scholarly journals The Relationship between Tissue Hardness and the Fall Risk of the Community-dwelling Elderly after Lower Limb Surgery

2016 ◽  
Vol 31 (3) ◽  
pp. 419-422
Author(s):  
Makoto GOTO ◽  
Kenji YAMAMOTO ◽  
Wataru SAKURAGI ◽  
Hideki KOEDA ◽  
Susumu NARUSE ◽  
...  
Keyword(s):  
Lower Limb ◽  
Fall Risk ◽  
Community Dwelling ◽  
Tissue Hardness ◽  
Lower Limb Surgery ◽  
The Relationship

scholarly journals Lower-Limb Factors Associated with Balance and Falls in Older Adults: A Systematic Review and Clinical Synthesis

2019 ◽  
Vol 110 (5) ◽  
Author(s):  
Christopher Neville ◽  
Hung Nguyen ◽  
Kim Ross ◽  
Mariana Wingood ◽  
Elizabeth Walker Peterson ◽  
...  
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Lower Limb ◽  
Fall Risk ◽  
Community Dwelling ◽  
Sufficient Evidence ◽  
Cochrane Library ◽  
Direct Link ◽  
Age Related ◽  
Falls In Older Adults

Background Despite sufficient evidence to suggest that lower-limb–related factors may contribute to fall risk in older adults, lower-limb and footwear influences on fall risk have not been systematically summarized for readers and clinicians. The purpose of this study was to systematically review and synethesize the literature related to lower-limb, foot, and footwear factors that may increase the risk of falling among community-dwelling older adults. Methods We searched PubMed, Embase, PsycINFO, CINAHL, Web of Science, Cochrane Library, and AgeLine. To describe the trajectory toward increasing risk of falls, we examined those articles that linked age-related changes in the lower limb or footwear to prospective falls or linked them to evidenced-based fall risk factors, such as gait and balance impairment. Results This systematic review consisted of 81 articles that met the review criteria, and the results reflect a narrative review of the appraised literature for eight pathways of lower-limb–related influences on fall risk in older adults. Six of the eight pathways support a direct link to fall risk. Two other pathways link to the intermediate factors but lack studies that provide evidence of a direct link. Conclusions This review provides strong guidance to advance understanding and assist with managing the link between lower-limb factors and falls in older adults. Due to the lack of literature in specific areas, some recommendations were based on observational studies and should be applied with caution until further research can be completed.

scholarly journals Reduced strength, poor balance and concern about falls mediate the relationship between knee pain and fall risk in older people

2019 ◽  
Author(s):  
Cameron J Hicks ◽  
Pazit Levinger ◽  
Jasmine C Menant ◽  
Stephen R Lord ◽  
Perminder S Sachdev ◽  
...  
Keyword(s):  
Older People ◽  
Knee Pain ◽  
Fall Risk ◽  
Postural Sway ◽  
Knee Extension ◽  
Community Dwelling ◽  
Pain Group ◽  
Eyes Closed ◽  
The Relationship

Abstract Aims Pain is an independent risk factor for falling. One in two older community-dwelling people with musculoskeletal pain fall each year. This study examined physical, psychological and medical factors as potential mediators to explain the relationship between knee pain and falls.Methods Three hundred and thirty-three community-dwelling people aged 70+ years (52% women) participated in this cohort study with a 1-year follow-up for falls. Participants completed questionnaires (medical history, general health and concern about falls) and underwent physical performance tests. Participants were classified into ‘pain’ and ‘no pain’ groups based on self-reported knee pain. Poisson Regression models were computed to determine the Relative Risk (RR) of having multiple falls and potential mediators for increased fall risk.Results One hundred and eighteen (35.5%) participants were categorised as having knee pain. This group took more medications and had more medical conditions (P <0.01) compared to the no pain group. The pain group had poorer balance, physical function and strength and reported increased concern about falls. Sixty one participants (19.5%) reported ≥ 2 falls, with the pain group twice as likely to experience multiple falls over the 12 month follow up (RR = 2.0, 95% confidence interval (CI) = 1.27 – 3.13). Concern about falls, knee extension torque and postural sway with eyes closed were identified as significant and independent mediators of fall risk, and when combined explained 23% of the relationship between knee pain and falls.Conclusion This study has identified several medical, medication, psychological, sensorimotor, balance and mobility factors to be associated with knee pain, and found the presence of knee pain doubles the risk of multiple falls in older community living people. Alleviating knee pain, as well as addressing associated risk factors may assist in preventing falls in older people with knee pain.

scholarly journals Reduced strength, poor balance and concern about falls mediate the relationship between knee pain and fall risk in older people

2019 ◽  
Author(s):  
Cameron J Hicks ◽  
Pazit Levinger ◽  
Jasmine C Menant ◽  
Stephen R Lord ◽  
Perminder S Sachdev ◽  
...  
Keyword(s):  
Older People ◽  
Knee Pain ◽  
Fall Risk ◽  
Postural Sway ◽  
Knee Extension ◽  
Community Dwelling ◽  
Pain Group ◽  
Eyes Closed ◽  
The Relationship

Abstract Aims Pain is an independent risk factor for falling. One in two older community-dwelling people with musculoskeletal pain fall each year. This study examined physical, psychological and medical factors as potential mediators to explain the relationship between knee pain and falls. Methods Three hundred and thirty-three community-dwelling people aged 70+ years (52% women) participated in this cohort study with a 1-year follow-up for falls. Participants completed questionnaires (medical history, general health and concern about falls) and underwent physical performance tests. Participants were classified into ‘pain’ and ‘no pain’ groups based on self-reported knee pain. Poisson Regression models were computed to determine the Relative Risk (RR) of having multiple falls and potential mediators for increased fall risk. Results One hundred and eighteen (35.5%) participants were categorised as having knee pain. This group took more medications and had more medical conditions (P <0.01) compared to the no pain group. The pain group had poorer balance, physical function and strength and reported increased concern about falls. Sixty one participants (19.5%) reported ≥ 2 falls, with the pain group twice as likely to experience multiple falls over the 12 month follow up (RR = 2.0, 95% confidence interval (CI) = 1.27 – 3.13). Concern about falls, knee extension torque and postural sway with eyes closed were identified as significant and independent mediators of fall risk, and when combined explained 23% of the relationship between knee pain and falls. Conclusion This study has identified several medical, medication, psychological, sensorimotor, balance and mobility factors to be associated with knee pain, and found the presence of knee pain doubles the risk of multiple falls in older community living people. Alleviating knee pain, as well as addressing associated risk factors may assist in preventing falls in older people with knee pain.

scholarly journals Reduced strength, poor balance and concern about falls mediate the relationship between knee pain and fall risk in older people

2020 ◽  
Author(s):  
Cameron J Hicks ◽  
Pazit Levinger ◽  
Jasmine C Menant ◽  
Stephen R Lord ◽  
Perminder S Sachdev ◽  
...  
Keyword(s):  
Older People ◽  
Knee Pain ◽  
Fall Risk ◽  
Postural Sway ◽  
Knee Extension ◽  
Community Dwelling ◽  
Pain Group ◽  
Eyes Closed ◽  
The Relationship

Abstract Aims Pain is an independent risk factor for falling. One in two older community-dwelling people with musculoskeletal pain fall each year. This study examined physical, psychological and medical factors as potential mediators to explain the relationship between knee pain and falls. Methods Three hundred and thirty-three community-dwelling people aged 70+ years (52% women) participated in this cohort study with a 1-year follow-up for falls. Participants completed questionnaires (medical history, general health and concern about falls) and underwent physical performance tests. Participants were classified into ‘pain’ and ‘no pain’ groups based on self-reported knee pain. Poisson Regression models were computed to determine the Relative Risk (RR) of having multiple falls and potential mediators for increased fall risk. Results One hundred and eighteen (35.5%) participants were categorised as having knee pain. This group took more medications and had more medical conditions (P <0.01) compared to the no pain group. The pain group had poorer balance, physical function and strength and reported increased concern about falls. Sixty one participants (19.5%) reported ≥ 2 falls, with the pain group twice as likely to experience multiple falls over the 12 month follow up (RR = 2.0, 95% confidence interval (CI) = 1.27 – 3.13). Concern about falls, knee extension torque and postural sway with eyes closed were identified as significant and independent mediators of fall risk, and when combined explained 23% of the relationship between knee pain and falls. Conclusion This study has identified several medical, medication, psychological, sensorimotor, balance and mobility factors to be associated with knee pain, and found the presence of knee pain doubles the risk of multiple falls in older community living people. Alleviating knee pain, as well as addressing associated risk factors may assist in preventing falls in older people with knee pain.

Ventilatory threshold is related to walking tolerance in patients with intermittent claudication

VASA ◽  
2012 ◽  
Vol 41 (4) ◽  
pp. 275-281 ◽  
Author(s):  
da Rocha Chehuen ◽  
G. Cucato ◽  
P. dos Anjos Souza Barbosa ◽  
A. R. Costa ◽  
M. Ritti-Dias ◽  
...  
Keyword(s):  
Blood Flow ◽  
Oxygen Uptake ◽  
Intermittent Claudication ◽  
Lower Limb ◽  
Ventilatory Threshold ◽  
Reactive Hyperemia ◽  
Ankle Brachial Index ◽  
Metabolic Parameters ◽  
Walking Distance ◽  
The Relationship

Background: This study assessed the relationship between lower limb hemodynamics and metabolic parameters with walking tolerance in patients with intermittent claudication (IC). Patients and methods: Resting ankle-brachial index (ABI), baseline blood flow (BF), BF response to reactive hyperemia (BFRH), oxygen uptake (VO2), initial claudication distance (ICD) and total walking distance (TWD) were measured in 28 IC patients. Pearson and Spearman correlations were calculated. Results: ABI, baseline BF and BF response to RH did not correlate with ICD or TWD. VO2 at first ventilatory threshold and VO2peak were significantly and positively correlated with ICD (r = 0.41 and 0.54, respectively) and TWD (r = 0.65 and 0.71, respectively). Conclusions: VO2peak and VO2 at first ventilatory threshold, but not ABI, baseline BF and BFHR were associated with walking tolerance in IC patients. These results suggest that VO2 at first ventilatory threshold may be useful to evaluate walking tolerance and improvements in IC patients.

scholarly journals Cost-Effectiveness of an Exercise Programme that Provided Group or Individual Training to Reduce the Fall Risk in Healthy Community-Dwelling People Aged 65–80: A Secondary Data Analysis

Healthcare ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 714
Author(s):  
Isaac Aranda-Reneo ◽  
Laura Albornos-Muñoz ◽  
Manuel Rich-Ruiz ◽  
María Ángeles Cidoncha-Moreno ◽  
Ángeles Pastor-López ◽  
...  
Keyword(s):  
Economic Evaluation ◽  
Cost Effectiveness ◽  
Older People ◽  
Incremental Cost ◽  
Fall Risk ◽  
Community Dwelling ◽  
Effective Measure ◽  
The Individual ◽  
The Cost ◽  
Individual Training

Research has demonstrated that some exercise programs are effective for reducing fall rates in community-dwelling older people; however, the literature is limited in providing clear recommendations of individual or group training as a result of economic evaluation. The objective of this study was to assess the cost-effectiveness of the Otago Exercise Program (OEP) for reducing the fall risk in healthy, non-institutionalized older people. An economic evaluation of a multicenter, blinded, randomized, non-inferiority clinical trial was performed on 498 patients aged over 65 in primary care. Participants were randomly allocated to the treatment or control arms, and group or individual training. The program was delivered in primary healthcare settings and comprised five initial sessions, ongoing encouragement and support to exercise at home, and a reinforcement session after six months. Our hypothesis was that the patients who received the intervention would achieve better health outcomes and therefore need lower healthcare resources during the follow-up, thus, lower healthcare costs. The primary outcome was the incremental cost-effectiveness ratio, which used the timed up and go test results as an effective measure for preventing falls. The secondary outcomes included differently validated tools that assessed the fall risk. The cost per patient was USD 51.28 lower for the group than the individual sessions in the control group, and the fall risk was 10% lower when exercises had a group delivery. The OEP program delivered in a group manner was superior to the individual method. We observed slight differences in the incremental cost estimations when using different tools to assess the risk of fall, but all of them indicated the dominance of the intervention group. The OEP group sessions were more cost-effective than the individual sessions, and the fall risk was 10% lower.

scholarly journals Bidirectional Relationship Between Subjective Age and Frailty: Findings From the NHATS

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 271-271
Author(s):  
Yuxiao Li ◽  
Minhui Liu ◽  
Christina Miyawaki ◽  
Xiaocao Sun ◽  
Tianxue Hou ◽  
...  
Keyword(s):  
Older Adults ◽  
Clinical Syndrome ◽  
Community Dwelling ◽  
Chronological Age ◽  
Subjective Age ◽  
Bidirectional Relationship ◽  
Study Participants ◽  
Community Dwelling Older Adults ◽  
The Relationship ◽  
Hispanic White

Abstract Frailty is a clinical syndrome that becomes increasingly common as people age. Subjective age refers to how young or old individuals experience themselves to be. It is associated with many risk factors of frailty, such as increased depression, worse cognitive function, and poorer psychological wellbeing. In this study, we examined the relationship between subjective age and frailty using the 2011-2015 waves of the National Health and Aging Trends Study. Participants were community-dwelling older adults without frailty in the initial wave (N=1,165). Subjective age was measured by asking participants, “What age do you feel most of the time?” Based on the Fried five phenotypic criteria: exhaustion, unintentional weight loss, low physical activity, slow gait, and weak grip strength, frailty was categorized into robust=0, pre-frail=1 or 2; frail=3 or more criteria met. Participants were, on average, 74.1±6.5 years old, female (52%), and non-Hispanic White (81%). Eighty-five percent of the participants felt younger, and 3% felt older than their chronological age, but 41% of them were pre-frail/frail. Generalized estimating equations revealed that an “older” subjective age predicted a higher likelihood of pre-frailty and frailty (OR, 95%CI= 1.01, 1.01-1.02). In contrast, frailty predicted an “older” subjective age (OR, 95%CI= 2.97, 1.65-5.35) adjusting for demographics and health conditions. These findings suggest a bidirectional relationship between subjective age and frailty. Older people who feel younger than their chronological age are at reduced risk of becoming pre-frail/frail. Intervention programs to delay frailty progression should include strategies that may help older adults perceive a younger subjective age.

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