Accidental Falls

Publication Title: 
Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality

This article describes a knowledge transfer process that was developed by Catholic Health East (CHE), headquartered in Newtown Square, PA, and that focuses upon one indicator of care, physical restraint use, in the skilled nursing/long-term care setting. The values-based process focuses on preserving residents' rights and using comparative data sharing as the basis for identifying opportunities for improvement. Further, it builds upon a collaborative cyclical model employed by all the CHE System's freestanding and hospital-based long-term care facilities.

Author(s): 
Carroll-Solomon, P. A.
Christian, V.
Denny, D. S.
Nordan, V. N.
Therriault, M. F.
Van Wicklen, R.
Publication Title: 
The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences

BACKGROUND: Exercise that challenges balance can improve mobility and prevent falls in older adults. Yoga as a physical activity option for older adults is not well studied. This trial evaluated the feasibility and effect of a 12-week Iyengar yoga program on balance and mobility in older people. METHODS: We conducted a blinded, pilot randomized controlled trial with intention-to-treat analysis. Participants were 54 community dwellers (mean age 68 years, SD 7.1) not currently participating in yoga or tai chi.

Author(s): 
Tiedemann, Anne
O'Rourke, Sandra
Sesto, Romina
Sherrington, Catherine
Publication Title: 
Archives of Physical Medicine and Rehabilitation

OBJECTIVE: To compare the effect of a custom-designed yoga program with 2 other balance training programs. DESIGN: Randomized controlled trial. SETTING: Research laboratory. PARTICIPANTS: A group of older adults (N=39; mean age, 74.15 ± 6.99 y) with a history of falling. INTERVENTIONS: Three different exercise interventions (Tai Chi, standard balance training, yoga) were given for 12 weeks.

Author(s): 
Ni, Meng
Mooney, Kiersten
Richards, Luca
Balachandran, Anoop
Sun, Mingwei
Harriell, Kysha
Potiaumpai, Melanie
Signorile, Joseph F.
Publication Title: 
Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality

Patient falls have been a concern in North American healthcare for many years. Studies have examined environmental, clinical, and patient variables for purposes of risk identification and fall reduction, primarily in the context of Western societies.

Author(s): 
Hilliard, D. J.
Frederick, L.
Tierney-Gumaer, R.
Simpson, M. J.
Publication Title: 
The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences

BACKGROUND: This study asked whether older adults were more likely than younger adults to err in the initial direction of their anticipatory postural adjustment (APA) prior to a step (indicating a motor program error), whether initial motor program errors accounted for reaction time differences for step initiation, and whether initial motor program errors were linked to inhibitory failure.

Author(s): 
Cohen, Rajal G.
Nutt, John G.
Horak, Fay B.
Publication Title: 
BMC complementary and alternative medicine

BACKGROUND: Tai Chi (TC) is a mind-body exercise that shows potential as an effective and safe intervention for preventing fall-related fractures in the elderly. Few randomized trials have simultaneously evaluated TC's potential to reduce bone loss and improve fall-predictive balance parameters in osteopenic women. METHODS: In a pragmatic randomized trial, 86 post-menopausal osteopenic women, aged 45-70, were recruited from community clinics. Women were assigned to either nine months of TC training plus usual care (UC) vs. UC alone.

Author(s): 
Wayne, Peter M.
Kiel, Douglas P.
Buring, Julie E.
Connors, Ellen M.
Bonato, Paolo
Yeh, Gloria Y.
Cohen, Calvin J.
Mancinelli, Chiara
Davis, Roger B.
Publication Title: 
The Journal of Nutrition, Health & Aging

OBJECTIVES: To elucidate the mechanism through which vitamin D is associated with decreased falls. DESIGN: This was a convenience sample from a larger observational study examining correlations between vitamin D and 1) falls, 2) motor function, and 3) cognition (n=159). SETTING: Falls data were collected via weekly on-line surveys completed in the participants' homes. Yearly evaluations of motor and cognitive function were conducted in an out-patient setting of a large tertiary medical center.

Author(s): 
Peterson, A.
Mattek, N.
Clemons, A.
Bowman, G. L.
Buracchio, T.
Kaye, J.
Quinn, J.
Publication Title: 
Parkinsonism & Related Disorders

Gait dysfunction and postural instability are two debilitating symptoms in persons with Parkinson's disease (PD). Tai Chi exercise has recently gained attention as an attractive intervention for persons with PD because of its known potential to reduce falls and improve postural control, walking abilities, and safety at a low cost.

Author(s): 
Amano, Shinichi
Nocera, Joe R.
Vallabhajosula, Srikant
Juncos, Jorge L.
Gregor, Robert J.
Waddell, Dwight E.
Wolf, Steven L.
Hass, Chris J.
Publication Title: 
Minerva Medica

Syncope is a frequent symptom in older patients. The diagnostic and therapeutic management may be complex, particularly in older adults with syncope and comorbidities or cognitive impairment. Morbidity related to syncope is more common in older persons and ranges from loss of confidence, depressive illness and fear of falling, to fractures and consequent institutionalization. Moreover, advan-ced age is associated with short and long-term morbidity and mortality after syncope.

Author(s): 
Ungar, A.
Morrione, A.
Rafanelli, M.
Ruffolo, E.
Brunetti, M. A.
Chisciotti, V. M.
Masotti, G.
Del Rosso, A.
Marchionni, N.
Publication Title: 
Journal of Manipulative and Physiological Therapeutics

OBJECTIVE: To discuss the evaluation and treatment used in the resolution of a case of double crush syndrome. CLINICAL FEATURES: A 63-yr-old male suffered from a 36-month history of right anterior leg numbness and recurrent lower back pain. Onset of initial complaint followed a slip and fall on ice. A clinical diagnosis of double crush syndrome was made after appropriate testing was performed. INTERVENTION AND OUTCOME: The patient was put on a 6-wk treatment plan at a two visit per week frequency. Treatment consisted of spinal manipulation and H-wave current electrotherapy.

Author(s): 
Flatt, D. W.

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