Дисертації: "Falls (Accidents) in old age"

1

Li, Yun Popescu Mihail. "Fall detection using sound sensors." Diss., Columbia, Mo. : University of Missouri--Columbia, 2009. http://hdl.handle.net/10355/6651.

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Title from PDF of title page (University of Missouri--Columbia, viewed on March 10, 2010). The entire thesis text is included in the research.pdf file; the official abstract appears in the short.pdf file; a non-technical public abstract appears in the public.pdf file. Thesis advisor: Dr. Mihail Popescu. Includes bibliographical references.

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Li, Hon-kwok. "A systematic review of qualitative studies on old people's psycho-social experiences of falls and their prevention." Click to view the E-thesis via HKUTO, 2008. http://sunzi.lib.hku.hk/hkuto/record/B41711026.

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賴漢國 and Hon-kwok Li. "A systematic review of qualitative studies on old people's psycho-social experiences of falls and their prevention." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2008. http://hub.hku.hk/bib/B41711026.

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4

Abbott, Carmen Casanova Waigandt Alex. "Community multidimensional fall risk screening." Diss., Columbia, Mo. : University of Missouri--Columbia, 2009. http://hdl.handle.net/10355/6136.

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The entire thesis text is included in the research.pdf file; the official abstract appears in the short.pdf file; a non-technical public abstract appears in the public.pdf file. Title from PDF of title page (University of Missouri--Columbia, viewed on Feb. 10, 2010). Thesis advisor: Alex Waigandt. Vita. Includes bibliographical references.

5

Lui, Wai-man. "Validity of the Chinese version of modified falls efficacy scale in predicting falls among community-dwelling elderly in Hong Kong /." View the Table of Contents & Abstract, 2005. http://sunzi.lib.hku.hk/hkuto/record/B31684063.

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6

Low, Chien-tat. "An exploratory study of environmental risk factors to elderly falls in Hong Kong a GIS case study of Mong Kok, 2006-2007 /." Click to view the E-thesis via HKUTO, 2008. http://sunzi.lib.hku.hk/hkuto/record/B40887923.

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7

Scott, Victoria Janice. "Study of factors associated with fall-related injuries among frail older adults." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape4/PQDD_0016/NQ48229.pdf.

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8

Maw, Kit-chee Christina. "Risk factors for falls among community-dwelling elderly attending the elderly health centre." Hong Kong : University of Hong Kong, 2002. http://sunzi.lib.hku.hk/hkuto/record.jsp?B25138753.

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9

Wan, Yim-lai. "Evidence-based fall prevention guidelines for hospitalized patients aged 65 or above." Click to view the E-thesis via HKUTO, 2009. http://sunzi.lib.hku.hk/hkuto/record/B43251602.

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10

Wong, Chun-ho Eyckle. "A study on fears of falling in old age home centre." Click to view the E-thesis via HKUTO, 2003. http://sunzi.lib.hku.hk/hkuto/record/B31979464.

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11

Tiedemann, Anne Public Health &amp Community Medicine Faculty of Medicine UNSW. "The development of a validated falls risk assessment for use in clinical practice." Awarded by:University of New South Wales. School of Public Health and Community Medicine, 2006. http://handle.unsw.edu.au/1959.4/27255.

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Falls risk factor assessment is the first step in the development of appropriate intervention strategies for the prevention of falls. However, few multifactorial, validated falls risk assessments exist which are suitable for use in busy clinical settings. This project aimed to develop a reliable and valid falls risk assessment that was feasible for use in various clinical settings. The QuickScreen Clinical Falls Risk Assessment was developed and evaluated via four methods; a) the test-retest reliability of the measures was assessed with 30 community-dwelling older people, b) the concurrent validity of the measures was assessed by comparison with performance in the Physiological Profile Assessment, c) the predictive validity of the measures was assessed by comparison of performance with prospective falls in two studies involving large samples of community dwelling older people and d) the feasibility of the assessment was evaluated with 40 clinicians who trialled the assessment with their patients. The QuickScreen clinical falls risk assessment consists of eight measures, including previous falls, total medications, psychoactive medications, visual acuity, touch sensation, the sit to stand test, the near tandem stand test and the alternate step test. The test-retest reliability of the assessment measures was acceptable (intraclass correlation coefficients ranged from 0.56 to 0.89) and the assessment measures discriminated between multiple fallers and non-multiple fallers with relative risk values ranging from 1.4 to 2.5. The clinicians that trialled the assessment reported that it was quick and easy to administer and that it assisted in the management of their elderly patients. These results show that the QuickScreen Clinical Falls Risk Assessment has proven validity, test-retest reliability and is practical for use in a variety of clinical settings.

12

Hill, Keith David. "Studies of balance in older people." Thesis, Connect to thesis, 1997. http://eprints.unimelb.edu.au/archive/00000953.

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13

尹艷麗 and Yim-lai Wan. "Evidence-based fall prevention guidelines for hospitalized patients aged 65 or above." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2009. http://hub.hku.hk/bib/B43251602.

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14

Lok, Yin-sun Viviane. "Cohort study of falls and mortality in Hong Kong elderly." View the Table of Contents & Abstract, 2006. http://sunzi.lib.hku.hk/hkuto/record/B36887353.

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15

Lui, Wai-man, and 呂慧雯. "Validity of the Chinese version of modified falls efficacy scale in predicting falls among community-dwelling elderly in Hong Kong." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2005. http://hub.hku.hk/bib/B45010262.

