Research status and prospect of exercise-based fall prevention in the elderly_West China Medical Journal

Authors：

LIU Zuoyan ¹ , XIANG Xiaona ² ,  HE Hongchen ¹

1. Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. West China School of Medicine, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

HE Hongchen, Email: 66362265@qq.com

Keywords：

Exercise; Elderly; Fall; Prevention

DOI：

10.7507/1002-0179.201904016

Video：

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Under the new era background of actively advocating the " active health” in the elderly, the prevention methods of falls not only include environmental modification, reasonable drugs, emotional support, disease prevention and control, etc., but exercise should also be integrated into them. Exercise training can significantly improve muscle strength, balance, and mobility in the elderly, thereby reducing the risk of falls. This paper reviews the biomechanical causes of falls in the elderly, the sports training prescriptions for fall prevention in the elderly, and the research prospects of sports training for fall prevention in the elderly. It is hoped that the elderly population could establish an active healthy lifestyle based on sports training, elevate the physical fitness continuously, reduce the fall injury, and improve the quality of life through strength, balance, and endurance training.

Citation： LIU Zuoyan, XIANG Xiaona, HE Hongchen. Research status and prospect of exercise-based fall prevention in the elderly. West China Medical Journal, 2019, 34(6): 712-715. doi: 10.7507/1002-0179.201904016 Copy

