力量變化的研究. 天津醫藥, 2012, 40(9): 938-939.
19.	Ribeiro F, Oliveira J. Effect of physical exercise and age on knee joint position sense. Arch Gerontol Geriatr, 2010, 51(1): 64-67.
20.	Oken BS, Zajdel D, Kishiyama S, et al. Randomized, controlled, six-month trial of yoga in healthy seniors: effects on cognition and quality of life. Altern Ther Health Med, 2006, 12(1): 40-47.
21.	Donat H, Ozcan A. Comparison of the effectiveness of two programmes on older adults at risk of falling: unsupervised home exercise and supervised group exercise. Clin Rehabil, 2007, 21(3): 273-283.
22.	Brand?o GS, Oliveira LVF, Brand?o GS, et al. Effect of a home-based exercise program on functional mobility and quality of life in elderly people: protocol of a single-blind, randomized controlled trial. Trials, 2018, 19(1): 684.
23.	Gillespie LD, Robertson MC, Gillespie WJ, et al. Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev, 2009(2): CD007146.
24.	Ashari A, Hamid TA, Hussain MR, et al. Effectiveness of individualized home-based exercise on turning and balance performance among adults older than 50yrs: a randomized controlled trial. Am J Phys Med Rehabil, 2016, 95(5): 355-365.
25.	許良醫. 運動訓練原則應用發展研究. 當代體育科技, 2018, 8(3): 48, 50.
26.	American College of Sports Medicine, Chodzko-Zajko WJ, Proctor DN, et al. American college of sports medicine position stand. Exercise and physical activity for older adults. Med Sci Sports Exerc, 2009, 41(7): 1510-1530.
27.	Lord SR, March LM, Cameron ID, et al. Differing risk factors for falls in nursing home and intermediate-care residents who can and cannot stand unaided. J Am Geriatr Soc, 2003, 51(11): 1645-1650.
28.	樊賢進, 李月紅. 普拉提運動降低老年女性跌倒次數的作用機制. 中國老年學雜志, 2015, 35(7): 1800-1801.
29.	王文萍. 核心力量和健身路徑鍛煉改善老年人跌倒風險因素的研究. 實用臨床護理學雜志, 2017, 2(19): 106-107.
30.	Cho SI, An DH. Effects of a fall prevention exercise program on muscle strength and balance of the old-old elderly. J Phys Ther Sci, 2014, 26(11): 1771-1774.
31.	Mirelman A, Rochester L, Maidan I, et al. Addition of a non-immersive virtual reality component to treadmill training to reduce fall risk in older adults (V-TIME): a randomised controlled trial. Lancet, 2016, 388(10050): 1170-1182.
32.	Khanuja K, Joki J, Bachmann G, et al. Gait and balance in the aging population: fall prevention using innovation and technology. Maturitas, 2018, 110: 51-56.
33.	孟凡嫣, 陳璇, 王艷, 等. 基于現實環境的功能性步態訓練對社區卒中后康復期老人步態特征及害怕跌倒的影響. 護理學報, 2018, 25(19): 1-4.
34.	李愛君, 高瑞堯, 鄭琦瑋, 等. 提高老年人肌肉力量和心肺功能的運動處方研究進展. 中國康復理論與實踐, 2017, 23(2): 179-184.
35.	陳紀言, 陳韻岱, 韓雅玲, 等. 經皮冠狀動脈介入治療術后運動康復專家共識. 中國介入心臟病學雜志, 2016, 24(7): 361-369.
36.	韋恩·L·威斯科特, 托馬斯·R·貝希勒. 50歲之后的力量訓練. 孫飛, 譯. 北京: 人民郵電出版社, 2018: 25-35.
37.	Zheng J, Pan Y, Hua Y, et al. Strategic targeted exercise for preventing falls in elderly people. J Int Med Res, 2013, 41(2): 418-426.
38.	Yang JE, Lee TY, Kim JK. The effect of a VR exercise program on falls and depression in the elderly with mild depression in the local community. J Phys Ther Sci, 2017, 29(12): 2157-2159.
39.	張鑫華, 王國祥. 從" 健康日本21”計劃實施看日本社會國民健康的管理與服務. 成都體育學院學報, 2014, 40(9): 19-23.
40.	Peters S, Handy TC, Lakhani B, et al. Motor and visuospatial attention and motor planning after stroke: considerations for the rehabilitation of standing balance and gait. Phys Ther, 2015, 95(10): 1423-1432.