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16

Gatts, Strawberry K. "Neural and biomechanical mechanisms underlying balance improvement with short term tai chi training in balance impaired older adults." view abstract or download file of text, 2005. http://www.oregonpdf.org.

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17

Munro, Bridget J. "Effects of household footwear-surface interactions on the gait of older arthritic females." Access electronically, 2005. http://www.library.uow.edu.au/adt-NWU/public/adt-NWU20050707.144901/index.html.

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18

White, Patricia, and University of Lethbridge Faculty of Arts and Science. "Attentional contributions to postural control are altered in older adults who fear falling." Thesis, Lethbridge, Alta. : University of Lethbridge, Dept. of Kinesiology, c2009, 2009. http://hdl.handle.net/10133/2569.

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The purpose of this thesis was to compare the contributions of attentional resources relevant to postural control between fall-fearful and non-fearful older adults. Levels of postural challenge and instructions of task prioritization were manipulated to obtain this goal. Results indicated that fall-fearful subjects demonstrated a reorganization of attentional resources when challenge to upright standing was imposed. Additionally, only non-fearful subjects demonstrated flexibility in the prioritization of the cognitive task. However both fall-fearful and non-fearful subjects demonstrated flexibility in the prioritization of the postural task. Findings suggested that fall-fearful older adults reorganize the allocation of attentional resources differently than non-fearful counterparts, potentially placing them at greater risk for falling as their awareness of the external environment and threats to balance may be compromised.
xii, 80 leaves : ill. ; 29 cm

19

Huang, Tzu-ting. "Fall-prevention in Taiwanese elderly adults /." Digital version accessible at:, 1998. http://wwwlib.umi.com/cr/utexas/main.

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20

Doyle, Tim L. "Using fractal dimension analysis to improve clinical balance and mobility assessments for discriminating fallers from non-fallers : a cross-sectional analysis." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2006. https://ro.ecu.edu.au/theses/323.

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Falling in the elderly involves high personal and financial costs. Traditional biomechanical assessment of gait and balance using variables such as centre of pressure (COP) is an active area of research that attempts to identify those characteristics associated with fallers. Non-traditional analysis techniques such as the fractaI dimension (FD) arc less well accepted. Therefore, statistical models to discriminate fallers and non-fallers utilising both traditional and non-traditional melhods should be investigated. The overall objectivc of this doctoral investigation, consisting of four studies, was to determine differences between elderly lallers and non-fallers using FD analysis to improve clinical balance and mobility assessments. The reliability of measures derived from a portable force plate was investigated in both young and elderly asymptomatic groups in studies I and 2. In studies 3 and 4 fallers were compared against non-fallers across a combination of clinical outcome measures, traditional, and FD COP analysis. Further, two statistical models were developed with and without FD variables.

21

Cheung, Hiu-yee Alice. "Contribution of risk-taking behaviors to falls for Chinese elderly /." View the Table of Contents & Abstract, 2006. http://sunzi.lib.hku.hk/hkuto/record/B36434115.

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22

Wong, Ka Yee Allison. "Physiological and psychological factors related to falls for elderly in Hong Kong." HKBU Institutional Repository, 2001. http://repository.hkbu.edu.hk/etd_ra/304.

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23

繆潔芝 and Kit-chee Christina Maw. "Risk factors for falls among community-dwelling elderly attending the elderly health centre." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2002. http://hub.hku.hk/bib/B31970758.

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24

Kung, Ka-kei, and 龔珈奇. "Fall history and perception of the steepness of stairs by community-dwelling elderly." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2010. http://hub.hku.hk/bib/B46455000.

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25

Ntagungira, Egide Kayonga. "Epidemiology of and risk factors for falls among the community-dwelling elderly people in selected districts of Umutara Province, Republic of Rwanda." Thesis, University of the Western Cape, 2005. http://etd.uwc.ac.za/index.php?module=etd&amp.

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Falls among elderly people have been identified as a significant and serious medical problem confronting a growing number of older people. Falls have been found to be a leading cause of disability, distress, admission to supervised care and death among older persons that pose a serious problem to public health. The purpose of this study was to determine the prevalence of and risk factors for falls in the community-dwelling elderly persons in the Umutara province of Rwanda.

26

Ko, Seung-uk. "Human gait analysis by gait pattern measurement and forward dynamic model combined with non linear feedback control /." Connect to this title online, 2007. http://hdl.handle.net/1957/3754.

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27

Li, Lee. "Do the elderly need to think when they walk? /." View the Table of Contents & Abstract, 2005. http://sunzi.lib.hku.hk/hkuto/record/B31941424.

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28

Lam, Kwei-yee. "Progressive moderate to high resistance training (PMHRT) by lower limb strengthening in ambulatory elderly persons with risk of falls /." View the Table of Contents & Abstract, 2005. http://sunzi.lib.hku.hk/hkuto/record/B35507160.

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29

陳意筠 and Yee-kwan Chan. "An evidence-based guideline for reducing fear of falling among community-dwelling older adults : a multi-component psycho-therapeutic intervention." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hdl.handle.net/10722/193044.

