Randomized Trial of Domiciliary Versus Center-based Rehabilitation: Which is More Effective in Reducing Falls and Improving Quality of Life in Older Fallers?

Abstract

This research demonstrates that delivering a similar service in different settings-home based or center based-impacts upon the effectiveness of the service. Community-dwelling older adults with a history of falls should be provided with center-based programs in preference to home-based programs where they are available.

Clinical Decision Making in Exercise Prescription for Fall Prevention

“…This problem may be reduced with time as more research comparing 2 or more active treatment approaches becomes available. 29 In this study, the clinical decisionmaking processes expressed by the participants were influenced less by the use of published programs and more by the findings of clinical assessments. Although the investigators did not anticipate this result, it is understandable, as assessment procedures are an established core component of both individualized exercise prescription 30 and fall risk reduction in older adults.…”

Strength and Balance Training for Adults With Peripheral Neuropathy and High Risk of Fall: Current Evidence and Implications for Future Research

“…Numerous studies, primarily in the physical therapy and geriatric literature, support the use of strength and balance training exercises among community dwelling adults with postural instability or high risk for falls (Allet et al, 2010; Arampatzis et al, 2011; Beling & Roller, 2009; Clemson et al, 2010; Comans et al, 2010; Conroy et al, 2010; Hagedorn & Holm, 2010; Iwamoto et al, 2009; Kruse et al, 2010; Miller et al, 2010; Morrison et al, 2010; Persch et al, 2009). These studies have direct application to oncology practice and research because many patients, particularly during chemotherapy or radiation therapy, or in advanced stages of disease, experience generalized weakness, muscle weakness, unsteadiness, or problems maintaining balance.…”

“…Strength and balance training exercises can easily be provided by a physical therapist and there is a great deal of data that supports physical therapist led exercise interventions that include specific exercises to strengthen the lower extremities and improve balance (Allet et al, 2010; Arampatzis et al, 2011; Beling & Roller, 2009; Clemson et al, 2010; Comans et al, 2010; Conroy et al, 2010; Hagedorn & Holm, 2010; Iwamoto et al, 2009; Kruse et al, 2010; Miller et al, 2010; Morrison et al, 2010; Persch et al, 2009). Participation in exercise programs focused on improving lower extremity strength and balance has been repeatedly demonstrated as safe, even among people with a very high risk of falls (Clemson et al, 2010; Comans et al, 2010; Conroy et al, 2010).…”

“…Home based programs have demonstrated similar efficacy in improving physical function but institution based programs may offer greater benefits in terms of reducing falls. Data suggests that while institutional based programs may be more effective, participation and adherence may increase when a home based program is offered (Comans, Brauer, & Haines, 2010). …”

Factors Associated With Older Patients' Engagement in Exercise After Hospital Discharge

“…15,19 A large community survey found that 243 while 36% of older people were willing to do home exercises only 22% were willing to 244 attend a group program 19 and a study that prescribed falls prevention exercises reported that 245 completing home based exercises resulted in increased adherence and reduced drop out when 246 compared to a centre based program. 40 This is the first study to the authors' knowledge to examine older patients' beliefs about the 249 risk of falling and their engagement in exercise in the post discharge period. Responses 250 identified that 88% of participants agreed that a fall could result in a serious injury but only 251 53% agreed that they personally could sustain a serious injury from a fall.…”