Arnold Catherine M, Sran Meena M, Harrison Elizabeth L
Catherine M. Arnold, BScPT, MSc, PhD candidate: Associate Professor, School of Physical Therapy, University of Saskatchewan, Saskatoon, Saskatchewan; Graduate student, College of Kinesiology, University of Saskatchewan, Saskatoon, Saskatchewan.
Physiother Can. 2008 Fall;60(4):358-72. doi: 10.3138/physio.60.4.358. Epub 2008 Nov 12.
To evaluate the influence of exercise on falls and fall risk reduction in community-dwelling older adults and to present an updated synthesis of outcome measures for the assessment of fall risk in community-dwelling older adults.
A systematic review was performed, considering English-language articles published from 2000 to 2006 and accessible through MEDLINE, CINAHL, PEDro, EMBASE, and/or AMED. Included were randomized controlled clinical trials (RCTs) that used an exercise or physical activity intervention and involved participants over age 50. Screening and methodological quality for internal validity were conducted by two independent reviewers.
The search retrieved 156 abstracts; 22 articles met the internal validity criteria. Both individualized and group exercise programmes were found to be effective in reducing falls and fall risk. The optimal type, frequency, and dose of exercise to achieve a positive effect have not been determined. A variety of outcome measures have been used to measure fall risk, especially for balance.
Falls and fall risk can be reduced with exercise interventions in the community-dwelling elderly, although the most effective exercise variables are unknown. Future studies in populations with comorbidities known to increase fall risk will help determine optimal, condition-specific fall-prevention programmes. Poor balance is a key risk factor for falls; therefore, the best measure of this variable should be selected when evaluating patients at risk of falling.
评估运动对社区居住的老年人跌倒及跌倒风险降低的影响，并对评估社区居住老年人跌倒风险的结局指标进行最新综述。
进行了一项系统综述，纳入2000年至2006年发表且可通过MEDLINE、CINAHL、PEDro、EMBASE和/或AMED获取的英文文章。纳入的是采用运动或身体活动干预且涉及50岁以上参与者的随机对照临床试验（RCT）。由两名独立评审员对内部效度的筛选和方法学质量进行评估。
检索到156篇摘要；22篇文章符合内部效度标准。发现个体化和团体运动计划在减少跌倒及跌倒风险方面均有效。尚未确定实现积极效果的最佳运动类型、频率和剂量。已使用多种结局指标来测量跌倒风险，尤其是平衡方面。
通过运动干预可降低社区居住老年人的跌倒及跌倒风险，尽管最有效的运动变量尚不清楚。未来针对已知会增加跌倒风险的合并症人群进行的研究将有助于确定最佳的、针对具体情况的跌倒预防计划。平衡能力差是跌倒的关键风险因素；因此，在评估有跌倒风险的患者时应选择该变量的最佳测量指标。