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Falls among the elderly are a major health issue in Hong Kong. This problem has been worsening and has become a public concern for the aging population. In Hong Kong, over 30,000 community-dwelling older adults have needed hospital admission after falling, and billions of dollars are spent on the related medical costs. The prevalence of recurrent falls is high. However, a lack of concern in helping community-dwelling older adults to prevent recurrent falling currently persists in clinical field. A local study reported that most community-dwelling older adults have a fear of falling (FOF) after an accidental fall. Thus, reducing FOF can reduce the fall rate because FOF and falls are interdependent. A systematic review can show that multi-component psycho-therapeutic intervention is effective in reducing FOF. Therefore, the establishment of a standardized evidence-based practice (EBP) guideline to reduce FOF among community-dwelling older adults via multi-component psycho-therapeutic intervention is necessary. This thesis aims to develop an EBP guideline to reduce FOF among community-dwelling older adults via multi-component psycho-therapeutic intervention. Seven related studies were reviewed and appraised as having a high level of evidence. These studies also reported to have significantly positive effects on the clients. The transferability and feasibility of the proposed program in Hospital A were examined, and the results show that the transferability and feasibility of the proposed program were high. An EBP guideline and an implementation plan were then developed. A pilot test was proposed to determine and solve the difficulties in the implementation process. Then, the guideline was refined. A comprehensive evaluation plan of the proposed program is included in the final chapter. The standardized EBP guideline, which is an evidence-based approach, provides a clear pathway for practitioners to educate community-dwelling older adults in reducing FOF via multi-component psycho-therapeutic intervention. This method contributes to the reduction in the recurrent fall rate and the decrease in related medical costs.
published_or_final_version
Nursing Studies
Master
Master of Nursing

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Wong, Wai-lung, and 黃偉龍. "Fall efficacy and reinvestment in older adults." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2003. http://hub.hku.hk/bib/B31257483.

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Dekenah, Ghabrielle Anne. "The development of a fall risk assessment and exercise intervention programme for geriatric subjects." Thesis, Stellenbosch : Stellenbosch University, 2012. http://hdl.handle.net/10019.1/71783.

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Thesis (M Sport Sc)--Stellenbosch University, 2012.
ENGLISH ABSTRACT: Falling is a common occurrence and one of the most serious problems in the elderly population (65 years and older). Falls account for 70% of accidental deaths in persons aged 75 years and older. Falls can be markers/indicators of poor health and declining function, and are often associated with significant morbidity. More than 90% of hip fractures occur as a result of falls, with most of these fractures occurring in persons over 70 years of age (Fuller, 2000). About one third of people aged 65 years and older fall each year, resulting in a substantial decrease in quality of life in addition to placing a huge burden on current health care systems. The purpose of this study was to determine whether a 12-week exercise intervention programme, consisting of two 30 minute exercise sessions a week, could lower the risk of falling in a group of elderly women. Female subjects (n=22) with an average age of 79.5 years were selected from three retirement homes situated in Stellenbosch, Western Cape, South Africa, according to specific inclusion and exclusion criteria. The subjects included presented no major cardiovascular and pulmonary disease signs and symptoms as recognised by the American College of Sports Medicine (2011); had no serious illnesses or co-morbidities; were mobile with no significant musculoskeletal disorders; had no uncorrected visual or vestibular problems as well as no significant cognitive impairments or major psychological disturbances; were not taking any psychotropic medications or Benzodiazepines that could affect their progress. Subjects also had to be willing to follow the 12-week exercise intervention programme and sign an informed consent document. The selected subjects then underwent a pre- and post-intervention assessment consisting of a subjective rating of their fear of falling, the Fall Risk Assessment: Biodex Balance system, Balance Evaluations Systems Test (BESTest) and the 30-Second Chair Stand Test. Statistica 10 was used to analyse the data. Data was analysed to assess any significant improvements that the exercise intervention had on each fall risk variable tested. The main fall risk variables consisted of: fear of falling, muscular strength, balance, gait and getting up strategies. Statistically significant improvements (p<0.001) were seen in: Fear of falling, muscular strength, balance, gait and getting up strategies after the 12-week exercise intervention programme. This study suggests that exercise intervention has the potential to decrease the risk of falling among elderly women and should play an extremely important role in the prevention of falling amongst this population group.
AFRIKAANSE OPSOMMING: Om te val is ‘n alledaagse gebeurtenis en een van die mees ernstige probleme vir ons bejaarde bevolking (65 jaar en ouer). Insidente van val verklaar tot 70% van toevallige sterftes met betrekking tot persone van 75 jarige ouderdom en ouer. Om te val kan ‘n teken van swak gesondheid en/of ‘n afname in funksionele kapasiteit wees, en is gewoonlik met morbiditeitspatrone gekoppel. Meer as 90% van heupfrakture kom as gevolg van valle voor, waar die meeste van die frakture in persone bo 70 jarige ouderdom voorkom (Fuller, 2000). Minstens een derde van persone bo 65 jaar en ouer val elke jaar, so ‘n val het ‘n noemenswaardige afname in lewenskwaliteit tot gevolg asook ‘n enorme druk wat op huidige gesondheidsorg sisteme geplaas word. Die doel van die studie was om te bepaal of ‘n 12 week oefenintervensieprogram, wat uit twee oefen sessies van 30 minute elk bestaan, die risiko van val vir n groep bejaarde vroue kan verlaag. Vroulike individue (n=22) met ‘n gemiddelde ouderdom van 79.5 jaar uit drie ouetehuise/aftree oorde in Stellenbosch, Wes-Kaap, Suid-Afrika geleë; is volgens bepaalde insluitings- en uitsluitingskriteria geselekteer. Individue wie ingesluit is het geen tekens of simptome van grootskaalse kardiovaskulêre of pulmonêre siekte getoon nie, soos herken deur die “American College of Sports Medicine (2011) ; het aan geen ernstige siektes of ko-morbiditeite gely nie; kon stap met geen merkwaardige muskulo-skeletale afwykings nie; het geen nie-gekorrigeerde visie of vestibulêre probleme asook geen beduidende kognitiewe gestremdhede of ernstige sielkundige steurnisse gehad nie; het nie enige psigotropiese medikasie of Benzodiazepines geneem wat hul kon beinvloed nie. Individue moes bereid gewees het om die 12 week oefenintervensieprogram te volg en moes ook ‘n ingeligte toestemmingsvorm onderteken. Die geselekteerde individue het ‘n pre- en post-intervensie assessering ondergaan wat uit ‘n subjektiewe bepaling van hul vrees vir val bestaan het, die Val Risiko Assessering asook “Biodex Balans System Test, Balance Evaluations Systems Test (BESTest)” asook die 30 Sekonde Stoel-staan Toets. Statistica 10 is gebruik om die data te analiseer. Data was geanaliseer om enige merkwaardige verandering wat die oefenintervensie op elke val risiko veranderlike wat getoets was gehad het, te bepaal. Die belangrikste val risiko veranderlikes het uit: die vrees vir val, spier sterkte, balans, stappatroon en opstaan tegnieke bestaan. Betekenisvolle statistiese veranderinge (p<0.001) is gerapporteer in: die vrees vir val, spiersterkte, balans, stappatroon en opstaan tegnieke na die 12 week oefenintervensieprogram. Die studie bevind dat die intervensieprogram die potensiaal het om die risiko van val onder bejaarde vroue te verminder en behoort ‘n uiters belangrike rol in die voorkoming van val onder die bevolkingsgroep te speel.

