Clinical and Molecular Osteoporosis Research Unit, Department of Orthopedics and Clinical Sciences, Lund University, Skåne University Hospital, Malmö, Sweden.
Scand J Public Health. 2013 Jul;41(5):442-54. doi: 10.1177/1403494813483215. Epub 2013 Apr 3.
Falls often result in soft tissue injuries, dislocations, fractures, longstanding pain and reduced quality of life. Therefore, fall preventive programmes have been developed.
In this review, we evaluate programmes that in randomized controlled trials (RCT) have been shown with fall reducing effect.
Physical exercise that includes several training modalities, especially balance and strength training, is the only intervention programme that reduces both the number of fallers and the number of falls in community dwellers. Home hazards modification reduces the fall risk in community-living elderly but has the best effects in high risk groups when the programme is led by occupational therapists. Vitamin D supplement in those with low levels of vitamin D, adjustment of psychotropic medication and modification of multi-pharmacy are drug-related programmes that reduce the fall risk. Anti-slip shoe devices in elderly who walk outdoors during icy conditions and multifaceted podiatry to patients with specific foot disability are interventions targeted at the lower extremities with a fall-reducing effect. First eye cataract surgery and pacemakers in patients with cardio-inhibitory carotid sinus hypersensitivity are surgical procedures with fall-reducing effect. Multifactorial standardized preventive programmes that include an exercise component and individually-designed subject-specific programmes also reduce the number of falls.
Fall preventive interventions should be provided to elderly by a structured approach, especially to high risk groups, as to reduce the number of falls and fallers.
跌倒常导致软组织损伤、脱位、骨折、长期疼痛和生活质量下降。因此，已经开发了预防跌倒的方案。
在本综述中，我们评估了在随机对照试验（RCT）中显示出具有降低跌倒效果的方案。
包含多种训练模式的体育锻炼，特别是平衡和力量训练，是唯一一种既能减少跌倒人数又能减少社区居民跌倒次数的干预方案。家庭危险物改造可以降低社区居住的老年人的跌倒风险，但当该方案由职业治疗师主导时，对高风险人群效果最佳。对于维生素 D 水平低的患者补充维生素 D、调整精神药物和多药物调整是降低跌倒风险的药物相关方案。在寒冷天气外出行走的老年人使用防滑鞋装置和针对特定足部残疾的患者进行多方面足病治疗是针对下肢具有降低跌倒效果的干预措施。对于患有心脏抑制性颈动脉窦过敏的患者进行首次白内障手术和起搏器手术是具有降低跌倒效果的手术程序。包含运动成分的多因素标准化预防方案和个体化设计的特定于患者的方案也可以减少跌倒次数。
应该通过结构化方法向老年人提供预防跌倒的干预措施，特别是向高风险人群提供，以减少跌倒人数和跌倒者人数。