1.	Jones TS, Ghosh TS, Horn K, et al. Primary care physicians perceptions and practices regarding fall prevention in adult’s 65 years and over. Accid Anal Prev, 2011, 43(5): 1605-1609.
2.	Rubenstein LZ. Falls in older people: epidemiology, risk factors and strategies for prevention. Age Ageing, 2006, 35(Suppl 2): ii37-ii41.
3.	Lacroix A, Kressig RW, Muehlbauer T, et al. Effects of a supervised versus an uniupervised combined balance and strength training program on balance and muscle power in healthy older adults: a randomized controlled trial. Gerontology, 2016, 62(3): 275-288.
4.	李立, 陈玉娟, 翟凤鸣, 等. 长期从事太极拳运动老年人足底压力分布特征及平衡能力研究. 中国康复医学杂志, 2016, 31(9): 984-988.
5.	Masud T, Morris RO. Epidemiology of falls. Age Ageing, 2001, 30(Suppl 4): 3-7.
6.	Means KM, Rodell DE, O’Sullivan PS. Balance, mobility, and falls among community-dwelling elderly persons: effects of a rehabilitation exercise program. Am J Phys Med Rehabil, 2005, 84(4): 238-250.
7.	Kim H, Suzuki T, Saito K, et al. Long-term effects of exercise and amino acid supplementation on muscle mass, physical function and falls in community-dwelling elderly Japanese sarcopenic women: a 4-year follow-up study. Geriatr Gerontol Int, 2016, 16(2): 175-181.
8.	Dadgari A, Aizan Hamid T, Hakim MN, et al. Randomized control trials on otago exercise program (OEP) to reduce falls among elderly community dwellers in shahroud, Iran. Iran Red Crescent Med J, 2016, 18(5): e26340.
9.	胡秀英. 老年护理手册. 2版. 北京: 科学出版社, 2015: 424-437.
10.	袁春香. 八段锦锻炼对预防老年人跌倒的研究. 临床医药文献杂志, 2017, 4(35): 6929-6930.
11.	Thomas EE, De Vito G, Macaluso A. Speed training with body weight unloading improves walking energy cost and maximal speed in 75-to 85 year-old healthy women. J Appl Physiol(1985), 2007, 103(5): 1598-1603.
12.	Auvinet B, Touzard C, Montestruc F, et al. Gait disorders in the elderly and dual task gait analysis: a new approach for identifying motor phenotypes. J Neuroeng Rehabil, 2017, 14(1): 7.
13.	邹晓峰, 李萍, 刘巍. 老年人步态与平衡的生物力学研究进展. 中国老年学杂志, 2010, 30(18): 2706-2708.
14.	Wang J, Chen Z, Song Y. Falls in aged people of the Chinese mainland: epidemiology, risk factors and clinical strategies. Ageing Res Rev, 2010(Suppl 1): S13-S17.
15.	Donath L, van Dieën J, Faude O. Exercise-based fall prevention in the elderly: what about agility?. Sports Med, 2016, 46(2): 143-149.
16.	Lee J, Yoo HN, Lee BH. Effects of augmented reality-based Otago exercise on balance, gait, and physical factors in elderly women to prevent falls: a randomized controlled trial. J Phys Ther Sci, 2017, 29(9): 1586-1589.
17.	Granacher U, Muehlbauer T, Zahner L, et al. Comparison of traditional and recent approaches in the promotion of balance and strength in older adults. Sports Med, 2011, 41(5): 377-400.
18.	王连成, 张祎, 章礼勤, 等. 老年跌倒患者下肢肌肉力量变化的研究. 天津医药, 2012, 40(9): 938-939.
19.	Ribeiro F, Oliveira J. Effect of physical exercise and age on knee joint position sense. Arch Gerontol Geriatr, 2010, 51(1): 64-67.
20.	Oken BS, Zajdel D, Kishiyama S, et al. Randomized, controlled, six-month trial of yoga in healthy seniors: effects on cognition and quality of life. Altern Ther Health Med, 2006, 12(1): 40-47.