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Wong, Chun-ho Eyckle, and 黃振浩. "A study on fears of falling in old age home centre." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2003. http://hub.hku.hk/bib/B31979464.

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33

Law, Man-wai, and 羅敏慧. "Evidence-based guidelines of fall prevention programme for hospitalized older patients." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hdl.handle.net/10722/193074.

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Background: Falls are one of the most common and serious problems facing the elderly and are known to be associated with significant mortality, morbidity, decreased functioning and premature institutionalization. In Hong Kong, the prevalence of falls among community-dwelling older adults is 19.3%. Moreover, the incidence of falls among older people in institutions is almost three times the fall rates for the community-dwelling elderly. Institutional falls are regarded as common adverse events in hospitalized older patients. Significant mortality, morbidity and healthcare costs associated with institutional falls led institutions to recognize falls as a high-priority safety risk for hospitalized patients. This demonstrated the significance of providing the health care providers with an evidenced-based practice guideline of an effective multifactorial fall prevention programme in order to prevent in-patient falls. Objectives: The objectives of the study are to systematically review and present the best evidence for the effectiveness of multifactorial fall prevention interventions in reducing falls in hospitals, to translate the reviewed evidence and to develop evidence-based practice guidelines for the multifactorial fall prevention programme as well as to develop a plan for implementing and evaluating the multifactorial fall prevention programme. Methods: The relevant literature was searched by several electronic databases. The related literature was then retrieved, reviewed and synthesized. The quality assessment of the studies was performed according to the methodological checklist for controlled trials designed by the Scottish intercollegiate Guideline Network (SIGN). Evidenced-based practice guidelines for the multifactorial fall prevention programme were then synthesized according to the findings of the reviewed literature, while the implementation potential being assessed in terms of transferability, feasibility and the cost-benefit ratio. Results: Five studies were identified according to the inclusion and exclusion criteria set. “Evidence-based guidelines of fall prevention programme for hospitalized older patients” were formulated based on the review of the selected studies. Fourteen recommendations of the evidence-based guidelines are formulated and graded according to the grading system of Scottish Intercollegiate Guidelines Network (SIGN). The evidence-based recommendations can offer nurses and other health care professionals the standards and strategies required for implementing multifactorial fall risk assessment and multifactorial fall prevention interventions, including environmental modifications, knowledge, medication reviews and exercise. A communication plan for various parties in hospitals including a pilot test for determining the feasibility of the innovation and an evaluation plan to determine the effectiveness of the fall prevention programme were subsequently developed. Conclusion: This study reviewed evidence for the effectiveness of the multifactorial fall prevention programme in reducing the incidence of falls, translated the reviewed evidence and developed evidence-based guidelines for a multifactorial fall prevention programme, which can provide the health care practitioners with an evidence-based approach in fall risk assessment and management so as to prevent in-patient falls.
published_or_final_version
Nursing Studies
Master
Master of Nursing

34

Hahn, Michael Eugene. "Biomechanical assessment of balance control in the elderly : muscular weakness and dynamic instability /." view abstract or download file of text, 2003. http://wwwlib.umi.com/cr/uoregon/fullcit?p3113008.

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Thesis (Ph. D.)--University of Oregon, 2003.
Typescript. Includes vita and abstract. Includes bibliographical references (leaves 157-170). Also available for download via the World Wide Web; free to University of Oregon users.

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Low, Chien-tat, and 劉振達. "An exploratory study of environmental risk factors to elderly falls inHong Kong: a GIS case study of Mong Kok,2006-2007." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2008. http://hub.hku.hk/bib/B40887923.

