We investigated, by studying medical records, background factors and consequences of accidental falls of patients 65-74 years who attended the Department of Orthopedics' emergency clinic in Lund. We also assessed possible prevention measures. Fractures occurred in three quarters of the registered falls. Women were more prone to sustain fractures than men. Forearm fractures were commonest among women while hip fractures were commonest among men. One third of the patients were admitted to an orthopedic ward because of the fall. The patients who were less healthy had sustained fractures oftener and also needed more hospital care. Information regarding risk factors for falls and fractures were often missing in the patients' medical records. Impaired walking and balance, and medication increased the risk of falls. Such patients constitute a high risk group for future falls and fractures. A newly developed instrument is suggested as a routine in the emergency department to increase the awareness of risk factors for falls in the elderly. Satisfactory documentation is a prerequisite for further treatment and referrals to prevent falls and fractures.
Prolonged occupational standing has previously been associated with low back pain (LBP) development. The immediate effects of a bout of prolonged standing on subsequent functional movement performance have not been investigated. It is possible that including a period of prolonged standing may have acute, detrimental effects. The purpose of the study is to investigate the impact of a prolonged standing exposure on biomechanical profiles (trunk muscle activation, joint stiffness and kinematics) during three functional movements. A total of 23 volunteers without history of LBP performed lumbar flexion, single-leg stance and unloaded squat movements pre- and post 2 h of standing exposure. It was found that 40% of the participants developed LBP during the standing exposure. There was a decrease in vertebral joint rotation stiffness in lateral bending and increased centre of pressure excursion during unilateral stance following standing exposure. There may be adverse effects to prolonged standing if followed by activities requiring precise balance or resistance of side loads. STATEMENT OF RELEVANCE: Prolonged standing may result in decreases in balance reactions during narrow base conditions as well as in the capacity to effectively resist side-loads at the trunk. Consideration should be given when prolonged standing is included in the workplace.
In order to test the hypothesis about rapid involution of functional parameters in residents in the Polar region, the functional parameters in men of 20-69 years have been compared in cross-sectional study. There is a tendency to a steady decrease of height, strength indices, parameter of muscle working capacity, balancing of the body when standing on one leg, vital capacity, cardiac output, tolerance to hypoxemia, level of physical health, adrenocorticotropic hormone and testosterone levels and an increase of body mass index, index of coordination (impairment of motor coordination), time of visual-motor response, systolic and diastolic blood pressure, index of functional changes, insulin level. More pronounced decline of functions is observed in men after 50 years.
Evaluate the ability of the American and British Geriatrics Society fall prevention guideline's screening algorithm to identify and stratify future fall risk in community-dwelling older adults.
Prospective cohort of community-dwelling older adults (n = 117) aged 65 to 90 years. Fall history, balance, and gait measured during a comprehensive geriatric assessment at baseline. Falls data were collected monthly for 1 year. The outcomes of any fall and any injurious fall were evaluated.
The algorithm stratified participants into 4 hierarchal risk categories. Fall risk was 33% and 68% for the "no intervention" and "comprehensive fall evaluation required" groups respectively. The relative risk estimate for falling comparing participants in the 2 intervention groups was 2.08 (95% CI 1.42-3.05) for any fall and 2.60 (95% Cl 1.53-4.42) for any injurious fall. Prognostic accuracy values were: sensitivity of 0.50 (95% Cl 0.36-0.64) and specificity of 0.82 (95% CI 0.70-0.90) for any fall; and sensitivity of 0.56 (95% CI 0.38-0.72) and specificity of 0.78 (95% Cl 0.67-0.86) for any injurious fall.
The algorithm was able to identify and stratify fall risk for each fall outcome, though the values of prognostic accuracy demonstrate moderate clinical utility. The recommendations of fall evaluation for individuals in the highest risk groups appear supported though the recommendation of no intervention in the lowest risk groups may not address their needs for fall prevention interventions. Further evaluation of the algorithm is recommended to refine the identification of fall risk in community-dwelling older adults.
Numerous methods for studying the prevention of falls and age-related sensorimotor degradation have been proposed and tested. Some approaches are too impractical to use with seniors or too expensive for practitioners. Practitioners desire a simple, reliable technique. The goals of this research were to develop such an approach and to apply it in exploring the effect of Tai Chi on age-related sensorimotor degradation. The method employed artificial-neural-network (ANN) models trained by using individuals' center-of-pressure (COP) measurements and age. Ninety-six White and Chinese adults without Tai Chi training were tested. In contrast, a third group, Chinese seniors with Tai Chi training, was tested to ascertain any influence from Tai Chi on sensorimotor aging. This study supported ANN technology with COP data as a feasible tool in the exploration of sensorimotor degradation and demonstrated that Tai Chi slowed down the effects of sensorimotor aging.