21.	Donat H, Ozcan A. Comparison of the effectiveness of two programmes on older adults at risk of falling: unsupervised home exercise and supervised group exercise. Clin Rehabil, 2007, 21(3): 273-283.
22.	Brandão GS, Oliveira LVF, Brandão GS, et al. Effect of a home-based exercise program on functional mobility and quality of life in elderly people: protocol of a single-blind, randomized controlled trial. Trials, 2018, 19(1): 684.
23.	Gillespie LD, Robertson MC, Gillespie WJ, et al. Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev, 2009(2): CD007146.
24.	Ashari A, Hamid TA, Hussain MR, et al. Effectiveness of individualized home-based exercise on turning and balance performance among adults older than 50yrs: a randomized controlled trial. Am J Phys Med Rehabil, 2016, 95(5): 355-365.
25.	许良医. 运动训练原则应用发展研究. 当代体育科技, 2018, 8(3): 48, 50.
26.	American College of Sports Medicine, Chodzko-Zajko WJ, Proctor DN, et al. American college of sports medicine position stand. Exercise and physical activity for older adults. Med Sci Sports Exerc, 2009, 41(7): 1510-1530.
27.	Lord SR, March LM, Cameron ID, et al. Differing risk factors for falls in nursing home and intermediate-care residents who can and cannot stand unaided. J Am Geriatr Soc, 2003, 51(11): 1645-1650.
28.	樊贤进, 李月红. 普拉提运动降低老年女性跌倒次数的作用机制. 中国老年学杂志, 2015, 35(7): 1800-1801.
29.	王文萍. 核心力量和健身路径锻炼改善老年人跌倒风险因素的研究. 实用临床护理学杂志, 2017, 2(19): 106-107.
30.	Cho SI, An DH. Effects of a fall prevention exercise program on muscle strength and balance of the old-old elderly. J Phys Ther Sci, 2014, 26(11): 1771-1774.
31.	Mirelman A, Rochester L, Maidan I, et al. Addition of a non-immersive virtual reality component to treadmill training to reduce fall risk in older adults (V-TIME): a randomised controlled trial. Lancet, 2016, 388(10050): 1170-1182.
32.	Khanuja K, Joki J, Bachmann G, et al. Gait and balance in the aging population: fall prevention using innovation and technology. Maturitas, 2018, 110: 51-56.
33.	孟凡嫣, 陈璇, 王艳, 等. 基于现实环境的功能性步态训练对社区卒中后康复期老人步态特征及害怕跌倒的影响. 护理学报, 2018, 25(19): 1-4.
34.	李爱君, 高瑞尧, 郑琦玮, 等. 提高老年人肌肉力量和心肺功能的运动处方研究进展. 中国康复理论与实践, 2017, 23(2): 179-184.
35.	陈纪言, 陈韵岱, 韩雅玲, 等. 经皮冠状动脉介入治疗术后运动康复专家共识. 中国介入心脏病学杂志, 2016, 24(7): 361-369.
36.	韦恩·L·威斯科特, 托马斯·R·贝希勒. 50岁之后的力量训练. 孙飞, 译. 北京: 人民邮电出版社, 2018: 25-35.
37.	Zheng J, Pan Y, Hua Y, et al. Strategic targeted exercise for preventing falls in elderly people. J Int Med Res, 2013, 41(2): 418-426.
38.	Yang JE, Lee TY, Kim JK. The effect of a VR exercise program on falls and depression in the elderly with mild depression in the local community. J Phys Ther Sci, 2017, 29(12): 2157-2159.
39.	张鑫华, 王国祥. 从" 健康日本21”计划实施看日本社会国民健康的管理与服务. 成都体育学院学报, 2014, 40(9): 19-23.
40.	Peters S, Handy TC, Lakhani B, et al. Motor and visuospatial attention and motor planning after stroke: considerations for the rehabilitation of standing balance and gait. Phys Ther, 2015, 95(10): 1423-1432.
41.	Di Martino S, Tramonti C, Unti E, et al. Aerobic rehabilitation program for improving muscle function in Parkinson’s disease. Restor Neurol Neurosci, 2018, 36(1): 13-20.
42.	Lee C, Dotson AJ, Brown WJ, et al. Cohort profile: the Austrilian longitudinal study on women’s health. Int J Epidemiol, 2005, 34(5): 987-991.

