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Arnold C1, Lanovaz J2, Farthing J2, Weimer M3, Kim S1
1University of Saskatchewan, School of Rehabilitation Science, Saskatoon, Canada, 2University of Saskatchewan, College of Kinesiology, Saskatoon, Canada, 3Saskatchewan Heath Authority, Saskatoon, Canada
Background: Older women are at risk of serious fall-related injury such as fractures, head trauma and even death. Upper body injuries account for over 50% of all fall-related injuries and are a common injury with forward falls, typically landing on outstretched hands. Women in particular are susceptible to upper limb fractures during this type of fall. Most fall prevention programming focuses on training balance, strength and agility to prevent falls, but little attention has focused on the impact of training strategies to prevent injury in the event where a fall is unavoidable. There is some limited but promising laboratory research that practicing descent control and faster reaction times may result in improved capacity to prevent injury.
Purpose: The purpose of this randomized controlled trial was to evaluate the effect of a standard fall prevention program called Staying on Your Feet (SOYF) compared to SOYF with the addition of fall arrest strategy training (FAST) on fall risk and upper limb reaction time in older women.
Methods: Forty women were randomly assigned to either SOYF-standard or SOYF-FAST, twice per week for 12 weeks. Prior to and after the intervention, participants were tested for upper body strength, upper limb reaction time, balance, fall risk, balance confidence, sit to stand performance and walking ability. SOYF-standard and SOYF-FAST were administered by trained physiotherapists and exercise therapists at two different senior residences. Exercise sessions lasted for 45 minutes and focused on progressive training of lower body strength, balance, walking practice and agility. FAST had additional focus on upper body strengthening, reaction time, and simulated descent practice landing on outstretched hands. Intention to treat repeated measures MANOVAs were used to compare outcomes between groups. Significance level was set at p .05.
Results: There were 21 women in SOYF-FAST (mean age 73 ± 8.8 years) and 19 women in SOYF-standard (mean age 76 ± 7.1 years). There were no significant differences in age, height, weight or attendance between groups. Both groups showed significant improvement in upper body eccentric and concentric strength, balance (one leg standing), sit to stand performance (number of chair stands in 30 seconds) and fall risk score (Fall Risk for Older People Community Version). There was a significant group*time interaction for upper limb reaction time where SOYF-FAST showed greater improvement in both limbs.
Conclusion(s): Training that specifically focused on upper body strength, reaction time, and practicing controlled and quicker reactions during a forward descent when added to standard fall prevention programming resulted in similar gains in fall risk and balance with additional improvements in upper limb reaction time.
Implications: Fall prevention programs should consider the potential importance of adding in FAST principles to address factors associated with capacity to prevent injury when a fall is unavoidable such as upper limb reaction time, concentric and eccentric strength, trunk control, and forward descent practice. Further prospective research is needed to determine the effect of FAST on falls and fall-related injuries.
Keywords: older adults, fall risk, exercise
Funding acknowledgements: Saskatchewan Health Research Foundation
Purpose: The purpose of this randomized controlled trial was to evaluate the effect of a standard fall prevention program called Staying on Your Feet (SOYF) compared to SOYF with the addition of fall arrest strategy training (FAST) on fall risk and upper limb reaction time in older women.
Methods: Forty women were randomly assigned to either SOYF-standard or SOYF-FAST, twice per week for 12 weeks. Prior to and after the intervention, participants were tested for upper body strength, upper limb reaction time, balance, fall risk, balance confidence, sit to stand performance and walking ability. SOYF-standard and SOYF-FAST were administered by trained physiotherapists and exercise therapists at two different senior residences. Exercise sessions lasted for 45 minutes and focused on progressive training of lower body strength, balance, walking practice and agility. FAST had additional focus on upper body strengthening, reaction time, and simulated descent practice landing on outstretched hands. Intention to treat repeated measures MANOVAs were used to compare outcomes between groups. Significance level was set at p .05.
Results: There were 21 women in SOYF-FAST (mean age 73 ± 8.8 years) and 19 women in SOYF-standard (mean age 76 ± 7.1 years). There were no significant differences in age, height, weight or attendance between groups. Both groups showed significant improvement in upper body eccentric and concentric strength, balance (one leg standing), sit to stand performance (number of chair stands in 30 seconds) and fall risk score (Fall Risk for Older People Community Version). There was a significant group*time interaction for upper limb reaction time where SOYF-FAST showed greater improvement in both limbs.
Conclusion(s): Training that specifically focused on upper body strength, reaction time, and practicing controlled and quicker reactions during a forward descent when added to standard fall prevention programming resulted in similar gains in fall risk and balance with additional improvements in upper limb reaction time.
Implications: Fall prevention programs should consider the potential importance of adding in FAST principles to address factors associated with capacity to prevent injury when a fall is unavoidable such as upper limb reaction time, concentric and eccentric strength, trunk control, and forward descent practice. Further prospective research is needed to determine the effect of FAST on falls and fall-related injuries.
Keywords: older adults, fall risk, exercise
Funding acknowledgements: Saskatchewan Health Research Foundation
Topic: Older people; Health promotion & wellbeing/healthy ageing; Outcome measurement
Ethics approval required: Yes
Institution: University of Saskatchewan
Ethics committee: Biomedical Ethics Review Board
Ethics number: Bio 16-72
All authors, affiliations and abstracts have been published as submitted.
