Objective To integrate the falling experience and coping styles of stroke home patients with falls through Meta synthesis, summarize existing problems based on the integration results, and propose suggestions. Methods We searched databases including PubMed, Medline, Embase, Web of Science, etc., from database establishment to January 2023, to collect qualitative studies on stroke patients’ falling experience at home. The quality of included studies was evaluated by “JBI Australian Evidence-based Health Care Centre (2008) Qualitative Research Quality Assessment Criteria”. The results were integrated by integrating methods. Results A total of 6 references were included, and 18 clear research results were extracted. Similar results were summarized and combined to form 6 new categories, and integrated into 3 main themes. The integration results showed that stroke patients with falls had severe psychological problems, poor coping styles, and unmet needs for fall prevention, resulting in reduced social participation and exercise. Conclusions It is necessary to improve the content of fall assessment and provide corresponding fall prevention health education based on the assessment results. It helps stroke patients and caregivers at home to establish correct coping strategies, thereby avoiding the occurrence of falls.
ObjectivesTo systematically evaluate the impact of Tai Chi on the fall and balance function of middle-aged and the elderly.MethodsPubMed, EMbase, Web of Science, The Cochrane Library, CNKI and WanFang Data databases were electronically searched to collect randomized controlled trials (RCTs) on the influence of Tai Chi on the balance function and fall of middle-aged and the elderly from inception to August, 2019. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was then performed by RevMan 5.3 software.ResultsA total of 20 RCTs involving 3 842 patients were included. The results of meta-analysis showed that the Tai Chi group was superior to the control group in the improvement of the fall rate (RR=0.82, 95%CI 0.75 to 0.90, P<0.000 01), single-leg standing test (MD=5.76, 95%CI 0.62 to 10.90, P=0.03), Berg balance scale (MD=1.04, 95%CI 0.23 to 1.85, P=0.01), timed up and go (MD=?0.71, 95%CI ?0.88 to ?0.54, P<0.000 01), chair stand test (MD=0.87, 95%CI 0.05 to 1.70, P=0.04) and other indicators, and the difference was statistically significant.ConclusionsThe current evidence shows that Tai Chi can improve the balance function of middle-aged and the elderly, reduce the fall rate, and have a certain preventive effect on falls. Due to limited quality and quantity of the included studies, more high quality studies are required to verify the above conclusion.
Objective To retrieve and summarize the best evidence for fall prevention after total hip arthroplasty in elderly patients. Methods BMJ Best Practice, UpToDate, JBI evidence-based healthcare center database, National Institute for Health and Clinical Excellence, Scottish Intercollegiate Guidelines Network, Cochrane Library, PubMed, Web of Science, EBSCO, International Collaboration of Orthopaedic Nurisng website, American Academy of Orthopaedic Surgeons website, European Society for Trauma and Emergency Surgery website, Medlive, China National Knowledge Infrastructure, Wanfang, Chongqing VIP, and SinoMed were systematically searched. The retrieval time was from the establishment of the databases to June 30, 2024. The quality of literature was evaluated, and evidence was extracted, evaluated, and summarized. Results A total of 12 articles were included, including 4 guidelines, 2 randomized controlled trials, 2 cohort studies, and 4 expert consensus studies. A total of 18 pieces of evidence were extracted, including 13 A-level recommendations and 5 B-level recommendations. The evidence covers six major themes of risk factors, assessment, multidisciplinary team support, health education, medication management, safety environment, and assistive devices. Conclusions The fall prevention after total hip arthroplasty in elderly patients involves multiple factors, and the fall prevention should be based on multidisciplinary team cooperation, achieving linkage between the hospital and the family to jointly ensure patient safety. In the future, it is recommended to combine individual patient differences with actual clinical scenarios when applying evidence.