41.	Di Martino S, Tramonti C, Unti E, et al. Aerobic rehabilitation program for improving muscle function in Parkinson’s disease. Restor Neurol Neurosci, 2018, 36(1): 13-20.
42.	Lee C, Dotson AJ, Brown WJ, et al. Cohort profile: the Austrilian longitudinal study on women’s health. Int J Epidemiol, 2005, 34(5): 987-991.

1. Jones TS, Ghosh TS, Horn K, et al. Primary care physicians perceptions and practices regarding fall prevention in adult’s 65 years and over. Accid Anal Prev, 2011, 43(5): 1605-1609.
2. Rubenstein LZ. Falls in older people: epidemiology, risk factors and strategies for prevention. Age Ageing, 2006, 35(Suppl 2): ii37-ii41.
3. Lacroix A, Kressig RW, Muehlbauer T, et al. Effects of a supervised versus an uniupervised combined balance and strength training program on balance and muscle power in healthy older adults: a randomized controlled trial. Gerontology, 2016, 62(3): 275-288.
4. 李立, 陳玉娟, 翟鳳鳴, 等. 長期從事太極拳運動老年人足底壓力分布特征及平衡能力研究. 中國康復醫學雜志, 2016, 31(9): 984-988.
5. Masud T, Morris RO. Epidemiology of falls. Age Ageing, 2001, 30(Suppl 4): 3-7.
6. Means KM, Rodell DE, O’Sullivan PS. Balance, mobility, and falls among community-dwelling elderly persons: effects of a rehabilitation exercise program. Am J Phys Med Rehabil, 2005, 84(4): 238-250.
7. Kim H, Suzuki T, Saito K, et al. Long-term effects of exercise and amino acid supplementation on muscle mass, physical function and falls in community-dwelling elderly Japanese sarcopenic women: a 4-year follow-up study. Geriatr Gerontol Int, 2016, 16(2): 175-181.
8. Dadgari A, Aizan Hamid T, Hakim MN, et al. Randomized control trials on otago exercise program (OEP) to reduce falls among elderly community dwellers in shahroud, Iran. Iran Red Crescent Med J, 2016, 18(5): e26340.
9. 胡秀英. 老年護理手冊. 2版. 北京: 科學出版社, 2015: 424-437.
10. 袁春香. 八段錦鍛煉對預防老年人跌倒的研究. 臨床醫藥文獻雜志, 2017, 4(35): 6929-6930.
11. Thomas EE, De Vito G, Macaluso A. Speed training with body weight unloading improves walking energy cost and maximal speed in 75-to 85 year-old healthy women. J Appl Physiol(1985), 2007, 103(5): 1598-1603.
12. Auvinet B, Touzard C, Montestruc F, et al. Gait disorders in the elderly and dual task gait analysis: a new approach for identifying motor phenotypes. J Neuroeng Rehabil, 2017, 14(1): 7.
13. 鄒曉峰, 李萍, 劉巍. 老年人步態與平衡的生物力學研究進展. 中國老年學雜志, 2010, 30(18): 2706-2708.
14. Wang J, Chen Z, Song Y. Falls in aged people of the Chinese mainland: epidemiology, risk factors and clinical strategies. Ageing Res Rev, 2010(Suppl 1): S13-S17.
15. Donath L, van Die?n J, Faude O. Exercise-based fall prevention in the elderly: what about agility?. Sports Med, 2016, 46(2): 143-149.
16. Lee J, Yoo HN, Lee BH. Effects of augmented reality-based Otago exercise on balance, gait, and physical factors in elderly women to prevent falls: a randomized controlled trial. J Phys Ther Sci, 2017, 29(9): 1586-1589.
17. Granacher U, Muehlbauer T, Zahner L, et al. Comparison of traditional and recent approaches in the promotion of balance and strength in older adults. Sports Med, 2011, 41(5): 377-400.
18. 王連成, 張祎, 章禮勤, 等. 老年跌倒患者下肢肌肉力量變化的研究. 天津醫藥, 2012, 40(9): 938-939.
19. Ribeiro F, Oliveira J. Effect of physical exercise and age on knee joint position sense. Arch Gerontol Geriatr, 2010, 51(1): 64-67.
20. Oken BS, Zajdel D, Kishiyama S, et al. Randomized, controlled, six-month trial of yoga in healthy seniors: effects on cognition and quality of life. Altern Ther Health Med, 2006, 12(1): 40-47.
