MODERN APPROACHES TO FALLS PREVENTION IN ELDERLY PERSONS
Abstract
Aging leads to the decrease in functional abilities, which affects the occurrence of falls that can often lead to disability. The aim of this review article is to analyze the contemporary approaches within the framework of measures for the prevention and control of falls in elderly persons. Published scientific works from the period 2003-2023 were used as data sources.Therapeutic exercises applied during rehabilitation and post-rehabilitation form the basis of good postural stability. Various systematic exercise programs have a significant place, but they need to be evidence-based and precisely applied. With the development of technology, several different methods and equipment are becoming available that can be used in the prevention of falls in a modern way. Robotic systems, applications, portable hardware devices, virtual reality equipment, as well as fall detection and prevention systems are just some of the newer technologies used in fall prevention. A multidisciplinary approach, which refers to the provision of information, teamwork of experts from different fields and monitoring of new technologies, could significantly contribute to the prevention of falls and improvement in the quality of life of the elderly.
References
Popis stanovništva, domaćinstava i stanova 2022. Starost i pol. Beograd: Republički zavod za statistiku; 2023.
United Nations, Department of Economic and Social Affairs, Population Division. World Population Ageing 2019 (ST/ESA/SER.A/444). New York: United Nations; 2020.
Li Z, Zhang Z, Ren Y, Wang Y, Fang J, Yue H, et al. Aging and age-related diseases: from mechanisms to therapeutic strategies. Biogerontology. 2021;22(2):165-87. doi: 10.1007/s10522-021-09910-5.
Clark BC. Neural mechanisms of age-related loss of muscle performance and physical function. J Gerontol A Biol Sci Med Sci. 2023;78(Suppl 1):8-13. doi: 10.1093/gerona/glad029.
Jafari H, Gustafsson T. Optimal controllers resembling postural sway during upright stance. PLoS One. 2023;18(5):e0285098. doi: 10.1371/journal.pone.0285098.
Jovanović L, Kovačević R, Ereš S, Kljajić D. Držanje tela-postura; kineziterapija u cilju prevencije i korekcije poremećaja držanja tela. Beograd: Atosprint; 2014.
World Health Organization. WHO global report on falls prevention in older age. Geneva (Switzerland): World Health Organization; 2007.
Roos PE, Dingwell JB. Using dynamic walking models to identify factors that contribute to increased risk of falling in older adults. Hum Mov Sci. 2013;32(5):984-96. doi: 10.1016/j.humov.2013.07.001.
Park SH. Tools for assessing fall risk in the elderly: a systematic review and meta-analysis. Aging Clin Exp Res. 2018;30(1):1-16. doi: 10.1007/s40520-017-0749-0.
Trajkov M, Jovanović S, Kljajić D. Ispitivanje posturalne stabilnosti pomoću Neurocom balance master kineziometrijske platforme. Zdravstvena zaštita. 2015;44(5):53-9. doi: 10.5937/ZZ1505053T.
Fragala MS, Cadore EL, Dorgo S, Izquierdo M, Kraemer WJ, Peterson MD, et al. Resistance training for older adults: position statement from the national strength and conditioning association. J Strength Cond Res. 2019;33(8):2019-52. doi: 10.1519/JSC.0000000000003230.
Fiatarone-Singh MA, Izquierdo M, Morley JE. Physical fitness and exercise. In: Sinclair AJ, Morley JE, Vellas B, Cesari M, Munshi M, editors. Pathy’s principles and practice of geriatric medicine. 6th ed. Oxford: John Wiley and Sons Ltd; 2022. p. 77-107.
Jovanović L, Kovačević R, Ereš S, Kljajić D. Osnovi kineziterapije. Beograd: Atosprint; 2016.
Izquierdo M, Merchant RA, Morley JE, Anker SD, Aprahamian I, Arai H, et al. International exercise recommendations in older adults (ICFSR): expert consensus guidelines. J Nutr Health Aging. 2021;25(7):824-53. doi: 10.1007/s12603-021-1665-8.
Fejzić E. Osobe umanjenih tjelesnih sposobnosti i arhitektonske barijere. Kotor: EXPEDITIO-Centar za održivi prostorni razvoj; 2007.