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36

Myers, Helen. "Fall risk assessment : A prospective investigation of nurses' clinical judgement and risk assessment tools in predicting patient falls in an acute care setting." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2003. https://ro.ecu.edu.au/theses/1494.

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Falls are a significant problem in acute care, hospital settings, and can have serious consequences, especially for older patients. Fall prevention has therefore been recognised as an important area for research and intervention. In order to target interventions and use resources effectively, a major strategy of many fall prevention programmes has been the development and/or use of risk assessment tools to identify patients who are at high risk of falling. Although many tools have been developed, few have been rigorously tested, and there is currently no evidence to support the clinical utility of fall risk assessment tools. There is a need to conduct further research to establish the efficacy of fall risk assessment tools for inpatient populations. Additionally, nurses clinical judgement in assessing fall risk may aid the development of fall risk assessment protocols and further research is needed to build on limited knowledge in this area. A prospective cohort study was used to evaluate two fall risk assessment tools and nurses' clinical judgement in predicting patient falls. Each patient was assessed for fall risk by the clinical judgement of the nurse caring for the patient and by the researcher using a data collection form containing the two fall risk assessment tools. The study wards comprised two aged care and rehabilitation wards, within a 570 bed acute care tertiary teaching hospital facility in Western Australia. Test-retest reliability of the two fall risk assessment tools and nurses' clinical judgement was established over a twenty four hour period. The ability of the fall risk assessment tools, and nurses' clinical judgements to discriminate between patients with a high probability of falling and , patients with a low probability of falling; was determined by calculating the sensitivity, specificity, positive predictive value and negative-predictive value for each method. The reference criterion used for these calculations was whether or not the patient fell within the hospitalisation period in which they were admitted to the study. In addition, the accuracy of each method was determined by calculating the number of times the risk assessment tool or clinical judgement classified the patient into the correct, fall risk category, expressed as a percentage. The same reference criterion was used for this calculation. Both the fall risk assessment tools and nurses' clinical judgement had good test-retest reliability. When assessing validity, all three methods of determining fall risk showed good sensitivity, ranging from 88% to 91 %,but poor specificity, ranging from 25% to 26%. This meant that the risk assessment methods classified too many patients who did not fall as at high risk for falling. All methods also had limited accuracy, ranging from 35% to 36%, and overall exhibited an inability to adequately discriminate between patient populations at risk of falling and those not at risk of falling. Consequently, neither nurses' clinical judgement nor the fall risk assessment tools could be recommended for assessing fall risk in the clinical setting. In addition, results indicated that there was a large difference between the accuracy of first year enrolled and registered nurses in assessing patient fall risk. First year enrolled nurses accurately predicted fall risk 44.4% of the time while first year registered nurses achieved an accuracy level of only 8.6%. These results are potentially biased, as measuring differences in accuracy between types of nurses was not a main focus of this study and in many cases the same nurse gave multiple judgements about patients' fall risk. The results however, provide an indication that further study is warranted using a specifically methodology to explore this issue. There are a number of specific recommendations arising from the results of this study. It is recommended that further studies be undertaken to assess the reliability and validity of current fall risk assessment tools in inpatient populations. If no valid and reliable fall risk assessment tool can be identified, research should be undertaken to develop such a tool. It is also recommended that studies be conducted to assess changes in fall risk profiles over time to determine if the sensitivity and specificity of instruments changes depending on the timing of the risk assessment. Differentiating between stable and transient risk factors should be an integral component of these types of studies. Further research is also required to determine if there are differences in fall risk factors between different specialties or if a generic risk assessment tool can be used for all inpatient populations. Additionally, further investigation into the clinical judgement of registered and enrolled nurses in .their first year of clinical practice should be undertaken and results reported to appropriate educational institutions. Changes in accuracy of clinical judgement in the first five years of clinical practice should also be measured.

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Lok, Yin-sun Viviane, and 駱燕生. "Cohort study of falls and mortality in Hong Kong elderly." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2006. http://hub.hku.hk/bib/B39725029.

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Cheung, Hiu-yee Alice, and 張曉怡. "Contribution of risk-taking behaviors to falls for Chinese elderly." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2006. http://hub.hku.hk/bib/B45010626.

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39

Lui, Wai-ming Priscilla, and 雷慧明. "Effect of exercise on fall prevention of community-dwelling elderly." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2012. http://hub.hku.hk/bib/B50222867.

