Falls in older people: epidemiology, risk factors and strategies for prevention

Laurence Z. Rubenstein

Abstract

Falls are a common and often devastating problem among older people, causing a tremendous amount of morbidity, mortality and use of health care services including premature nursing home admissions. Most of these falls are associated with one or more identifiable risk factors (e.g. weakness, unsteady gait, confusion and certain medications), and research has shown that attention to these risk factors can significantly reduce rates of falling. Considerable evidence now documents that the most effective (and cost-effective) fall reduction programmes have involved systematic fall risk assessment and targeted interventions, exercise programmes and environmental-inspection and hazard-reduction programmes. These findings have been substantiated by careful meta-analysis of large numbers of controlled clinical trials and by consensus panels of experts who have developed evidence-based practice guidelines for fall prevention and management. Medical assessment of fall risks and provision of appropriate interventions are challenging because of the complex nature of falls. Optimal approaches involve interdisciplinary collaboration in assessment and interventions, particularly exercise, attention to co-existing medical conditions and environmental inspection and hazard abatement.

Quelle:  http://ageing.oxfordjournals.org/content/35/suppl_2/ii37.short

Full Text / pdf / online im internet – Zugriff vom 02.10.2012 – Falls in older people: epidemiology, risk factors and strategies for prevention – http://ageing.oxfordjournals.org/content/35/suppl_2/ii37.full.pdf

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The Relationship between Quadriceps Strength and Balance to Fall of Elderly Admitted to a Nursing Home

Tome Ikezoe1), Yasuyoshi Asakawa2), Akimitsu Tsutou3)

1) Department of Physical Therapy, College of Medical Technology, Kyoto University 2) Department of Physical Therapy, Faculty of Medicine, Gunma University 3) Faculty of Health Sciences, Kobe University School of Medicine

Released 2004/01/16

Keywords: Fall, Elderly, Quadriceps strength, Balance

ABSTRACT

This study was undertaken to determine the relationship between quadriceps strength and balance to falls of institutionalized elderly people.

The subjects comprised 25 elderly women aged 75.3 ± 3.4 years. The values of the postural sway in two standing positions, functional reach test, and quadriceps strength were compared between two groups of elderly adults, those with or without a history of fall.

Quadriceps strength was measured using isometric contraction of the knee extension. There were no significant differences between the two groups in the postural sway in the two standing positions and the functional reach test.

Quadriceps strength in the non-fall group was, however, significantly higher than that in the fall group (1.48 Nm/kg vs. 1.08 Nm/kg, p<0.01). The discriminating criterion for muscle strength between the two groups was 1.28 Nm/kg, with an apparent error rate of 24.8%.

These findings suggest that (1) the degree of quadriceps strength may be a useful indicator for the prospect of fall in institutionalized elderly people, and (2) quadriceps strength should be maintained at least more than 1.28 Nm/kg to prevent fall.

Quelle:  https://www.jstage.jst.go.jp/article/jpts/15/2/15_2_75/_article

Full Text / pdf:

https://www.jstage.jst.go.jp/article/jpts/15/2/15_2_75/_pdf

 

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Relationship between Falls and Knee Extension Strength in the Elderly

Yasuyoshi Asakawa1), Tome Ikezoe1), Kan Hazaki1), Ichiro Kawano2), Seigo Irie2), Hideto Kanzaki2), Nobuo Aoki3)

1) Division of Physical Therapy, College of Medical Technology, Kyoto University, 53 Shougoin Kawahara-cho, Sakyo-ku, Kyoto-city 606-01, Japan. 2) Department of Physical Therapy, Kyoto University Hospital 3) Kenkoen Geriatric Clinic

Released 2001/12/27

Keywords: Fall, Knee extension strength, Elderly

ABSTRACT

This study examined the relationship between falls and knee extension strength in the eldely. Twenty-seven elderly persons who resided at the same home for aged were asked about their individual histories of falling during the previous year, including the location where the fall had occured, such as near the bed, in the toilet, or in the corridor.

The isometric maximal knee extension strength of the subjects was determined, measured by a hand-held dynamometer in the knee flexed at 90 degrees, as a percentage of their weight. Calculations were obtained on the dominant side and non-dominant side, and the sum of both sides was also noted.

The subjects were then divided into two groups: no-fall group (n=18), and fall group (n=9). The fall group was further divided into the fall outside the home group (n=2) and the fall in the home group (n=7). The knee extension strength was compared by two-sample t-test between the no-fall and the fall outside the home group, and between the no-fall and the fall in the home group.

In addition, the range of knee extension strength in the fall in the home group was examined by scattergraph, in which the knee extension strength of all subjects were plotted. The two-sample t-test revealed significant differences in knee extension strength between the no-fall group and the fall in the home group (p<0.05). The scattergraph indicated that the knee extension strength of the subjects who had a fall in the home was at a range less than approximately 35% of their weight.

These results suggested that poor knee extension strength was closely related to falls in the home, and it is thus desirable that elderly maintain their knee extension strength above approximately 35% of their weight in each side to prevent falls in the home.

Quelle:  https://www.jstage.jst.go.jp/article/jpts/8/2/8_2_45/_article

 

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JÖRG LINDER AKTIV-TRAINING
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76534 Baden-Baden
Tel.: 07223 / 8004699
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Radfahren mit dem Theraband

……nicht nur im Bereich Sturzprävention eine sinnvolle Übung.

Wenn der koordinative Anspruch erhöht werden soll, wird die Übung wie im Video, sitzend auf einem Physioball durchgeführt.

Video von: http://www.youtube.com/watch?v=5aKskCQL6i4

 

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Personal Training Long Line

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Enstehung der Osteoporose

Enstehung der Osteoporose – Wann entsteht Knochenschwund?

Wenn über die Jahre hinweg mehr Knochengewebe abgebaut als erneuert wird, führt dies zu einer negativen Knochenbilanz.

Ursachen negativer Knochenbilanz

Eine negative Knochenbilanz hat verschiedene Ursachen: Einmal die erhöhte Aktivität abbauender Zellen (Osteoklasten) und dann die verminderte Aktivität aufbauender Zellen (Osteoblasten).

Dies führt insgesamt zu einer Atrophie der Knochenmasse und später zu einer Osteoporose. Bei der Osteoporose wird der abgebaute Knochen nicht wieder vollständig ersetzt.

Aktives Bewegungstraining ist Osteoporoseprävantion. Gesundheit durch Bewegung.

Baden-Baden, Offenburg, Karlsruhe, Nordschwarzwald >>>

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Die Zellen unserer Knochen

Osteoklasten:

Die Osteoklasten bauen alte, schwache Knochen ab. Sie werdem von zahlreichen Hormonen (Parathormon; Östrogen, etc.) gesteuert. Östrogene unterdrücken die Arbeit der Osteoklasten

Osteoblasten:

Die Osteoblasten bauen neue Knochen auf, in dem sie neues Kollagen bilden. Gezielte Reizsetzung durch entsprechendes Training fördert die Aktivität der Osteoblasten.

Östrogene fördern nicht die Arbeit der Osteoblasten (die erst aktiv werden während / nach einem mechanischen Reiz.)

Osteozyten:

Etwa jeder zehnte Osteoblast wird als Osteozyt in neugebildetes Knochengewebe eingebaut. Osteozyten sind für den Stoffwechsel im Knochen zuständig. Osteozyten registrieren den Muskelzug am Knochen und geben das Signal an die Baueinheiten der Oberfläche wieder.

Osteoporoseprävention durch aktives Training – Gesundheit durch Bewegung – www.aktiv-training.de