ObjectiveTo assess the methodological quality of systematic reviews of Tai Chi for preventing falls in the elderly and the quality of evidence for outcome indicators.MethodsPubMed, Web of Science, The Cochrane Library, EMbase, CNKI, WanFang Data, CBM and VIP databases were electronically retrieved. According to the inclusion criteria and exclusion criteria, the final articles were selected and the relevant literature information was extracted by reading the abstract and the full text. The methodological quality of the included systematic reviews was evaluated using AMSTAR 2 tool, and the quality of the outcome indicators of the included systematic reviews was further graded according to the GRADE system.ResultsA total of 11 systematic reviews/meta-analyses were included. The AMSTAR 2 evaluation showed that 10 studies were in critically-low methodological quality, and 1 study was in low methodological quality. The GRADE evaluation results showed that among the 36 outcome indicators included, there were 10 intermediate quality indicators, 20 low-level quality indicators and 6 extremely low-level quality indicators. Among the indicators of intermediate quality, single-leg stand test (MD = 5.33, 95%CI 3.35 to 7.32, P< 0.01; WMD = 1.76, 95%CI −7.00 to 10.52, P< 0.01), time up and go test (MD = 1.04, 95%CI 0.67 to 1.41, P< 0.01), the berg balance scale (MD = 2.18, 95%CI 0.93 to 3.43, P< 0.01), number of falls (RR = 0.82, 95%CI 0.73 to 0.92), P< 0.01), the incidence of 2-falls (OR = 0.69, 95%CI 0.49 to 0.97, P< 0.01) and the incidence of 3-falls (OR = 0.39, 95%CI 0.21 to 0.73, P< 0.01). The results of the above indicators were statistically significant, indicating that Tai Chi was better than control group.ConclusionsAt present, the methodological quality of relevant systematic reviews of Tai Chi for preventing falls in the elderly was relatively low and the quality of the evidence was not good, so it can’t be proved that Tai Chi can effectively prevent falls in the elderly, which needs to be further studied at a high level.
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.
Objective To integrate the falling experience and coping styles of stroke home patients with falls through Meta synthesis, summarize existing problems based on the integration results, and propose suggestions. Methods We searched databases including PubMed, Medline, Embase, Web of Science, etc., from database establishment to January 2023, to collect qualitative studies on stroke patients’ falling experience at home. The quality of included studies was evaluated by “JBI Australian Evidence-based Health Care Centre (2008) Qualitative Research Quality Assessment Criteria”. The results were integrated by integrating methods. Results A total of 6 references were included, and 18 clear research results were extracted. Similar results were summarized and combined to form 6 new categories, and integrated into 3 main themes. The integration results showed that stroke patients with falls had severe psychological problems, poor coping styles, and unmet needs for fall prevention, resulting in reduced social participation and exercise. Conclusions It is necessary to improve the content of fall assessment and provide corresponding fall prevention health education based on the assessment results. It helps stroke patients and caregivers at home to establish correct coping strategies, thereby avoiding the occurrence of falls.
ObjectiveTo compare the application of self-made tumble risk factors assessment scale before and after its revision in patients with mental disorder, in order to guide the clinical work. MethodsWe retrospectively analyzed the clinical data of 2 209 patients with mental disorders who were discharged from the hospital between January 1, 2012 and December 31, 2013. All the patients in our hospital underwent the assessment by "table of tumble risk factors for hospitalized patients and nursing measures" within one hour of admission. A total score of 4 or higher meant high tumble risk, and the standardized intervention measures were taken immediately. In 2013, the assessment scale was revised, and binocular vision disorder, low compliance or communication disorders, restlessness were added as risk factors for tumble. The difference among patients with a tumble score of 4 or higher between the year of 2012 and 2013 was compared and analyzed. ResultsIn 2012, 52 patients had a tumble score of 4 or higher, among whom there were 16 males and 36 females; 35 were younger than 65 years old and 17 were older than 65 years. There were 25 patients with organic mental disorders, 10 with spirit obstacle caused by active substance, 12 with schizophrenia, and 5 other cases. In 2013, 154 patients' tumble score was 4 or higher, among whom there were 58 males and 96 females; 142 were younger than 65 years old and 12 were older than 65. Organic mental disorders occurred in 22 patients, 8 had spirit obstacle caused by active substance, 120 had schizophrenia, and there were 4 other cases. In 2013, the number of patients with a tumble score of 4 or higher were significantly more than that in 2012 and young patients with schizophrenia were also significantly more than in 2012 (P<0.05). There were two cases of tumble adverse events, while no adverse events occurred in tumble in 2013. ConclusionCognitive impairment, low compliance, communication barriers and restlessness are high risk factors for tumble in patients with mental disorders. Correct evaluation and early intervention can effectively prevent the occurrence of tumble.
ObjectiveTo analyze the incidence and mortality trends of falls among elderly in China from 1990 to 2019, and to evaluate the impact of age, period, and cohort on their long-term trends. MethodsThe joinpoint regression model and age-period-cohort model were used to analysis. The annual percent change (APC) and the average annual percent change (AAPC) were used to analyze the incidence and mortality of falls among elderly in China from 1990 to 2019. The influence of age, period and cohort on the incidence and mortality of falls were analyzed. ResultsThe standardized incidence and mortality rates of falls among the elderly in China showed fluctuating upward trends from 1990 to 2019 (AAPC=1.929%, 1.535%, P<0.001), The increase rate of falls incidence was higher in men than that in women (AAPC=1.928%, 1.923%, P<0.001), and the increase rate of falls mortality was lower in men than that in women (AAPC=1.407%, 1.562%, P<0.001). The results of the age-period-cohort model showed that the age effect and period effect coefficients of incidence and mortality of falls in Chinese elderly men and women showed an overall fluctuating upward trend, while the cohort effect coefficients showed an overall downward trend. ConclusionFrom 1990 to 2019, the age standardized incidence and mortality rate of falls among the elderly in China show fluctuating upward trends. The incidence of falls in elderly women is higher than that in men, and the mortality rate of falls in elderly men is higher than that in women. It is recommended to strengthen the prevention work for falls in the oldest old, the incidence of falls in elderly women, and the mortality of falls in elderly men.
ObjectivesTo systematically evaluate the impact of Tai Chi on the fall and balance function of middle-aged and the elderly.MethodsPubMed, EMbase, Web of Science, The Cochrane Library, CNKI and WanFang Data databases were electronically searched to collect randomized controlled trials (RCTs) on the influence of Tai Chi on the balance function and fall of middle-aged and the elderly from inception to August, 2019. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was then performed by RevMan 5.3 software.ResultsA total of 20 RCTs involving 3 842 patients were included. The results of meta-analysis showed that the Tai Chi group was superior to the control group in the improvement of the fall rate (RR=0.82, 95%CI 0.75 to 0.90, P<0.000 01), single-leg standing test (MD=5.76, 95%CI 0.62 to 10.90, P=0.03), Berg balance scale (MD=1.04, 95%CI 0.23 to 1.85, P=0.01), timed up and go (MD=−0.71, 95%CI −0.88 to −0.54, P<0.000 01), chair stand test (MD=0.87, 95%CI 0.05 to 1.70, P=0.04) and other indicators, and the difference was statistically significant.ConclusionsThe current evidence shows that Tai Chi can improve the balance function of middle-aged and the elderly, reduce the fall rate, and have a certain preventive effect on falls. Due to limited quality and quantity of the included studies, more high quality studies are required to verify the above conclusion.