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Objective: To evaluate the effectiveness of exercises on fall prevention among community-dwelling elderly. Design: Systematic review of randomized controlled trials. Method: The literature search of articles was conducted through the electronic databases of PubMed, Medline and EMBASE and manual search, and was confined to articles in English language with full text and publications from 2002 to 2012. Randomized controlled trials with exercise as the only intervention which aimed at reducing falls in older people aged 60 or above in community i.e. community-dwelling elderly were included. The primary outcomes were number of fallers, fall rate, time to the first and subsequent falls. Data Extraction: A total of 145 articles were retrieved through the electronic data bases (137 articles) and manual search (8 articles) of which 10 were selected after applying the inclusion criteria. According to the checklist developed by National Institute for Health and Clinical Excellence (NICE) for randomized controlled trials, the overall methodological quality of the 10 studies was rated as good as they had fulfilled 79%-93% of the assessment criteria in the NICE checklist. Results: The studies involved a sample size of 3,138 at the median age of 69 to 83. All the subjects were ambulatory and able to mobilize independently. The duration of exercise interventions ranged from 1.5 months to 12 months at a total of 11-156 hours. Eight studies showed that exercises were effective in fall prevention whereas two studies found no evidence of such effectiveness. The effect of exercises on fall prevention was multifactorial including the duration, frequency and continuity of the exercise programs, the health status of the target population and the individuals’ adherence to the exercise programs. Shorter exercise programs and make-up class arrangement resulted in higher adherence rate. Tailor-made (based on the functional capabilities of the subjects) and progressive (gradual increase of the intensity and challenge of the exercises during the intervention period) nature of the exercise programs also enhanced their effectiveness on the elderly. For the studies in which exercise did not have any positive effect on fall prevention, the subjects were generally older (median age at 81) and frailer (with 3-7 frail attributes). Conclusions: This review suggests exercise may be an effective intervention for fall prevention among community-dwelling elderly. Different types of exercise including strengthening, balance, endurance and weight-bearing exercises as well as Tai Chi may prevent falls. The elderly’s age and health status must be taken into consideration when designing exercise intervention programs for the elderly. Further researches are recommended to determine the optimal type, intensity, frequency and duration of exercises in fall prevention. Observations from the studies provide insights for future researches, such as the fall prevention effect of group and home exercises, tailor-made and progressive exercise programs. In Hong Kong, no randomized controlled trial studies have been conducted to examine different intervention programs on fall prevention. To achieve generalizabilty of the studies in the review, further local researches, particularly well designed and powered randomized controlled trials have to be conducted to assess the effect of different kinds of exercise interventions on fall prevention among the community-dwelling elderly.
published_or_final_version
Public Health
Master
Master of Public Health

40

林桂儀 and Kwei-yee Lam. "Progressive moderate to high resistance training (PMHRT) by lower limbstrengthening in ambulatory elderly persons with risk of falls." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2005. http://hub.hku.hk/bib/B45010742.

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Peel, Nancye M. "The protective effect of healthy ageing on the risk of fall-related hip fracture injury in older people /." [St. Lucia, Qld.], 2005. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe19388.pdf.

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42

Li, Lee, and 李利. "Do the elderly need to think when they walk?" Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2005. http://hub.hku.hk/bib/B45013895.

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43

Hess, Jennifer A. "High intensity strength training to enhance balance control in frail older adults." view abstract or download file of text, 2004. http://wwwlib.umi.com/cr/uoregon/fullcit?p3136416.

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Thesis (Ph. D.)--University of Oregon, 2004.
Typescript. Includes vita and abstract. Includes bibliographical references (leaves 135-143). Also available for download via the World Wide Web; free to University of Oregon users.

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Zhao, Yanan. "The effect of a tailor-made exercise program on improving balance among older adults at risk of falling." HKBU Institutional Repository, 2015. https://repository.hkbu.edu.hk/etd_oa/223.

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Context: There is a paucity of information on well-designed exercise programs for the Primary Falls Prevention. Objective: This study aimed to evaluate a tailor-made exercise program for improving balance and balance-related fitness among older adults without history of falls but who were at risk of falling. Design, Setting, and Participants: A single-blind and randomized controlled trial for 61 older adults (age = 70 ± 3 years, males = 25%) with no history of falls but who were at risk of falling enrolled at the local senior center. Intervention: Participants were randomly allocated into three groups. An intervention group receiving a tailor-made Exercise for Balance Improvement Program (ExBP; n = 20), an active control group receiving the 8-form Yang-style Tai Chi (TC; n = 20), and a no-treatment concurrent control group (CON; n = 21). The ExBP was developed based on demographic and clinical characteristics of old adults as well as on the most reported deficits in balance and balance-related systems. The movements chosen in ExBP were those used in previous studies for older adults. The movements were integrated with considerations of movement specificity, movement complexity and organization, movement safety, feasibility and gracefulness, as well as the transfer of exercise learning. Modifications of these movements were made following experts and end-users’ evaluations. Training dosage was set at “90 minutes per session x 3 sessions per week x 16 weeks with an 8-week follow-up. Outcome Measurements: The primary outcome was a composite measure of balance capacities, including Fall Risk Test (FRT), Postural Stability Test (PST), Limits of Stability Test (LOS), and a modified Clinical Test of Sensory Organization and Balance (m-CTSIB). The secondary outcomes referred to those balance-related fitness including 30s Chair Stand Test (CS), Chair Sit-and-Reach Test (SR), 8ft Up and Go Test (UG), 2min Step Test (Step), Choice Stepping Response Time (CSRT), as well as Fear of Falling (FF). All the testing parameters were collected one week before the intervention (pre-test), at the end of 12th week (mid-test), at the end of 16th week (post-test), and at the end of 24th week (follow-up test). Analysis of variance with pre-test data as covariance and repeated measures analysis of variance were conducted to examine Group effect and Time effect, respectively. Results: All testing parameters in the ExBP group demonstrated an improvement trend from pre-test to post-test, especially in FRT, m-CTSIB, CS, SR, UG, and FF (p < .05). In comparison with the CON group at post-test, there were significant improvements in the ExBP group in FRT, m-CTSIB with compromised somatosensation, m-CTSIB with compromised vision and somatosensation, CS, UG, Step, and FES (p < .05), while the improvements at mid-test were only shown in UG and FF. There were no significant differences on any of the testing parameters between post-test and follow-up test. In addition, continuous improvements were shown in FRT, PST, m-CTSIB, SR, UG, CSRT, and FF during the follow-up period. In comparison with the TC group at mid-test, ExBP showed significantly more improvements in FRT, UG, Step and FF. Although without statistically significant group difference at post-test except in Step, improvements in FRT, PST in anterior-and-posterior direction, m-CTSIB with compromised somatosensation, m-CTSIB with compromised vision and somatosensation, SR, UG, Step, and CSRT were more pronounced in the ExBP group. The losses of training effect from post-test to follow-up test in ExBP was lower than the Tai Chi especially in FRT, m-CTSIB with compromised vision and somatosensation, Step, and CSRT. Conclusion: The ExBP can be applied as an effective exercise program for improving balance and balance-related fitness among older adults at risk of falling. In comparison with Tai Chi, training effects from ExBP occurred earlier and lasted longer.

