Purpose: To evaluate the influence of exercise on falls and fall risk reduction in community-dwelling older adults and to present an updated synthesis of outcome measures for the assessment of fall risk in community-dwelling older adults. Method: A systematic review was performed, considering English-language articles published from 2000 to 2006 and accessible through MEDLINE, CINAHL, PEDro, EMBASE, and/or AMED. Included were randomized controlled clinical trials (RCTs) that used an exercise or physical activity intervention and involved participants over age 50. Screening and methodological quality for internal validity were conducted by two independent reviewers. Results: The search retrieved 156 abstracts; 22 articles met the internal validity criteria. Both individualized and group exercise programmes were found to be effective in reducing falls and fall risk. The optimal type, frequency, and dose of exercise to achieve a positive effect have not been determined. A variety of outcome measures have been used to measure fall risk, especially for balance. Conclusions: Falls and fall risk can be reduced with exercise interventions in the community-dwelling elderly, although the most effective exercise variables are unknown. Future studies in populations with comorbidities known to increase fall risk will help determine optimal, condition-specific fallprevention programmes. Poor balance is a key risk factor for falls; therefore, the best measure of this variable should be selected when evaluating patients at risk of falling. RÉ SUMÉObjet : É valuer l'influence de l'exercice sur les chutes et sur la ré duction du risque de chute chez les aîné s qui vivent dans la communauté et pré senter une synthè se à jour des mesures d'impactes pour l'é valuation du risque de chute chez les aîné s qui vivent dans la communauté . Me´thodologie : Une é tude mé thodique a é té effectué e d'aprè s des articles en anglais qui ont é té publié s de 2000 à 2006 et accessibles par le truchement de MEDLINE, CINAHL, PEDro, EMBASE et/ou AMED. On a inclut des essais cliniques alé atoires (EAC) contrô lé s qui utilisaient intervention par exercice ou par activité physique et comprenaient des participants â gé s de plus de 50 ans. La sé lection et la qualité mé thodologique pour la validité interne é taient conduites par deux é valuateurs indé pendants. Re´sultats : La recherche a repé ré 156 ré sumé s ; 22 articles satisfaisaient au critè re de validité interne. Les programmes d'exercice individualisé s et en groupe se sont avé ré s efficaces dans la ré duction des chutes et du risque de chute. Le type, la fré quence et la dose optimal d'exercices requis pour obtenir un effet positif n'ont pas é té dé terminé s. Diverses mesures d'impactes ont é té utilisé es pour mesurer le risque de chute, surtout pour l'é quilibre. Conclusion : Les chutes et le risque de chute peuvent ê tre ré duits par des interventions d'exercices chez les aîné s qui vivent dans la communauté bien que les variables des exercices les plus efficaces soient encore...

During a descent movement that simulates fall arrest, the energy-absorbing capacity of the upper extremities in older women is nearly half that of young women. Absorbing the full energy of a fall in the upper extremities is a challenging task even for healthy young women. Strengthening of upper extremity muscles should enhance this ability and presumably reduce the risk for injury to the hip and head during a fall.

There is strong support for a clinical master's degree in orthopaedic manual therapy in BC. There is greater support for a part-time programme with an inter-professional component, using a combination of e-learning and classroom teaching to reduce travel time and time away from family.

The results suggest a reasonable margin between failure load in vitro and applied mobilization load in vivo.

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