1. Jones TS, Ghosh TS, Horn K, et al. Primary care physicians perceptions and practices regarding fall prevention in adult’s 65 years and over. Accid Anal Prev, 2011, 43(5): 1605-1609.
2. Rubenstein LZ. Falls in older people: epidemiology, risk factors and strategies for prevention. Age Ageing, 2006, 35(Suppl 2): ii37-ii41.
3. Lacroix A, Kressig RW, Muehlbauer T, et al. Effects of a supervised versus an uniupervised combined balance and strength training program on balance and muscle power in healthy older adults: a randomized controlled trial. Gerontology, 2016, 62(3): 275-288.
4. 李立, 陈玉娟, 翟凤鸣, 等. 长期从事太极拳运动老年人足底压力分布特征及平衡能力研究. 中国康复医学杂志, 2016, 31(9): 984-988.
5. Masud T, Morris RO. Epidemiology of falls. Age Ageing, 2001, 30(Suppl 4): 3-7.
6. Means KM, Rodell DE, O’Sullivan PS. Balance, mobility, and falls among community-dwelling elderly persons: effects of a rehabilitation exercise program. Am J Phys Med Rehabil, 2005, 84(4): 238-250.
7. Kim H, Suzuki T, Saito K, et al. Long-term effects of exercise and amino acid supplementation on muscle mass, physical function and falls in community-dwelling elderly Japanese sarcopenic women: a 4-year follow-up study. Geriatr Gerontol Int, 2016, 16(2): 175-181.
8. Dadgari A, Aizan Hamid T, Hakim MN, et al. Randomized control trials on otago exercise program (OEP) to reduce falls among elderly community dwellers in shahroud, Iran. Iran Red Crescent Med J, 2016, 18(5): e26340.
9. 胡秀英. 老年护理手册. 2版. 北京: 科学出版社, 2015: 424-437.
10. 袁春香. 八段锦锻炼对预防老年人跌倒的研究. 临床医药文献杂志, 2017, 4(35): 6929-6930.
11. Thomas EE, De Vito G, Macaluso A. Speed training with body weight unloading improves walking energy cost and maximal speed in 75-to 85 year-old healthy women. J Appl Physiol(1985), 2007, 103(5): 1598-1603.
12. Auvinet B, Touzard C, Montestruc F, et al. Gait disorders in the elderly and dual task gait analysis: a new approach for identifying motor phenotypes. J Neuroeng Rehabil, 2017, 14(1): 7.
13. 邹晓峰, 李萍, 刘巍. 老年人步态与平衡的生物力学研究进展. 中国老年学杂志, 2010, 30(18): 2706-2708.
14. Wang J, Chen Z, Song Y. Falls in aged people of the Chinese mainland: epidemiology, risk factors and clinical strategies. Ageing Res Rev, 2010(Suppl 1): S13-S17.
15. Donath L, van Dieën J, Faude O. Exercise-based fall prevention in the elderly: what about agility?. Sports Med, 2016, 46(2): 143-149.
16. Lee J, Yoo HN, Lee BH. Effects of augmented reality-based Otago exercise on balance, gait, and physical factors in elderly women to prevent falls: a randomized controlled trial. J Phys Ther Sci, 2017, 29(9): 1586-1589.
17. Granacher U, Muehlbauer T, Zahner L, et al. Comparison of traditional and recent approaches in the promotion of balance and strength in older adults. Sports Med, 2011, 41(5): 377-400.
18. 王连成, 张祎, 章礼勤, 等. 老年跌倒患者下肢肌肉力量变化的研究. 天津医药, 2012, 40(9): 938-939.
19. Ribeiro F, Oliveira J. Effect of physical exercise and age on knee joint position sense. Arch Gerontol Geriatr, 2010, 51(1): 64-67.
20. Oken BS, Zajdel D, Kishiyama S, et al. Randomized, controlled, six-month trial of yoga in healthy seniors: effects on cognition and quality of life. Altern Ther Health Med, 2006, 12(1): 40-47.
21. Donat H, Ozcan A. Comparison of the effectiveness of two programmes on older adults at risk of falling: unsupervised home exercise and supervised group exercise. Clin Rehabil, 2007, 21(3): 273-283.
22. Brandão GS, Oliveira LVF, Brandão GS, et al. Effect of a home-based exercise program on functional mobility and quality of life in elderly people: protocol of a single-blind, randomized controlled trial. Trials, 2018, 19(1): 684.
23. Gillespie LD, Robertson MC, Gillespie WJ, et al. Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev, 2009(2): CD007146.
24. Ashari A, Hamid TA, Hussain MR, et al. Effectiveness of individualized home-based exercise on turning and balance performance among adults older than 50yrs: a randomized controlled trial. Am J Phys Med Rehabil, 2016, 95(5): 355-365.
25. 许良医. 运动训练原则应用发展研究. 当代体育科技, 2018, 8(3): 48, 50.
26. American College of Sports Medicine, Chodzko-Zajko WJ, Proctor DN, et al. American college of sports medicine position stand. Exercise and physical activity for older adults. Med Sci Sports Exerc, 2009, 41(7): 1510-1530.
27. Lord SR, March LM, Cameron ID, et al. Differing risk factors for falls in nursing home and intermediate-care residents who can and cannot stand unaided. J Am Geriatr Soc, 2003, 51(11): 1645-1650.
28. 樊贤进, 李月红. 普拉提运动降低老年女性跌倒次数的作用机制. 中国老年学杂志, 2015, 35(7): 1800-1801.
29. 王文萍. 核心力量和健身路径锻炼改善老年人跌倒风险因素的研究. 实用临床护理学杂志, 2017, 2(19): 106-107.
30. Cho SI, An DH. Effects of a fall prevention exercise program on muscle strength and balance of the old-old elderly. J Phys Ther Sci, 2014, 26(11): 1771-1774.
31. Mirelman A, Rochester L, Maidan I, et al. Addition of a non-immersive virtual reality component to treadmill training to reduce fall risk in older adults (V-TIME): a randomised controlled trial. Lancet, 2016, 388(10050): 1170-1182.
32. Khanuja K, Joki J, Bachmann G, et al. Gait and balance in the aging population: fall prevention using innovation and technology. Maturitas, 2018, 110: 51-56.
33. 孟凡嫣, 陈璇, 王艳, 等. 基于现实环境的功能性步态训练对社区卒中后康复期老人步态特征及害怕跌倒的影响. 护理学报, 2018, 25(19): 1-4.
34. 李爱君, 高瑞尧, 郑琦玮, 等. 提高老年人肌肉力量和心肺功能的运动处方研究进展. 中国康复理论与实践, 2017, 23(2): 179-184.
35. 陈纪言, 陈韵岱, 韩雅玲, 等. 经皮冠状动脉介入治疗术后运动康复专家共识. 中国介入心脏病学杂志, 2016, 24(7): 361-369.
36. 韦恩·L·威斯科特, 托马斯·R·贝希勒. 50岁之后的力量训练. 孙飞, 译. 北京: 人民邮电出版社, 2018: 25-35.
37. Zheng J, Pan Y, Hua Y, et al. Strategic targeted exercise for preventing falls in elderly people. J Int Med Res, 2013, 41(2): 418-426.
38. Yang JE, Lee TY, Kim JK. The effect of a VR exercise program on falls and depression in the elderly with mild depression in the local community. J Phys Ther Sci, 2017, 29(12): 2157-2159.
39. 张鑫华, 王国祥. 从" 健康日本21”计划实施看日本社会国民健康的管理与服务. 成都体育学院学报, 2014, 40(9): 19-23.
40. Peters S, Handy TC, Lakhani B, et al. Motor and visuospatial attention and motor planning after stroke: considerations for the rehabilitation of standing balance and gait. Phys Ther, 2015, 95(10): 1423-1432.
41. Di Martino S, Tramonti C, Unti E, et al. Aerobic rehabilitation program for improving muscle function in Parkinson’s disease. Restor Neurol Neurosci, 2018, 36(1): 13-20.
42. Lee C, Dotson AJ, Brown WJ, et al. Cohort profile: the Austrilian longitudinal study on women’s health. Int J Epidemiol, 2005, 34(5): 987-991.

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Research status and prospect of exercise-based fall prevention in the elderly

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