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Wong, Wai-lung, and 黃偉龍. "The role of movement specific reinvestment, fall efficacy and perception in walking and falling in community-dwelling older adultsin Hong Kong." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2012. http://hub.hku.hk/bib/B48521760.

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In six experiments, the relationships between history of falls, reinvestment, fear of falling, perception, balance ability and walking ability of community-dwelling older adults was investigated. In addition, the Movement Specific Reinvestment Scale (MSRS) (Masters, Polman, & Hammond, 1993; Masters, Eves, & Maxwell, 2005) was further validated, using a Chinese version (MSRS-C). In the first experiment (Chapter 2), it was shown that elder fallers scored significantly higher than non-fallers on both the movement self-consciousness and the conscious motor processing components of the MSRS-C. The conscious motor processing component of the MSRS-C was found to discriminate previous faller from non-faller status. In the second experiment (Chapter 3), findings demonstrated that internal focus of attention was greater in elder repeat fallers and increased as task demands increased. However, external focus of attention increased in both elder repeat fallers and elder non-fallers as task demands increased. Elder repeat fallers scored significantly higher than elder non-fallers on the MSRS-C. In the third and fourth experiments (Chapter 4), it was revealed that elder fallers demonstrated greater fear of falling and a higher propensity for movement specific reinvestment than non-fallers. Elderly people perceived stairs as steeper than they were and judged stairs as steeper when making visual-matching and verbal-report estimates that required conscious involvement compared to haptic estimates that are thought to require little conscious involvement. Overestimations when making explicit, conscious judgments were reduced by carrying out a concurrent secondary task during estimation, but there was little effect of the secondary task on implicit, non-conscious judgments of steepness. In Chapter 5, focus group work was conducted to investigate whether (1) elderly people respond differently when asked to complete the MSRS-C in respect of contexts that are not directly related to balance or locomotion and (2) elderly people are better able to differentiate a 4-point Likert response format when completing the MSRS-C than the original 6-point format. Experiment five (Chapter 6) further validated the MSRS-C based on the findings from Chapter 5. Results revealed that both the MSRS-C (general) and MSRS-C (walking) can be used with a six-point or a four-point response format to differentiate elderly Chinese fallers from non-fallers. The overall findings were discussed in the context of theories of motor learning and reinvestment. Implications for rehabilitation training were elucidated.
published_or_final_version
Human Performance
Doctoral
Doctor of Philosophy

46

Kempster, Cody C., and University of Lethbridge Faculty of Arts and Science. "Postural anxiety influences the allocation of attentional resources among younger and older adults." Thesis, Lethbridge, Alta. : University of Lethbridge, Dept. of Kinesiology, 2010, 2010. http://hdl.handle.net/10133/2555.

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The purpose of this thesis was to investigate the influence of postural anxiety on the capacity for Flexible Resource Allocation (FRA) among younger (YA) and older adults (OA). Two experiments were conducted to explore (a) the influence of heightened postural anxiety on the flexible allocation of attention among OA and (b) the influence of concurrent postural challenge and postural anxiety on FRA among YA. Participants performed a postural task concurrently to a cognitive task according to three instructional sets directing task priority. Experiment one revealed that FRA was compromised among OA during circumstances of heightened anxiety. This capacity however, remained available among YA. Therefore, for the second experiment I varied the support surface to explore whether the capacity for FRA could be sustained when posture was challenged beyond static stance. Results indicated that YA altered cognitive task performance according to instructional set without compromising postural stability. These findings suggest that even when posture is challenged during heightened postural anxiety, YA maintain the capacity to automatically allocate attention to a postural task while performing a secondary task. Conversely, it seems that heightened postural anxiety strengthens the attentional bias to posture and subsequently compromises FRA among OA. Overall, results from this thesis suggest that the capacity for FRA is age and situation dependent.
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Price, Stephanie Anne. "A qualitative study of the impact of hip fracture in the elderly population." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2000. https://ro.ecu.edu.au/theses/1367.

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The social, emotional and economic impact of falling in the elderly population is significant. Falls are the leading cause of injury related deaths and hospitalisation amongst people aged 65 years and older, a major factor in their morbidity and mortality rates. Post fall sequelae can have major ramifications that include reduction or avoidance of activities, attributable to an enduring fear of future falls. Twenty-three older people who had fallen in the community were located via hospital records and invited to participate in the study. Subjective accounts of the impact of falling and sustaining a hip fracture were obtained by means of open response interviews of ten older people (mean age 82). Qualitative analysis identified themes relating to self-concept, social support and self-efficacy. There is strong empirical evidence that self- efficacy predicts behavior and functioning following hip-fracture whereby low confidence generally leads to avoidance of activity. This was supported in the present study. Reduced mobility can have serious consequences for the health status of the elderly and actually increases the likelihood of falling.

