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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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Promoting mobility after hip fracture (ProMo): study protocol and selected baseline results of a year-long randomized controlled trial among community-dwelling older people.

https://arctichealth.org/en/permalink/ahliterature129064
Source
BMC Musculoskelet Disord. 2011;12:277
Publication Type
Article
Date
2011
Author
Sarianna Sipilä
Anu Salpakoski
Johanna Edgren
Ari Heinonen
Markku A Kauppinen
Marja Arkela-Kautiainen
Sanna E Sihvonen
Maija Pesola
Taina Rantanen
Mauri Kallinen
Author Affiliation
Gerontology Research Centre, University of Jyväskylä, Jyväskylä, Finland. sarianna.sipila@jyu.fi
Source
BMC Musculoskelet Disord. 2011;12:277
Date
2011
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Aged, 80 and over
Aging
Biomechanical Phenomena
Disability Evaluation
Female
Finland
Hip Fractures - diagnosis - physiopathology - rehabilitation
Hip Joint - physiopathology
Humans
Independent living
Male
Middle Aged
Patient compliance
Physical Therapy Modalities
Program Evaluation
Range of Motion, Articular
Recovery of Function
Research Design
Time Factors
Treatment Outcome
Abstract
To cope at their homes, community-dwelling older people surviving a hip fracture need a sufficient amount of functional ability and mobility. There is a lack of evidence on the best practices supporting recovery after hip fracture. The purpose of this article is to describe the design, intervention and demographic baseline results of a study investigating the effects of a rehabilitation program aiming to restore mobility and functional capacity among community-dwelling participants after hip fracture.
Population-based sample of over 60-year-old community-dwelling men and women operated for hip fracture (n = 81, mean age 79 years, 78% were women) participated in this study and were randomly allocated into control (Standard Care) and ProMo intervention groups on average 10 weeks post fracture and 6 weeks after discharged to home. Standard Care included written home exercise program with 5-7 exercises for lower limbs. Of all participants, 12 got a referral to physiotherapy. After discharged to home, only 50% adhered to Standard Care. None of the participants were followed-up for Standard Care or mobility recovery. ProMo-intervention included Standard Care and a year-long program including evaluation/modification of environmental hazards, guidance for safe walking, pain management, progressive home exercise program and physical activity counseling. Measurements included a comprehensive battery of laboratory tests and self-report on mobility limitation, disability, physical functional capacity and health as well as assessments for the key prerequisites for mobility, disability and functional capacity. All assessments were performed blinded at the research laboratory. No significant differences were observed between intervention and control groups in any of the demographic variables.
Ten weeks post hip fracture only half of the participants were compliant to Standard Care. No follow-up for Standard Care or mobility recovery occurred. There is a need for rehabilitation and follow-up for mobility recovery after hip fracture. However, the effectiveness of the ProMo program can only be assessed at the end of the study.
Current Controlled Trials ISRCTN53680197.
Notes
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PubMed ID
22145912 View in PubMed
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Sense of coherence: effect on adherence and response to resistance training in older people with hip fracture history.

https://arctichealth.org/en/permalink/ahliterature115151
Source
J Aging Phys Act. 2014 Jan;22(1):138-45
Publication Type
Article
Date
Jan-2014
Author
Erja Portegijs
Sanna Read
Inka Pakkala
Mauri Kallinen
Ari Heinonen
Taina Rantanen
Markku Alen
Ilkka Kiviranta
Sanna Sihvonen
Sarianna Sipilä
Author Affiliation
Gerontology Research Center and Dept. of Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
Source
J Aging Phys Act. 2014 Jan;22(1):138-45
Date
Jan-2014
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Aged
Aged, 80 and over
Female
Finland
Hip Fractures - physiopathology - psychology - rehabilitation
Humans
Independent living
Male
Mobility Limitation
Muscle Strength - physiology
Needs Assessment
Outcome Assessment (Health Care)
Patient Compliance - psychology - statistics & numerical data
Resistance Training - methods - statistics & numerical data
Sense of Coherence
Social Support
Walking - physiology
Abstract
Our aim was to study the effects of sense of coherence (SOC) on training adherence and interindividual changes in muscle strength, mobility, and balance after resistance training in older people with hip fracture history. These are secondary analyses of a 12-week randomized controlled trial of progressive resistance training in 60- to 85-year-old community-dwelling people 0.5-7 years after hip fracture (n = 45; ISRCTN34271567). Pre- and posttrial assessments included SOC, knee extension strength, walking speed, timed up-and-go (TUG), and Berg Balance Scale (BBS). Group-by-SOC interaction effects (repeated-measures ANOVA) were statistically significant for TUG (p = .005) and BBS (p = .040), but not for knee extension strength or walking speed. Weaker SOC was associated with poorer training adherence (mixed model; p = .009). Thus, more complicated physical tasks did not improve in those with weaker SOC, independently of training adherence. Older people with weaker SOC may need additional psychosocial support in physical rehabilitation programs to optimize training response.
PubMed ID
23538559 View in PubMed
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