Yang Y, Wang K, Liu H, Qu J, Wang Y, Chen P, Zhang T, Luo J. The impact of Otago exercise programme on the prevention of falls in older adult: a systematic review. Front Public Health. 2022;10:953593. doi: 10.3389/fpubh.2022.953593.
Bull FC, Al-Ansari SS, Biddle S, Borodulin K, Buman MP, Cardon G, et al. World health organization 2020 guidelines on physical activity and sedentary behaviour. Br J Sports Med. 2020;54(24):1451-62. doi: 10.1136/bjsports-2020-102955.
Božić D, Zelenović M. Uticaj fizičke aktivnosti na prevenciju i broj padova kod starijih osoba. SportLogia. 2022;18(1):42-56. doi: 10.5550/sgia.221801.se.bz.
Voukelatos A, Merom D, Sherrington C, Rissel C, Cumming RG, Lord SR. The impact of a home-based walking programme on falls in older people: the easy steps randomised controlled trial. Age Ageing. 2015;44(3):377-83. doi: 10.1093/ageing/afu186.
Wolf SL, Sattin RW, Kutner M, O'Grady M, Greenspan AI, Gregor RJ. Intense tai chi exercise training and fall occurrences in older, transitionally frail adults: a randomized, controlled trial. J Am Geriatr Soc. 2003;51(12):1693-701. doi: 10.1046/j.1532-5415.2003.51552.x.
Sherrington C, Michaleff ZA, Fairhall N, Paul SS, Tiedemann A, Whitney J, et al. Exercise to prevent falls in older adults: an updated systematic review and meta-analysis. Br J Sports Med. 2017;51(24):1750-8. doi: 10.1136/bjsports-2016-096547.
Aquatic Exercise Association. Aquatic fitness professional manual. 7th ed. United States: Human Kinetics; 2017.
Jansen CP, Nerz C, Labudek S, Gottschalk S, Kramer-Gmeiner F, Klenk J, et al. Lifestyle-integrated functional exercise to prevent falls and promote physical activity: results from the LiFE-is-LiFE randomized non-inferiority trial. Int J Behav Nutr Phys Act. 2021;18(1):115. doi: 10.1186/s12966-021-01190-z.
Robson E, Edwards J, Gallagher E, Baker D. Steady as you go (SAYGO): a falls-prevention program for seniors living in the community. Can J Aging. 2003;22(2):207-16. doi:10.1017/S0714980800004529.
Thompson LA, Badache M, Brusamolin JAR, Savadkoohi M, Guise J, de Paiva GV, et al. Multidirectional overground robotic training leads to improvements in balance in older adults. Robotics (Basel). 2021;10(3):101. doi: 10.3390/robotics10030101.
Avioz-Sarig O, Olatunji S, Sarne-Fleischmann V, Edan Y. Robotic system for physical training of older adults. Int J Soc Robot. 2021;13(5):1109-24. doi: 10.1007/s12369-020-00697-y.
Di P, Hasegawa Y, Nakagawa S, Sekiyama K, Fukuda T, Hujang J, et al. Fall detection and prevention control using walking-aid cane robot. IEEE/ASME Trans Mechatron. 2016; 21(2):625-37. doi: 10.1109/TMECH.2015.2477996.
Araújo F, Nogueira MN, Silva J, Rego S. A technological-based platform for risk assessment, detection, and prevention of falls among home-dwelling older adults: protocol for a quasi-experimental study. JMIR Res Protoc. 2021;10(8):e25781. doi: 10.2196/25781.
Mirelman A, Rochester L, Maidan I, Del Din S, Alcock L, Nieuwhof F, et al. Addition of a non-immersive virtual reality component to treadmill training to reduce fall risk in older adults (V-TIME): a randomised controlled trial. Lancet. 2016;388(10050):1170-82. doi: 10.1016/S0140-6736(16)31325-3.
Delahoz YS, Labrador MA. Survey on fall detection and fall prevention using wearable and external sensors. Sensors (Basel). 2014;14(10):19806-42. doi: 10.3390/s141019806.