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Combined resistance and balance-jumping exercise reduces older women's injurious falls and fractures: 5-year follow-up study.

https://arctichealth.org/en/permalink/ahliterature273603
Source
Age Ageing. 2015 Sep;44(5):784-9
Publication Type
Article
Date
Sep-2015
Author
Saija Karinkanta
Pekka Kannus
Kirsti Uusi-Rasi
Ari Heinonen
Harri Sievänen
Source
Age Ageing. 2015 Sep;44(5):784-9
Date
Sep-2015
Language
English
Publication Type
Article
Keywords
Accidental Falls - prevention & control
Age Factors
Aged
Aging
Female
Finland - epidemiology
Follow-Up Studies
Fractures, Bone - diagnosis - epidemiology - physiopathology - prevention & control
Geriatric Assessment
Humans
Incidence
Independent living
Kaplan-Meier Estimate
Muscle strength
Odds Ratio
Postural Balance
Proportional Hazards Models
Prospective Studies
Registries
Resistance Training
Risk factors
Time Factors
Treatment Outcome
Women's health
Abstract
previously, a randomised controlled exercise intervention study (RCT) showed that combined resistance and balance-jumping training (COMB) improved physical functioning and bone strength. The purpose of this follow-up study was to assess whether this exercise intervention had long-lasting effects in reducing injurious falls and fractures.
five-year health-care register-based follow-up study after a 1-year, four-arm RCT.
community-dwelling older women in Finland.
one hundred and forty-five of the original 149 RCT participants; women aged 70-78 years at the beginning.
participants' health-care visits were collected from computerised patient register. An injurious fall was defined as an event in which the subject contacted the health-care professionals or was taken to a hospital, due to a fall. The rate of injured fallers was assessed by Cox proportional hazards model (hazard ratio, HR), and the rate of injurious falls and fractures by Poisson regression (risk ratio, RR).
eighty-one injurious falls including 26 fractures occurred during the follow-up. The rate of injured fallers was 62% lower in COMB group compared with the controls (HR 0.38, 95% CI 0.17 to 0.85). In addition, COMB group had 51% less injurious falls (RR 0.49, 95% CI 0.25 to 0.98) and 74% less fractures (RR 0.26, 95% CI 0.07 to 0.97).
home-dwelling older women who participated in a 12-month intensive multi-component exercise training showed a reduced incidence for injurious falls during 5-year post-intervention period. Reduction in fractures was also evident. These long-term effects need to be confirmed in future studies.
PubMed ID
25990940 View in PubMed
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Concern about falling in older women with a history of falls: associations with health, functional ability, physical activity and quality of life.

https://arctichealth.org/en/permalink/ahliterature106791
Source
Gerontology. 2014;60(1):22-30
Publication Type
Article
Date
2014
Author
Radhika Patil
Kirsti Uusi-Rasi
Pekka Kannus
Saija Karinkanta
Harri Sievänen
Author Affiliation
The UKK Institute for Health Promotion Research, Tampere University Hospital, Tampere, Finland.
Source
Gerontology. 2014;60(1):22-30
Date
2014
Language
English
Publication Type
Article
Keywords
Accidental Falls - prevention & control
Activities of Daily Living - psychology
Aged
Aged, 80 and over
Aging - physiology - psychology
Fear - psychology
Female
Finland
Health status
Humans
Independent Living - psychology
Logistic Models
Motor Activity
Quality of Life
Questionnaires
Risk factors
Abstract
Fear of falling has been linked to activity restriction, functional decline, decreased quality of life and increased risk of falling. Factors that distinguish persons with a high concern about falling from those with low concern have not been systematically studied.
This study aimed to expose potential health-related, functional and psychosocial factors that correlate with fear of falling among independently living older women who had fallen in the past year.
Baseline data of 409 women aged 70-80 years recruited to a randomised falls prevention trial (DEX) (NCT00986466) were used. Participants were classified according to their level of concern about falling using the Falls Efficacy Scale International (FES-I). Multinomial logistic regression analyses were performed to explore associations between health-related variables, functional performance tests, amount of physical activity, quality of life and FES-I scores.
68% of the participants reported a moderate to high concern (FES-I = 20) about falls. Multinomial logistic regression showed that highly concerned women were significantly more likely to have poorer health and quality of life and lower functional ability. Reported difficulties in instrumental activities of daily living, balance, outdoor mobility and poorer quality of life contributed independently to a greater concern about falling.
Concern about falling was highly prevalent in our sample of community-living older women. In particular, poor perceived general health and mobility constraints contributed independently to the difference between high and low concern of falling. Knowledge of these associations may help in developing interventions to reduce fear of falling and activity avoidance in old age.
PubMed ID
24107382 View in PubMed
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Effects of a Multimodal Exercise Program on Physical Function, Falls, and Injuries in Older Women: A 2-Year Community-Based, Randomized Controlled Trial.

