Sherrington C, Lord S R, Finch C F
Prince of Wales Medical Research Institute, The University of New South Wales, Australia.
J Sci Med Sport. 2004 Apr;7(1 Suppl):43-51. doi: 10.1016/s1440-2440(04)80277-9.
Injuries resulting from falls are a significant public health issue, particularly for older people. This review provides an update of the evidence on the effects of various physical activity (PA) or exercise intervention strategies for the prevention of unintentional falls among older people. Six systematic reviews, and three randomised controlled trials not incorporated in previous reviews, were located with a literature search. There is clear evidence that a targeted supervised home exercise program of strength and balance exercise and walking practice, prescribed by a trained health professional, can prevent falls among older community dwellers. There is also an indication that untargeted group exercise (ie, not individually prescribed) can prevent falls among community dwellers, particularly if it involves Tai Chi or other exercises which challenge balance. There is some indication that individual prescription of PA is more important in frailer groups. Further investigation is required to establish the effects of PA in residential aged care, and the relative effects of different types of PA in different populations. In addition, multidisciplinary, multifactorial. health/environmental risk factor screening/intervention programs have been found to be effective in preventing falls. For many individuals with physical risk factors for falls (eg, impaired strength, balance or functional ability), PA alone is likely to reduce the risk of falls. For those with additional risk factors (eg, visual impairments, psychoactive medication use), other interventions may also be required.
跌倒造成的伤害是一个重大的公共卫生问题，对老年人而言尤为如此。本综述更新了有关各种身体活动（PA）或运动干预策略对预防老年人意外跌倒效果的证据。通过文献检索找到了六项系统综述以及三项未纳入先前综述的随机对照试验。有明确证据表明，由训练有素的健康专业人员制定的针对力量、平衡训练和步行练习的有针对性的家庭监督锻炼计划，可以预防老年社区居民跌倒。也有迹象表明，无针对性的团体运动（即非个性化定制）可以预防社区居民跌倒，特别是如果它涉及太极拳或其他挑战平衡的运动。有一些迹象表明，在身体较为虚弱的人群中，PA的个性化定制更为重要。需要进一步研究以确定PA在老年护理机构中的效果，以及不同类型的PA在不同人群中的相对效果。此外，多学科、多因素的健康/环境风险因素筛查/干预计划已被证明在预防跌倒方面是有效的。对于许多有跌倒身体风险因素（如力量、平衡或功能能力受损）的个体，仅PA可能会降低跌倒风险。对于那些有其他风险因素（如视力障碍、使用精神活性药物）的个体，可能还需要其他干预措施。