OBJECTIVES: To investigate the long-term effects of habitual physical activity on changes in musculoskeletal health, functional performance, and fracture risk in elderly men and women. DESIGN: Ten-year prospective population-based study. SETTING: Malmö-Sjöbo Prospective Study, Sweden. PARTICIPANTS: Participants were 152 men and 206 women aged 50, 60, 70, and 80 who were followed for 10 years. MEASUREMENTS: Distal radius bone mineral density (BMD) (single photon absorptiometry), upper limb muscle (grip) strength, balance, gait velocity, occupational and leisure-time activity, and fractures (interview-administered questionnaire) were reassessed after 10 years. Annual changes for all measures were compared between participants with varying habitual physical activity histories at baseline and follow-up: inactive-inactive (n=202), active-inactive (n=47), inactive-active (n=49), and active-active (n=60). Data for men and women were pooled, because there were no sex-by-activity group interactions. To detect possible differences in fracture incidence between the varying habitual activity groups, participants were classified into two activity groups based on their activity classification at baseline and follow-up: inactive:less active versus active:more active. RESULTS: The annual rate of bone loss was 0.6% per year less in individuals classified as active at both time points than in those classified as inactive at both time points (P
This study of postmenopausal women (n=2,928) with an eight-year follow-up revealed that impairment in functional status associated with the increased fracture risk. The standing-on-one-foot and grip strength tests and a question about self-assessed ability to move can be used to identify women with a high risk of suffering a fracture.
Poor functional status has pointed to associate with injurious falls and consequent fractures. Our aim was to define association between functional capacity and fractures.
This study was based on the Osteoporosis Risk Factor and Prevention Study (OSTPRE). A total of 2,928 postmenopausal women took part in the functional capacity and muscle strength tests. The duration of fracture follow-up varied from 6.43 to 9.86 (mean 8.37) years and the first fracture was the end-point event for the statistical analyses. All analyses were done with Cox-regression.
A total of 261 end-point fractures occurred. In multivariate analysis the inability to stand-on-one-foot for 10 seconds increased the risk of hip fracture (hazard ratio with 95% CI) 9.11-fold (1.98-42.00). Decreased grip strength associated with 1.05-fold (1.01-1.09) increased risk of hip fractures. Low leg extension strength associated with 1.02-fold (1.00-1.03) higher risk for all fractures. The self-assessed ability to walk less than 100 meters at baseline increased the risk of ankle 2.36-fold (1.10-5.08), hip 11.57-fold (2.73-49.15) and clinical vertebral fractures 3.85-fold (1.45-10.22).
According to these results the standing-on-one-foot less than 10 seconds, grip strength and a question about ability to walk less than 100 meters may help to predict postmenopausal fractures.
This study investigated the associations of sensory-motor functions with mobility in elderly people. All 75- and 80-year-old residents of the city of Jyväskylä, Finland, were invited to take part in the study. A total of 617 (93%) persons were interviewed, and 500 (75%) took part in laboratory examinations. Self-reported mobility was recorded during the interview. Basic mobility functions (maximal walking speed and stair-mounting ability) and sensory-motor functions (maximal isometric muscle strength, standing balance, reaction time and visual acuity) were measured in the laboratory. Multivariate analyses showed that poor sensory-motor functions were significantly associated with poor performance in basic mobility functions and that poor performance in basic mobility functions was associated with self-reported disability in mobility. The associations discovered were consistent with models of the disablement process. Muscle strength, balance, reaction time and vision all have individual significance for mobility, underlining the need for multifactorial approaches in prevention and rehabilitation.
The aim of the study was to explore the effects of baby swimming on subsequent motor abilities.
A range of motor abilities was examined in 4-year-old children who had previously participated in a programme of baby swimming (n= 19) and compared with a matched group of coevals who had not had this experience (n= 19).
As predicted from the nature of the exercises that comprise the programme, the effects of baby swimming were restricted to abilities associated with prehension and balance.
Suggestions are made as to how the theme of this hypothesis-generating, demonstration study can be pursued in the future with more rigorous experimental controls and applications to children with disabilities and impairments.
The postural and functional balance abilities of workers in physically demanding jobs were assessed in relation to age and occupation. Postural balance was tested with a force platform, and functional balance was measured during walking on a wooden plank. The subjects, 23-61 years of age, were fire fighters (men, n = 69), construction workers (men, n = 52), nursing staff (women, n = 51), and home care workers (women, n = 66). In the older (> or = 50 years) groups the time used for the functional balance test was 3-5 s longer and the velocity moment of the postural balance was 16-30 mm2/s higher than in the groups aged