Modelling the population-level impact of tai-chi on falls and fall-related injury among community-dwelling older people

Day, Lesley Margaret; Finch, Caroline F.; Harrison, James Edward; Hoareau, Effie; Segal, Leonie; Ullah, Shahid

doi:10.1136/ip.2009.025452

Cited by 20 publications

(33 citation statements)

References 27 publications

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“…The power of this Cochrane and other systematic reviews of evidence to directly underpin policy decisions cannot be overstated, yet they are not common in sports medicine. The power of active collaborations with policy makers and investment of research effort in developing realistic cost–benefit estimates for both different preventive actions as well as the costs of inaction have also been demonstrated for falls prevention in older people 32–34. Other successful injury prevention information strategies have including the development and validation of injury indicators that could also be used to monitor policy need and success over time 14 15 35…”

Section: Challenges For Better Information Provision To the Public Hementioning

confidence: 99%

Getting sports injury prevention on to public health agendas – addressing the shortfalls in current information sources

Finch

2011

Br J Sports Med

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Public health policy is a successful population-level strategy for injury prevention but it is yet to be widely applied to the sports sector. Such policy is generally coordinated by government health departments concerned with the allocation of limited resources to health service delivery and preventive programs for addressing large community health issues. Prioritisation of sports injury prevention (SIP) requires high-quality evidence about the size of the problem and its public health burden; identification of at-risk vulnerable groups; confirmed effective prevention solutions; evidence of intervention cost-effectiveness; and quantification of both financial and policy implications of inaction. This paper argues that the major reason for a lack of sports injury policy by government departments for health or sport to date is a lack of relevant information available for policy makers to make their decisions. Key information gaps evident in Australia are used to highlight this problem. SIP policy does not yet rank highly because, relative to other health/injury issues, there is very little hard evidence to support: claims for its priority ranking, the existence of solutions that can be implemented and which will work, and potential cost-savings to government agencies. Moreover, policy action needs to be integrated across government portfolios, including sport, health and others. Until sports medicine research generates high-quality population-level information of direct relevance and importance to policy makers, especially intervention costing and implementation cost-benefit estimates, and fully engage in policy-informing partnerships, SIP will continue to be left off the public health agenda.

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Section: Challenges For Better Information Provision To the Public Hementioning

confidence: 99%

Getting sports injury prevention on to public health agendas – addressing the shortfalls in current information sources

Finch

2011

Br J Sports Med

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“…Exercise is an effective intervention for the prevention of falls; however, some forms of exercises have been shown to be more effective than others, with systematic reviews and meta-analyses finding high-dose exercise, including challenging balance training, the most effective [32,33]. Several Web-based falls-prevention programs have been introduced [34,35]. Some exercise programs, such as the Otago program, have been the focus of Australian nationwide public health strategies to address the issue.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of Web-Based Versus Face-To-Face Delivery of Education in Prescription of Falls-Prevention Exercise to Health Professionals: Randomized Trial

Maloney¹,

Haas²,

Keating³

et al. 2011

J Med Internet Res

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BackgroundExercise is an effective intervention for the prevention of falls; however, some forms of exercises have been shown to be more effective than others. There is a need to identify effective and efficient methods for training health professionals in exercise prescription for falls prevention.ObjectiveThe objective of our study was to compare two approaches for training clinicians in prescribing exercise to prevent falls.MethodsThis study was a head-to-head randomized trial design. Participants were physiotherapists, occupational therapists, nurses, and exercise physiologists working in Victoria, Australia. Participants randomly assigned to one group received face-to-face traditional education using a 1-day seminar format with additional video and written support material. The other participants received Web-based delivery of the equivalent educational material over a 4-week period with remote tutor facilitation. Outcomes were measured across levels 1 to 3 of Kirkpatrick’s hierarchy of educational outcomes, including attendance, adherence, satisfaction, knowledge, and self-reported change in practice.ResultsOf the 166 participants initially recruited, there was gradual attrition from randomization to participation in the trial (n = 67 Web-based, n = 68 face-to-face), to completion of the educational content (n = 44 Web-based, n = 50 face-to-face), to completion of the posteducation examinations (n = 43 Web-based, n = 49 face-to-face). Participant satisfaction was not significantly different between the intervention groups: mean (SD) satisfaction with content and relevance of course material was 25.73 (5.14) in the Web-based and 26.11 (5.41) in the face-to-face group; linear regression P = .75; and mean (SD) satisfaction with course facilitation and support was 11.61 (2.00) in the Web-based and 12.08 (1.54) in the face-to-face group; linear regression P = .25. Knowledge test results were comparable between the Web-based and face-to-face groups: median (interquartile range [IQR]) for the Web-based group was 90.00 (70.89–90.67) and for the face-to-face group was 80.56 (70.67–90.00); rank sum P = .07. The median (IQR) scores for the exercise assignment were also comparable: Web-based, 78.6 (68.5–85.1), and face-to-face, 78.6 (70.8–86.9); rank sum P = .61. No significant difference was identified in Kirkpatrick’s hierarchy domain change in practice: mean (SD) Web-based, 21.75 (4.40), and face-to-face, 21.88 (3.24); linear regression P = .89.ConclusionWeb-based and face-to-face approaches to the delivery of education to clinicians on the subject of exercise prescription for falls prevention produced equivalent results in all of the outcome domains. Practical considerations should arguably drive choice of delivery method, which may favor Web-based provision for its ability to overcome access issues for health professionals in regional and remote settings.Trial RegistrationAustralian New Zealand Clinical Trials Registry number: ACTRN12610000135011; http://www.anzctr.org.au/ACTRN12610000135011.aspx (Archived by WebC...

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“…We read with great interest the impressive article in the October 2010 issue by Day and colleagues,1 who found that tai chi can have a large effect on falls and fall-related hospitalisation rates.…”

mentioning

confidence: 99%

Attention should be paid to preventing knee injury in tai chi exercise

2011

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Modelling the population-level impact of tai-chi on falls and fall-related injury among community-dwelling older people

Cited by 20 publications

References 27 publications

Getting sports injury prevention on to public health agendas – addressing the shortfalls in current information sources

Getting sports injury prevention on to public health agendas – addressing the shortfalls in current information sources

Effectiveness of Web-Based Versus Face-To-Face Delivery of Education in Prescription of Falls-Prevention Exercise to Health Professionals: Randomized Trial

Attention should be paid to preventing knee injury in tai chi exercise

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