“Exercise and Vitamin D in Fall Prevention Among Older Women” the Article by Uusi-Rasi et al.

Introduction

Written by Uusi-Rasi et al., the article “Exercise and vitamin D in fall prevention among older women” was published online in 2015 in JAMA Internal Medicine journal. It has been proven in several clinical trials conducted by Gillespie et al. (2012) and Palvanen et al. (2014) that regular exercises may reduce the risk of falling up to 50%. The objective of the research was to investigate the effects of exercise and vitamin D in reducing injurious falls.

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Strengths and Limitations of the Study

409 women participated in a 2-year randomized placebo-controlled vitamin D and exercise trial (Uusi-Rasi et al., 2015). The sample was chosen with the help of several steps that eliminated the invalid participants from the 9730 invited participants (Uusi-Rasi et al., 2015). Some of them did not respond, lost interest was dismissed upon medical check-up, or could not participate due to health issues. The outcomes of the study were reports of women about their falls and estimations of bone density and vitamin D level. There were several studies regarding the effectiveness of vitamin D in fall prevention, in particular, conducted by Gillespie et al. (2012) and Annweiler, Schott, Berrut, Fantino, and Beauchet (2009).

However, they did not study the combined effect of vitamin D and exercise. Easiness of estimating the outcomes and use of different combinations of variables make the method feasible. Taking into account that participants had at least one fall within a year and did not take vitamin D supplements, the method is realistic and valid. The strengths of the research also include its 2-year duration and comprehensive assessment of physical functioning. However, the vitamin D effect was not determined because of the fortification of milk products in the country where the research was conducted.

Significance of the Study

The results were interpreted based on the primary and secondary outcomes. Exercise training reduced injurious falls, though it did not influence the total fall rate. Even though vitamin D maintained bone mineral density, it did not reduce falls. Due to the large limitation, the study is incomplete as the authors suggest that future research is needed. The reported observations support some of the previous studies conducted by Gillespie et al. (2012) and refute the others conducted by Glendenning et al. (2012). The overall results of the study place it in the same line with other works in the field and signify its contribution to the research of the issue providing new perspectives for the following investigations.

Conclusion

To sum up, the research does not significantly contribute to human knowledge due to its considerable limitation. The important conclusions made by the authors are that physical training prevents injurious falls and vitamin D reduces bone loss. The research provided a thorough theoretical description of the study and produced some practical applications for nurses who could encourage elderly women to exercise to enhance mobility. However, the significance of the study is little as additional research should be conducted.

References

Annweiler, C., Schott, A. M., Berrut, G., Fantino, B., & Beauchet, O. (2009). Vitamin D-related changes in physical performance: A systematic review. The Journal of Nutrition, Health & Aging, 13(10), 893-898.

Gillespie, L. D., Robertson, M. C., Gillespie, W. J., Sherrington, C., Gates, S., Clemson, L. M., & Lamb, S. E. (2012). Interventions for preventing falls in older people living in the community. Cochrane Database of Systematic Reviews, (9).

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Glendenning, P., Zhu, K., Inderjeeth, C., Howat, P., Lewis, J. R., & Prince, R. L. (2012). Effects of three‐monthly oral 150,000 IU cholecalciferol supplementation on falls, mobility, and muscle strength in older postmenopausal women: A randomized controlled trial. Journal of Bone and Mineral Research, 27(1), 170-176.

Palvanen, M., Kannus, P., Piirtola, M., Niemi, S., Parkkari, J., & Järvinen, M. (2014). Effectiveness of the Chaos Falls Clinic in preventing falls and injuries of home-dwelling older adults: A randomised controlled trial. Injury, 45(1), 265-271.

Uusi-Rasi, K., Patil, R., Karinkanta, S., Kannus, P., Tokola, K., Lamberg-Allardt, C., & Sievänen, H. (2015). Exercise and vitamin D in fall prevention among older women. JAMA Internal Medicine, 175(5), 703. Web.

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