NSG7020 - Week 9 project

First Author

Conceptual

Design/Method

Sample &

Major

Measurement

Data Analysis

Findings

Appraisal:

(Year)

Framework

Setting

Variables

Worth to

Studied (and

Practice

their

Definitions)

Barnett et al., (2003)

Fall prevention, exercise intervention

Randomized controlled trial

163 community-dwelling older people (65+), South Western Sydney, Australia

Balance, muscle strength, reaction time, physical functioning, health status, fall rate

Physical performance (balance, strength, etc.), falls rate, health status (Short-Form 36, fear of falling scales)

Comparison of exercise vs. control group outcomes, incidence rate ratio (IRR) for falls

Exercise group improved balance and had 40% fewer falls than controls

Supports group exercise programs to reduce falls in older adults

Chang et al. (2004)

Multifactorial fall risk assessment and management

Systematic review and meta-analysis

Older adults in randomized clinical trials, various healthcare settings

Exercise program, multifactorial intervention, fall risk, fall rate

Risk ratio, incidence rate ratio (IRR)

Random effects analysis, metaregression

Exercise programs and multifactorial interventions reduce fall risk and monthly fall rate in older adults

Supports the implementation of exercise and multifactorial risk management programs to reduce falls in older adults, with exercise showing significant benefits.

El-Khoury et al. (2013)

Fall prevention through exercise interventions

Systematic review and meta-analysis of randomized controlled trials

4,305 older adults (>60 years) in community settings

Exercise intervention (I), fall rates (O), injurious falls, medical care, severe falls, fractures

Rate ratio of falls and injuries

Random effects models for pooled rate ratios across studies

Exercise significantly reduced fall-related injuries, medical care, severe falls, and fractures (rate ratios: 0.63-0.39).

Strong evidence supporting exercise programs to prevent falls and related injuries in older adults, beneficial for fall prevention initiatives in retirement communities.

(Oh et al., 2012)

Falls prevention and exercise interventions for elderly people.

Randomized controlled trial.

65 elderly community-dwelling participants who had fallen in the past year, divided into exercise group (EG, n=36) and control group (CG, n=29).

Exercise program vs. no exercise program; balance, muscle strength, flexibility, fear of falling.

Walking speed, balance, back strength, lower extremity strength, flexibility, fear of falling.

Statistical tests (e.g., p-values).

Exercise improved balance, flexibility, strength, and reduced fear of falling.

Exercise programs significantly reduce fear of falling and improve physical capabilities, beneficial for elderly fall prevention.

Sherrington et al. (2008)

Exercise as a prevention strategy for falls

Systematic review and meta-analysis

44 trials, 9,603 participants, general community and residential care

Exercise programs vs. no exercise, fall rates

Fall rates

Pooled effect estimate, relative risk (RR), 95% CI, I2 statistic

Exercise reduced fall rates by 17%, with greater effects seen in programs focusing on balance exercises and higher exercise doses

Provides evidence that structured exercise programs, particularly those challenging balance, can significantly reduce falls in older adults.

(Taylor et al., 2012)

None

Randomized controlled trial.

684 community-residing older adults (mean age 74.5; 73% female) across 11 sites in New Zealand.

Independent: Tai chi (once/twice a week) vs. low-level exercise.

Dependent: Fall rates, mobility, balance, lower limb strength.

Fall rates (monthly falls calendars), mobility (Timed-Up and-Go), balance (step test), lower limb strength (chair stand test).

Adjusted incident rate ratios (IRR), multilevel mixed-effects Poisson regression, fixed-effect analyses.

No significant difference in fall rates between tai chi and low-level exercise groups, with a 58% reduction in fall rates across all groups. Balance and strength improved similarly, but no difference in mobility.

The study suggests that both tai chi and low-level exercise are effective for improving strength and balance, but neither significantly reduces falls compared to the other. It emphasizes the importance of exercise for older adults but questions the specific benefits of tai chi for fall prevention.