ObjectiveTo systematically review studies investigating the rate of falls among Chinese elderly. MethodsThe CNKI, VIP, CBM, WanFang Data, EMbase, The Cochrane Library and PubMed databases were electronically searched to identify cross-sectional studies on the rate of falls in Chinese elderly published from January 1st, 2000 to December 31st, 2021. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was then performed using Stata 16.0 software. Results A total of 54 cross-sectional studies, involving 111 098 cases were included. The results of meta-analysis showed that the rate of falls among Chinese elderly was 19.3% (95%CI 16.9% to 21.6%). Subgroup analyses showed that the fall rates were 16.1% and 21.9% for males and females, respectively. The rates for 60-69, 70-79, and >80 years age groups were 16.3%, 21.7%, and 27.3%, respectively. The rates for the North, South, East, Southwest, and Central parts of China were 16.6%, 17.9%, 18.7%, 22.0%, and 25.8%, respectively. For the urban and rural elderly, the rates were 16.4% and 23.1%, respectively. The rates for those with or without spouses were 24.2% and 26.8%, respectively, while for the solitary and non-solitary elderly were 21.1% and 17.8%, respectively. The rates for elderly with or without exercise habits were 22.1% and 27.1%, respectively. ConclusionThe rate of falls is high among Chinese elderly, especially among females, older individuals, those in Southwest China, rural individuals, those without spouse, solitary individuals and those without exercise habits.
ObjectiveThis study aimed to systematically review the quality of psychometric properties and methodological quality of the Chinese versions of fear of falling assessment tools for the elderly, providing evidence-based guidance for medical staff in selecting high-quality assessment tools. MethodsWe systematically searched CNKI, WanFang Data, VIP, CBM, PubMed, Embase, and Web of Science databases for studies related to the evaluation of psychometric properties and methodological quality of fear of falling assessment tools for the elderly. The search spanned from the inception of the databases to January 19, 2024. Two researchers independently screened literature and extracted data using the consensus-based standards for the selection of health measurement instruments. The COSMIN risk of bias checklist and quality criteria were employed to evaluate instrument measurement characteristics and formulate final recommendations. ResultsFifteen studies involving 11 Chinese versions of fear of falling assessment tools for the elderly were included. None of the studies reported measurement error, cross-cultural validity, or responsiveness. Due to insufficient or uncertain content validity and low or below-quality evidence, all 11 tools received a recommendation of level B. ConclusionAmong the 11 instruments, the Chinese version of IFES demonstrates the most balanced measurement characteristics, along with good reliability and validity. However, further verification of other measurement characteristics of this instrument is warranted.
Objective To systematically review injury, death, and their causes in elderly people in China from 2000 to 2020 and to prevent and reduce the occurrence of injuries and death. Methods The CNKI, VIP, WanFang Data, PubMed, SinoMed, and Web of Science databases were searched to collect studies on injury and death among elderly people over 60 years of age who resided in China from January 2000 to December 2020. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. A meta-analysis was then performed using R 4.1.2 software. Results A total of 41 studies with 187 488 subjects were included, including 125 million elderly individuals. The pooled injury mortality rate was 135.58/105 (95%CI 113.36/105 to 162.14/105, P<0.001). Subgroup analysis showed that male injury death (146.00/105, 95%CI 116.00 to 183.74, P=0.001) was significantly higher than that of females (127.90/105, 95%CI 102.31 to 159.88, P=0.001) and that overall injury mortality increased exponentially with age (R2=0.957), especially in those over 80 years old. The spatial distribution showed that the injury death rate in the central region was higher than that in the east and west and higher in the countryside than in the city. The time of death distribution showed that after China became an aging society (2000-2020), the time of death was significantly later than before (1990-2000). There were more than 12 types of injuries that caused death, the top three of which were falling, traffic accidents, and suicide. Conclusion From 2000 to 2020, the injury mortality rate of the elderly people in China initially increase and then slightly decrease. The phenomenon affects more men than women, especially those beyond the age of 80. Regional differences are identified, and the types of injuries that cause death are mainly falls, traffic accidents, and suicide. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.
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.