https://arctichealth.org/en/permalink/ahliterature266859
Source
J Am Geriatr Soc. 2015 Jul;63(7):1306-13
Publication Type
Article
Date
Jul-2015
Author
Radhika Patil
Kirsti Uusi-Rasi
Kari Tokola
Saija Karinkanta
Pekka Kannus
Harri Sievänen
Source
J Am Geriatr Soc. 2015 Jul;63(7):1306-13
Date
Jul-2015
Language
English
Publication Type
Article
Keywords
Accidental Falls - prevention & control
Activities of Daily Living
Aged
Aged, 80 and over
Body Composition
Disability Evaluation
Exercise Therapy - methods
Female
Finland
Geriatric Assessment
Health Status Indicators
Humans
Postural Balance - physiology
Treatment Outcome
Abstract
To investigate the effects of multimodal supervised exercise on physical functioning, falls, and related injuries in older women.
Two-year randomized controlled trial.
Tampere, Finland.
Women aged 70 to 80 who had fallen in the previous year (n = 409).
Participants were randomly assigned to an exercise or control group (ClinicalTrial.gov NCT00986466). Exercisers participated in group exercise classes twice a week for 12 months and once a week for the subsequent 12 months and home exercises. Controls maintained their current physical activity.
Physical functioning assessed at baseline and at 6-month intervals during the intervention. Falls and related injuries monitored with fall diaries.
Intention-to-treat analyses showed that exercise led to significant improvements in physical functioning. Leg strength differed significantly between the groups (mean change: 14.1%, 95% confidence interval (CI) = 8.0 to 20.2 in exercisers; 1.6%, 95% CI = -4.5 to 7.7 in controls; P
PubMed ID
26115073 View in PubMed
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Effects of Vitamin D and Exercise on the Wellbeing of Older Community-Dwelling Women: A Randomized Controlled Trial.

https://arctichealth.org/en/permalink/ahliterature288109
Source
Gerontology. 2016;62(4):401-8
Publication Type
Article
Date
2016
Author
Radhika Patil
Saija Karinkanta
Kari Tokola
Pekka Kannus
Harri Sievänen
Kirsti Uusi-Rasi
Source
Gerontology. 2016;62(4):401-8
Date
2016
Language
English
Publication Type
Article
Keywords
Accidental Falls - prevention & control
Affect
Aged
Aged, 80 and over
Aging - physiology - psychology
Double-Blind Method
Exercise
Fear - psychology
Female
Finland
Humans
Quality of Life - psychology
Vitamin D - administration & dosage
Abstract
Evidence for the effects of exercise and vitamin D supplementation on quality of life (QoL), fear of falling (FoF) and mental wellbeing in older adults is conflicting.
To study the effects of vitamin D supplementation and multimodal group exercise on psychosocial functions of wellbeing, including QoL, mental wellbeing and FoF.
This is a 2-year, double-blind, placebo-controlled vitamin D and open exercise intervention trial with 409 older Finnish women (70-80 years of age) randomized to 4 treatment arms: (1) placebo without exercise, (2) vitamin D (800 IU/day) without exercise, (3) placebo and exercise, and (4) vitamin D (800 IU/day) with exercise. Exercisers participated in group exercise twice per week for 12 months and once per week for the subsequent 12 months, plus home exercises.
When comparing with the placebo without exercise group, there were no statistically significant differences between groups receiving either vitamin D, exercise or both treatments for changes in QoL or mental wellbeing (although a slight decline was seen in mental wellbeing in those receiving vitamin D only, p = 0.044). The initial slight reduction in FoF was significant in all intervention groups compared with controls (p
PubMed ID
26682749 View in PubMed
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Improved femoral neck BMD in older Finnish women between 2002 and 2010.

https://arctichealth.org/en/permalink/ahliterature114155
Source
Maturitas. 2013 Jul;75(3):241-5
Publication Type
Article
Date
Jul-2013
Author
Kirsti Uusi-Rasi
Saija Karinkanta
Ari Heinonen
Harri Sievänen
Author Affiliation
UKK Institute for Health Promotion Research, Tampere, Finland. kirsti.uusi-rasi@uta.fi
Source
Maturitas. 2013 Jul;75(3):241-5
Date
Jul-2013
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Aged, 80 and over
Analysis of Variance
Body Height
Bone Density
Cohort Studies
Female
Femur Neck - metabolism
Finland - epidemiology
Hip Fractures - epidemiology - metabolism
Humans
Incidence
Osteoporosis, Postmenopausal - metabolism
Abstract
The number of hip fractures among Finns over 50-years of age rose constantly between 1970 and 1997, but since then, there has been a nationwide decline in incidence of hip fractures. One possible explanation, although not the only one, for the declining fracture rates, could be improved bone mineral density (BMD). The aim of this study was to evaluate differences in femoral neck BMD between older Finnish women born about a decade apart.
We compared the baseline data of two population-based samples of home-dwelling 70-80-year-old women who were initially recruited in exercise intervention studies (N=216 in Cohort1, and N=389 in Cohort 2). Femoral neck BMD was measured with DXA. Between-cohort differences were evaluated with analysis of covariance using age, height, weight, and use of hormone therapy as covariates.
The later-born Cohort 2 was somewhat older and taller than Cohort 1. Adjusted mean difference (95% CI) in femoral neck BMD between the cohorts was 0.043g/cm(2) (0.023-0.064) corresponding the mean difference of 0.36 (0.19-0.53) in T-score in favor of Cohort 2.
Despite several factors that basically could have indicated lower mean BMD in Cohort 2, the finding was the opposite. This suggests that the mean femoral neck BMD has increased substantially among older Finnish women within a decade, but primary reason for this improvement remains unclear, but improved social and economic resources may have at least partly accounted for this favorable phenomenon.
PubMed ID
23642771 View in PubMed
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