21. Donat H, Ozcan A. Comparison of the effectiveness of two programmes on older adults at risk of falling: unsupervised home exercise and supervised group exercise. Clin Rehabil, 2007, 21(3): 273-283.
22. Brand?o GS, Oliveira LVF, Brand?o GS, et al. Effect of a home-based exercise program on functional mobility and quality of life in elderly people: protocol of a single-blind, randomized controlled trial. Trials, 2018, 19(1): 684.
23. Gillespie LD, Robertson MC, Gillespie WJ, et al. Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev, 2009(2): CD007146.
24. Ashari A, Hamid TA, Hussain MR, et al. Effectiveness of individualized home-based exercise on turning and balance performance among adults older than 50yrs: a randomized controlled trial. Am J Phys Med Rehabil, 2016, 95(5): 355-365.
25. 許良醫. 運動訓練原則應用發展研究. 當代體育科技, 2018, 8(3): 48, 50.
26. American College of Sports Medicine, Chodzko-Zajko WJ, Proctor DN, et al. American college of sports medicine position stand. Exercise and physical activity for older adults. Med Sci Sports Exerc, 2009, 41(7): 1510-1530.
27. Lord SR, March LM, Cameron ID, et al. Differing risk factors for falls in nursing home and intermediate-care residents who can and cannot stand unaided. J Am Geriatr Soc, 2003, 51(11): 1645-1650.
28. 樊賢進, 李月紅. 普拉提運動降低老年女性跌倒次數的作用機制. 中國老年學雜志, 2015, 35(7): 1800-1801.
29. 王文萍. 核心力量和健身路徑鍛煉改善老年人跌倒風險因素的研究. 實用臨床護理學雜志, 2017, 2(19): 106-107.
30. Cho SI, An DH. Effects of a fall prevention exercise program on muscle strength and balance of the old-old elderly. J Phys Ther Sci, 2014, 26(11): 1771-1774.
31. Mirelman A, Rochester L, Maidan I, et al. Addition of a non-immersive virtual reality component to treadmill training to reduce fall risk in older adults (V-TIME): a randomised controlled trial. Lancet, 2016, 388(10050): 1170-1182.
32. Khanuja K, Joki J, Bachmann G, et al. Gait and balance in the aging population: fall prevention using innovation and technology. Maturitas, 2018, 110: 51-56.
33. 孟凡嫣, 陳璇, 王艷, 等. 基于現實環境的功能性步態訓練對社區卒中后康復期老人步態特征及害怕跌倒的影響. 護理學報, 2018, 25(19): 1-4.
34. 李愛君, 高瑞堯, 鄭琦瑋, 等. 提高老年人肌肉力量和心肺功能的運動處方研究進展. 中國康復理論與實踐, 2017, 23(2): 179-184.
35. 陳紀言, 陳韻岱, 韓雅玲, 等. 經皮冠狀動脈介入治療術后運動康復專家共識. 中國介入心臟病學雜志, 2016, 24(7): 361-369.
36. 韋恩·L·威斯科特, 托馬斯·R·貝希勒. 50歲之后的力量訓練. 孫飛, 譯. 北京: 人民郵電出版社, 2018: 25-35.
37. Zheng J, Pan Y, Hua Y, et al. Strategic targeted exercise for preventing falls in elderly people. J Int Med Res, 2013, 41(2): 418-426.
38. Yang JE, Lee TY, Kim JK. The effect of a VR exercise program on falls and depression in the elderly with mild depression in the local community. J Phys Ther Sci, 2017, 29(12): 2157-2159.
39. 張鑫華, 王國祥. 從" 健康日本21”計劃實施看日本社會國民健康的管理與服務. 成都體育學院學報, 2014, 40(9): 19-23.
40. Peters S, Handy TC, Lakhani B, et al. Motor and visuospatial attention and motor planning after stroke: considerations for the rehabilitation of standing balance and gait. Phys Ther, 2015, 95(10): 1423-1432.
41. Di Martino S, Tramonti C, Unti E, et al. Aerobic rehabilitation program for improving muscle function in Parkinson’s disease. Restor Neurol Neurosci, 2018, 36(1): 13-20.
42. Lee C, Dotson AJ, Brown WJ, et al. Cohort profile: the Austrilian longitudinal study on women’s health. Int J Epidemiol, 2005, 34(5): 987-991.

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Research status and prospect of exercise-based fall prevention in the elderly

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