|P||Population||The elderly population in the community.|
|I||Intervention or Issue of interest||Use of regular exercises to control falls|
|C||Comparison||The elderly who do not exercise regularly.|
|O||Outcome||Reduction of falls and emergency room visits.|
|T||Time frame||During 90 days of hospitalization.|
|Search||Initial Search Terms||Database||AND/OR?||Added Search Terms||Title (Ti) |
|Number of Articles Found|
|1.||Prevention of falls among the elderly||MEDLINE||Systematic review of prevention of falls||A systematic literature review examining the rationale and evidence.||Exercise in the Prevention of falls in older people.||Nine|
|2.||Physical exercise efficacy in prevention of falls.||PubMed||Meta-analysis of physical exercise||Accident prevention. |
Prevention and control.
|Impact of physical exercise||Seven|
|3.||Intervention exercises for older adults.||MEDLINE||Systematic review of exercise intervention.||Systematic review||Physical exercises interventions.||Fifty-six|
|4.||Physical and cognitive interventions reducing risk of falls among the elderly.||PubMed||Systematic review of physical interventions.||Falls prevention. |
Systematic review report.
|Effects of cognitive and physical activities.||Eight|
|5.||Interventions aimed in preventing falls among the elderly in the community.||National Center for Biotechnology Information (NCBI)||Community dwelling prevention of falls.||Interventions to the prevention of falls.||Prevention interventions.||Eight|
|6.||A multimodal six months exercise on fall and risk.||MDPI Publisher of Open Journals||Effect of multimodal on prevention of falls.||Risk falls. |
|7.||Use of robotics in falls prevention.||CINAHL||Use of robotics in curbing prevention of falls.||Effective programs |
Use of robotics.
|Use of robotic in increasing knowledge.||Two|
|8.||Intervention comparison in prevention of falls.||MEDLINE||Analysis of intervention comparison.||Intervention comparison.||Comparison interventions.||seven|
Level of Evidence and Justification Presented
The study covers level one evidence since there is randomized controlled trials that have been analyzed among elderly in regards to prevention of falls. Falls are considered to be the most cause of injury to the elderly in the community. Falls are due to changes in vestibular, somatosensory and visual functions, which hinders balance in the elderly. For instance, researchers suggest that falls cause hip fractures leading to a percentage of 90%, increasing the cost of hospitalization (Thomas et al., 2017). The integrated model for rehabilitation regards interventions that lead to a reduction of risk factors. The elderly who practice regular exercise are entitled to a decrease in falls since their bones and muscles are strengthened, hence establishing balance during falls. The evidence for the use of exercises is extracted from nine studies that were randomized since 1996. Researchers suggest activity appears to be a lucrative intervention in preventing falls.
The study illustrates level one evidence since there are two systematic reviews in seven randomized controlled trials. Recent studies have portrayed how regular exercise prevent falls among the elderly. In the study conducted the main objective was to ascertain whether current evidence in research findings support the effect of physical activity in reducing falls. Control trials that were randomized included 781 patients; four had cognitive impairment (Chan et al., 2015). After the meta-analysis in seven trials conducted, analysts concluded physical exercise has a positive influence on the prevention of falls among the elderly.
The study covers evidence level five evidence since there is systematic review from meta-analysis conducted by researchers. Evidence regarding the most therapeutic physical exercise for the elderly continues to be a debate by researchers suggesting different activities. The aim of the study was to assess the diversity of physical movements using a reviewed meta-analysis of practical intervention exercises (Tricco et al., 2017). The study included 56 meta-analyses that considered by the researchers in regards to sample size, population, interventions and outcomes. The review identified exercise-based video games to be the most therapeutic form of activities that the elderly enjoyed performing. The study ascertained physical activities were helpful in the prevention of falls as the elderly were motivated in performing the exercises (Di Lorito et al., 2021). Additionally, the review identified some gaps in previous researches that entailed a lack of studies evaluating essential group interventions.
The study captures level one evidence since a systematic review of eight clinical trials were analyzed by the researchers. Cognitive impairments are regarded as a predisposing factor of falls as compared to non-impaired. To reduce the number of falls, physical and cognitive interventions should be developed and instituted for the elderly in curbing falls. The main objective of the study was to identify the impact of physical and cognitive interventions. Eight clinical trials were included in the review to scrutinize the effect of physical exercises and cognitive interventions (Booth et al., 2016). The researchers in the study suggested that physical exercise impacted the elderly positively by providing gait speed, functioning mobility and balance, thus reducing the risk of falls.
