Effect of home-based exercise on falls in community-dwelling older adults: an umbrella review

Shafizadeh, Mohsen; Parvinpour, Shahab; Ali, Khalid

doi:10.1007/s11332-022-00993-2

Cited by 4 publications

(2 citation statements)

References 45 publications

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“…Our findings suggest that exercises may reduce the rate of falls among dialysis patients. This is consistent with results from other studies among older people living in the community [28][29][30], older adults receiving geriatrician-led care [31] and healthy older adults [32]. However, the components of the exercises that are effective for particular groups of patients need to be ascertained.…”

Section: Discussionsupporting

confidence: 88%

Interventions to reduce falls among dialysis patients: a systematic review

Gute,

Zimbudzi

2023

BMC Nephrol

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Introduction Despite all available evidence regarding increased morbidity and mortality among dialysis patients due to falls and their complications, and an increase in risk factors for falls, relatively little attention has been focused on evidence-based interventions that can reduce falls. We evaluated the effectiveness of fall prevention interventions among dialysis patients. Methods We searched Ovid-Medline, Ovid-Embase, PubMed, Cumulated Index to Nursing and Allied Health Literature and the Cochrane Central Register of Controlled Trials (Central) from inception to 19 July 2023 for studies that evaluated the effectiveness of fall prevention interventions among dialysis patients. The search, screening and extraction of data followed standardised processes and the methodological quality of studies was independently assessed by two reviewers. Data was analysed using a narrative synthesis approach. Results Of the 18 studies that had full text review, five were eligible. Three studies were performed in the USA and one each in UK and Japan. Four studies were conducted in outpatient hemodialysis centres and one in a hospital-based nephrology unit. Reported sample sizes ranged from 51 to 96 participants per study with a follow-up period of 3 to 35 months. There was moderate-quality evidence that exercises reduce the rate of falls compared to usual care and low to moderate quality of evidence that multifactorial falls prevention interventions reduce the rate of falls. However, treatment effects could not be quantitatively estimated for all interventions due to substantial heterogeneity of included studies. Conclusions This systematic review reflects that there is insufficient evidence regarding falls prevention strategies specific to dialysis patients. Available data based on low to moderate quality studies, suggest that among dialysis patients, exercises may reduce falls and the effectiveness of multifactorial interventions such as staff and patient education still need to be explored using high-quality prospective studies.

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Section: Discussionsupporting

confidence: 88%

Interventions to reduce falls among dialysis patients: a systematic review

Gute,

Zimbudzi

2023

BMC Nephrol

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“…Among nonpharmacologic therapy, both center-based exercise (CBE) and home-based exercise (HBE) have been found to reduce pain and improve function in people with KOA compared to no intervention or usual care (4)(5)(6)(7)(8). HBE refers to exercise that takes place in an informal and flexible setting, generally in patients' homes (9,10), which offers a sense of familiarity within one's surroundings, providing comfort and accessibility while also reducing costs, environmental challenges, and travel time to a healthcare center (11)(12)(13)(14). Therefore, HBE represents an alternative to increase the accessibility of exercise programs and relieve the burden on the health care system (12-15).…”

Section: Introductionmentioning

confidence: 99%

Home-based vs center-based exercise on patient-reported and performance-based outcomes for knee osteoarthritis: a systematic review with meta-analysis

Zhang,

Huang,

Tian

et al. 2024

Front. Public Health

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BackgroundHome-based exercise (HBE) represents an alternative to increase the accessibility of rehabilitation programs and relieve the burden on the health care system for people with knee osteoarthritis.ObjectivesTo summarize for the first time the effectiveness of HBE as compared to center-based exercise (CBE), both with and without HBE, on patient-reported and performance-based outcomes in people with KOA.MethodsSearches were conducted on PubMed, Cochrane, Embase, Web of Science, and Scopus until March 10, 2023, without date or language restrictions. Randomized controlled trials investigating HBE versus CBE or HBE combined with CBE for people with KOA were eligible. The primary outcomes were patient-reported: pain, physical disability, and quality of life. The secondary outcomes were performance-based: walking ability, lower limb muscle strength, and balance function. Risk of bias was assessed with the Cochrane Risk of Bias tool and quality of evidence according to the GRADE.ResultsEleven trials involving 956 participants were included. There was no difference in short-term pain (SMD, 0.22 [95% CI, −0.04 to 0.47], p = 0.09; I2 = 0%), physical disability (SMD, 0.17 [95% CI, −0.19 to 0.54], p = 0.35; I2 = 0%), walking ability (SMD, −0.21 [95% CI, −0.64 to 0.22], p = 0.33; I2 = 35%) and lower limb muscle strength (SMD, −0.24 [95% CI, −0.88 to 0.41], p = 0.47; I2 = 69%) between HBE and CBE. HBE combined with CBE has better benefits compared with HBE alone in short-term pain (SMD, 0.89 [95% CI, 0.60 to 1.17], p < 0.001; I2 = 11%) and physical disability (SMD, 0.25 [95% CI, 0.00 to 0.50], p = 0.05; I2 = 0%).ConclusionBased on limited evidence, HBE is as effective as CBE on short-term pain, physical disability, walking ability, and lower limb muscle strength in people with knee osteoarthritis. Furthermore, combining HBE with CBE may enhance the overall efficacy of the intervention.Systematic review registrationPROSPERO, CRD42023416548.

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Person-focused interventions for fall risk assessment, fall prevention and fall injury prevention in long-term care facilities: a scoping review

Jung,

Lim,

et al. 2024

Inj Prev

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ObjectiveFalls are a significant concern in long-term care facilities (LTCFs) as fall-related injuries can result in functional impairment, disability and death. Older adults living in LTCFs are at greater risk for falls than those in the community. Using scoping review methodology, we aimed to synthesise evidence examining intervention effects of person-focused interventions for risk assessment and prevention in LTCFs in order to identify evidence-based practices in LTCFs.MethodsWe included three databases (Ovid-Medline, CINAHL and EMBASE) to identify original research from 2007 to 2022 in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guideline. From the initial search, we identified 988 articles. Following the removal of duplicates, title and abstract screening, and full-text review against inclusion/exclusion criteria, 20 studies remained for analysis. Then, we conducted a narrative synthesis to summarise the included studies.ResultsIdentified evidence-based interventions for fall prevention include (1) exercise programmes (eg, high-intensity functional exercise, aerobic exercise, short stick exercises, etc); (2) multifactorial programmes; and (3) other interventions (eg, lavender olfactory stimulation). Outcomes of included studies included the number of falls, fall rate, risk of falls and fear of falls before and after interventions.ConclusionOverall, most studies reported significant effects of person-focused interventions in LTCFs. Available evidence supports that well-designed person-focused interventions can reduce falls and fear of falls for individuals in LTCFs.

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Effect of home-based exercise on falls in community-dwelling older adults: an umbrella review

Cited by 4 publications

References 45 publications

Interventions to reduce falls among dialysis patients: a systematic review

Interventions to reduce falls among dialysis patients: a systematic review

Home-based vs center-based exercise on patient-reported and performance-based outcomes for knee osteoarthritis: a systematic review with meta-analysis

Person-focused interventions for fall risk assessment, fall prevention and fall injury prevention in long-term care facilities: a scoping review

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