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Sessford, Karus David. "The effect of anxiety on motor learning during a postural task." Thesis, Lethbridge, Alta. : University of Lethbridge, Dept. of Kinesiology, c2011, 2011. http://hdl.handle.net/10133/3122.

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The effect of anxiety on motor learning during a balance relevant task was investigated. Twenty participants (mean age 22.0 ± 2.7 years) were randomly divided into groups that completed the task whilst standing directly on the platform or on 9cm high pedestals, thus constructing Non-Anxious (NA) or Anxious (A) environments. Participants trained for 36 trials in a continuous, pseudo-random oscillating balance task consisting of pseudo-random amplitude translation at 0.5Hz for 45 seconds each on Day 1 and returned for Retention and Transfer tests on Day 2. Motor performance was impaired by training in an anxious environment and this effect persisted across retesting in both non-anxious and anxious environments. Anxiety also tended to further impair transfer of motor performance improvements to a non-anxious environment. These findings have implications for the success of balance training programs in patients who are anxious or afraid of falling.
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Lugade, Vipul Anand 1980. "Balance Control and Stability during Gait - An Evaluation of Fall Risk among Elderly Adults." Thesis, University of Oregon, 2011. http://hdl.handle.net/1794/12063.

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Falls are a significant source of physical, social, and psychological suffering among elderly adults. Falls lead to morbidity and even mortality. Over one-third of adults over the age of 65 years will fall within a calendar year, with almost 10,000 deaths per year attributed to falls. The direct cost of falls exceeds $10 billion a year in the United States. Fall incidents have been linked to multiple risk factors, including cognitive function, muscle strength, and balance control. The ability to properly identify balance impairment is a tremendous challenge to the medical community, with accurate assessment of fall risk lacking. Therefore, the purpose of this study was to assess balance control during gait among young adults, elderly adults, and elderly fallers; determine which biomechanical measures can best identify fallers retrospectively; demonstrate longitudinal changes in elderly adults and prospectively assess fall risk; and provide a method for mapping clinical variables to sensitive balance control measures using artificial neural networks. The interaction of the whole body center of mass (CoM) in relation to the base of support (BoS) assessed static and dynamic balance control throughout gait. Elderly fallers demonstrated reduced balance control ability, specifically a decreased time to contact with the boundary of the BoS, when compared to young adults at heel strike. This decreased time might predispose older adults to additional falls due to an inability to properly respond to perturbations or slips. Inclusion of these balance control measures along with the Berg Balance Scale and spatiotemporal measures demonstrated sensitivity and specificity values of up to 90% when identifying 98 elderly fallers and non-fallers, respectively. Additionally, 27 older adults were followed longitudinally over a period of one year, with only the interaction of the CoM with the BoS demonstrating an ability to differentiate fallers and non-fallers prospectively. As the collection and analysis of these biomechanics measures can be time consuming and expensive, an artificial neural network demonstrated that clinical measures can accurately predict balance control during ambulation. This model approached a solution quickly and provides a means for assessing longitudinal changes, intervention effects, and future fall risk. This dissertation includes both previously published and unpublished co-authored material.
Committee in charge: Dr. Li-Shan Chou, Chair; Dr. Andrew Karduna, Member; Dr. Marjorie Woollacott, Member; Dr. Ronald Stock, Member; Dr. Arthur Farley, Outside Member

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Vogler, Constance. "Reducing fall risk in older people discharged from hospital: a randomised controlled trial comparing (i) seated lower limb resistance training, (ii) functional weight-bearing exercises and (iii) social visits." Thesis, The University of Sydney, 2007. https://hdl.handle.net/2123/28062.

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Whilst exercise therapy has been found in trials to reduce fall rates in older people, not all exercise interventions have been found to be equally effective in preventing falls or reducing fall risk factors. Older people who have recently been discharged from hospital are at an increased risk of falling, but they are a population that has not been well studied in interventional trials. This study aimed to investigate the effects of different types of exercise therapy on fall risk factors in older people recently discharged from hospital, using a randomised controlled trial. It also aimed to determine the extent to which gains in physical performance and functional ability were maintained or lost following the completion of the 12-week trial. Firstly a reliability study of outcome factors for risk of falling was tested in the home setting, using portable equipment, to determine intra-rater reliability. Secondly, the main randomised controlled trial of subjects recently discharged from two hospitals in Sydney’s northern suburbs was performed, comparing the impact of seated resistance, fimctional weight-bearing exercises and social visits on fall risk factors. After the interventions at 12 weeks, there were significant improvements in composite fall risk (measured by the Physiological Profile assessment), coordinated stability, maximal balance range, body sway and fingerpress reaction time when comparing the functional weight-bearing exercises with control. There was a significant improvement in composite fall risk for the seated resistance group when compared with control. There was evidence of detraining (complete or partial) for all of the above measures that had improved at 12 weeks. Seated resistance exercises had the highest rate of musculoskeletal injury. It can be concluded that in people recently discharged from hospital, functional weight-bearing exercises had a greater impact on improving fall risk factors than seated resistance exercises. Twelve weeks after the cessation of exercises, detraining had occurred, highlighting the importance of longer-term exercises to maintain improvements in this population.

Дисертації з теми "Falls (Accidents) in old age"

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