Evidence level one is used in the study as an evaluation of five systematic studies are conducted. Falls among the elderly are the leading cause of morbidity and mortality in the United States. The main objective of the study was to offer preventive services geared towards preventing falls among the elderly living in the community. The study found evidence use of exercise was therapeutic and prevented falls (Guirguis-Blake et al., 2018). The study utilized five studies assessing physical activity and three studies evaluating tai chi. Additionally, the study did not find any importance in supplementing vitamin D to the elderly. The effective physical exercise included offering individual, physical therapy and group classes.
The study uses level five evidence because quasi-experimental outcomes are determined by the use of structured questionnaires. The study evidence is considered to be level three since quasi was in use. The study’s aim was to assess and evaluate the effectiveness of using the robotic program on exercise, knowledge and balance. The study evidenced significant knowledge improvement that aided the elderly in preventing falls. Researchers suggest an increase in knowledge among the elderly results in to increase in physical activity (Maneeprom et al., 2019). The researchers justified that implementation of a robotic program in regards to fall prevention among the elderly increases knowledge that is essential in promoting physical exercise.
The study used level six evidence since only a single descriptive control was conducted where each health care worker was evaluating three patients. The researchers in the study aimed to evaluate how short and medium effects of a multimodal program that entailed the use of physical activities influenced falls. The study recorded falls were regarding balance, gait and bone density was measured (Puente-González et al., 2021). The survey ascertained use of a multimodal program produced a positive influence on balance, gait and mineral density of bones in the elderly. The evidence illustrated in the study is level one since evaluation of studies was conducted. Falls among the elderly seems to be a matter of concern and needs critical intervention by health care workers to reduce the risk of falls, emergency room visits and cut down the cost during hospitalization.
Booth, V., Hood, V., & Kearney, F. (2016). Interventions incorporating physical and cognitive elements to reduce falls risk in cognitively impaired older adults: A systematic review. JBI Database of Systematic Reviews and Implementation Reports, 14(5), 110–135. Web.
Chan, W. C., Yeung, J. W., Wong, C. S., Lam, L. C., Chung, K. F., Luk, J. K., Lee, J. S., & Law, A. C. (2015). Efficacy of physical exercise in preventing falls in older adults with cognitive impairment: a systematic review and meta-analysis. Journal of the American Medical Directors Association, 16(2), 149–154. Web.
Di Lorito, C., Long, A., Byrne, A., Harwood, R. H., Gladman, J., Schneider, S., Logan, P., Bosco, A., & van der Wardt, V. (2021). Exercise interventions for older adults: A systematic review of meta-analyses. Journal of Sport and Health Science, 10(1), 29–47. Web.
Guirguis-Blake, J. M., Michael, Y. L., Perdue, L. A., Coppola, E. L., Beil, T. L., & Thompson, J. H. (2018). Interventions to prevent falls in community-dwelling older adults: A systematic review for the U.S. Preventive Services Task Force. Agency for Healthcare Research and Quality (U.S.). Web.
Maneeprom, N., Taneepanichskul, S., Panza, A., & Suputtitada, A. (2019). Effectiveness of robotics fall prevention program among elderly in senior housings, Bangkok, Thailand: A quasi-experimental study. Clinical Interventions in Aging, 14, 335–346. Web.
Puente-González, A. S., Sánchez-Sánchez, M. C., Fernández-Rodríguez, E. J., Hernández-Xumet, J. E., Barbero-Iglesias, F. J., & Méndez-Sánchez, R. (2021). Effects of 6-month multimodal physical exercise program on bone mineral density, fall risk, balance, and gait in patients with Alzheimer’s Disease: A controlled clinical trial. Brain Sciences, 11(1), 63. Web.
Thomas, E., Battaglia, G., Patti, A., Brusa, J., Leonardi, V., Palma, A., & Bellafiore, M. (2019). Physical activity programs for balance and fall prevention in elderly: A systematic review. Medicine, 98(27). Web.
Tricco, A. C., Thomas, S. M., Veroniki, A. A., Hamid, J. S., Cogo, E., Strifler, L., Khan, P. A., Robson, R., Sibley, K. M., MacDonald, H., Riva, J. J., Thavorn, K., Wilson, C., Holroyd-Leduc, J., Kerr, G. D., Feldman, F., Majumdar, S. R., Jaglal, S. B., Hui, W., & Straus, S. E. (2017). Comparisons of interventions for preventing falls in older adults: A Systematic review and meta-analysis. JAMA, 318(17), 1687–1699. Web.