Article

OBJECTIVE: To evaluate effects of a multifactorial fall prevention program on
fall incidence and physical function in community-dwelling older adults. DESIGN:
Multicenter randomized controlled trial. SETTING: Three medical centers and
adjacent community health centers. PARTICIPANTS: Community-dwelling older adults
(N=616) who have fallen in the previous year or are at risk of falling.
INTERVENTIONS: After baseline assessment, eligible subjects were randomly
allocated into the intervention group (IG) or the control group (CG), stratified
by the Physiological Profile Assessment (PPA) fall risk level. The IG received a
3-month multifactorial intervention program including 8 weeks of exercise
training, health education, home hazards evaluation/modification, along with
medication review and ophthalmology/other specialty consults. The CG received
health education brochures, referrals, and recommendations without direct
exercise intervention. MAIN OUTCOME MEASURES: Primary outcome was fall incidence
within 1 year. Secondary outcomes were PPA battery (overall fall risk index,
vision, muscular strength, reaction time, balance, and proprioception), Timed Up
& Go (TUG) test, Taiwan version of the International Physical Activity
Questionnaire, EuroQol-5D, Geriatric Depression Scale (GDS), and the Falls
Efficacy Scale-International at 3 months after randomization. RESULTS:
Participants were 76+/-7 years old and included low risk 25.6%, moderate risk
25.6%, and marked risk 48.7%. The cumulative 1-year fall incidence was 25.2% in
the IG and 27.6% in the CG (hazard ratio=.90; 95% confidence interval, .66-1.23).
The IG improved more favorably than the CG on overall PPA fall risk index,
reaction time, postural sway with eyes open, TUG test, and GDS, especially for
those with marked fall risk. CONCLUSIONS: The multifactorial fall prevention
program with exercise intervention improved functional performance at 3 months
for community-dwelling older adults with risk of falls, but did not reduce falls
at 1-year follow-up. Fall incidence might have been decreased simultaneously in
both groups by heightened awareness engendered during assessments, education,
referrals, and recommendations.
CI - Copyright (c) 2013 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS