Trail‐Walking Exercise and Fall Risk Factors in Community‐Dwelling Older Adults: Preliminary Results of a Randomized Controlled Trial

OBJECTIVES: To evaluate the effects of a trail‐walking exercise (TWE) program on the rate of falls in community‐dwelling older adults. DESIGN: Pilot randomized controlled trial (RCT). SETTING: This trial was conducted in Japan and involved community‐dwelling older adults as participants. PARTICIPANTS: Sixty participants randomized into a TWE group (n=30) and a walking (W) group (n=30). INTERVENTION: Exercise class combined with multicomponent trail walking program, versus exercise class combined with simple indoor walking program. MEASUREMENT: Measurement was based on the difference in fall rates between the TWE and W groups. RESULTS: Six months after the intervention, the incidence rate ratio (IRR) of falls for the TWE group compared with the W group was 0.20 (95% confidence interval (CI)=0.04–0.91); 12 months after the intervention, the IRR of falls for the TWE group compared with the W group was 0.45 (95% CI=0.16–1.77). CONCLUSION: The results of this pilot RCT suggest that the TWE program was more effective in improving locomotion and cognitive performance under trail‐walking task conditions than walking. In addition, participants who took part in the TWE demonstrated a decrease in the incidence rate of falls 6 months after trial completion. Further confirmation is needed, but this preliminary result may promote a new understanding of accidental falls in older adults.     

Sitting Time,Physical Activity,and Risk of Mortality in Adults

Background

It is unclear what level of moderate to vigorous intensity physical activity (MVPA) offsets the health risks of sitting.

Development, implementation, and evaluation of an Interprofessional Falls Prevention Program for older adults

This article describes the development and implementation of an Interprofessional Falls Prevention Program (IFPP) designed for community-dwelling seniors. The program was a collaborative pilot research study conducted in a retirement home and an outpatient hospital setting. The pilot was successful and was positioned into a permanent falls prevention program. The IFPP aimed at improving physical function and balance and reducing the fear of falling in seniors with a history of falls. The pilot study included an interprofessional falls assessment followed by a 12-week program of once-weekly group education and exercise sessions, 3- and 6-month follow-up visits, and individual counseling. To measure program effectiveness, the Berg Balance Scale, the Timed Up and Go Test, the Falls Efficacy Scale, and the Morse Fall Risk Scale were used at baseline, upon program completion, and at 3- and 6-month follow-up. Process measures were also collected, including patient satisfaction. Persistent improvements were found in participants' balance, strength, functional mobility, and fear of falling. Patient satisfaction with the program was high. Challenges faced in program implementation are also highlighted.     

Falling and fall risk factors in adults with haemophilia: an exploratory study

Falls are a particular risk in persons with haemophilia (PWH) because of damaged joints, high risk of bleeding, possible impact on the musculoskeletal system and functioning and costs associated with treatment for these fall‐related injuries. In addition, fall risk increases with age and PWH are increasingly entering the over 65 age group. The aim of this study was to determine the occurrence of falls during the past year and to explore which fall risk factors are present in community‐dwelling PWH. Dutch speaking community‐dwelling adults were included from the age of 40 years with severe or moderate haemophilia A or B, independent in their mobility and registered at the University Hospitals Leuven. They were asked to come to the haemophilia centre; otherwise a telephone survey was conducted. Demographic and social variables, medical variables, fall evaluation and clinical variables were queried. From the 89 PWH, 74 (83.1%) participated in the study. Twenty‐four (32.4%) fell in the past year, and 10 of them (41.7%) more than once with an average of four falls. Living conditions, physical activity, avoidance of winter sports due to fear of falling, orthopaedic status, urinary incontinence and mobility impairments are potential fall risk factors in adult PWH. This exploratory study indicates that PWH are attentive to falling since they are at higher risk for falls and because of the serious consequences it might have. Screening and fall prevention should be stimulated in the daily practice of haemophilia care.     

Perceived Competence and Physical Activity in Older Adults

The association between older adults’ self-perceived physical competence and continued involvement in physical activity (PA) was examined. Seventy-two older adults (60–79 years) completed the Physical Self Perception Profile (PSPP; Fox and Corbin, 1989) and International Physical Activity Questionnaire to assess the relationship between physical self-perception and various dose responses in PA participation (vigorous, moderate, walking, inactive/sitting levels). Results indicated a positive correlation between all subscales of the PSPP and both moderate exercise and vigorous exercise. In addition, Sport, Body, and Strength were positively correlated with walking. Age (60–69 vs. 70–79 years) and gender, however, were found to modify those relationships. Mann Whitney University tests revealed that participants in the younger grouping were significantly more likely to spend a greater amount of time walking than those in the older adult grouping. Moreover, males were significantly more likely to participate in vigorous exercise and reported a higher perception of sports competence than their female counterparts. The results of this study suggest that perceived competence be assessed during pre-exercise screening in order to customize exercise programs that will increase the likelihood of continued PA engagement.     

Physical Activity and Reported Barriers to Activity Among Type 2 Diabetic Patients in the United Arab Emirates

OBJECTIVES: This study was designed to assess the physical activity practice among type 2 diabetic patients in the United Arab Emirates (UAE). METHODS: This is a cross-sectional study of type 2 diabetic patients who participated in the outpatient clinics in Al-Ain District, during 2006. The patients completed an interviewer-administered questionnaire, and measurements of blood pressure, body mass index, body fat, abdominal circumference, glycemic control (HbA1c), and fasting lipid profile. RESULTS: Of the 390 patients recruited, only 25% reported an increase in their physical activity levels following the diagnosis of diabetes, and only 3% reported physical activity levels that meet the recommended guidelines. More than half of the study subjects had uncontrolled hypertension (53%) and unacceptable lipid profiles; 71% had a high low-density lipoprotein (LDL), 73% had low high-density lipoprotein (HDL), and 59% had hypertriglyceridemia. Forty-four percent were obese and a further 34% were overweight. Abdominal obesity was also common (59%). Only 32% had an acceptable glycemic control. CONCLUSIONS: The physical activity practice of type 2 diabetic patients in the UAE is largely inadequate to meet the recommended level necessary to prevent or ameliorate diabetic complications. Interventions aiming at overcoming the barriers to physical activity are urgently needed.