From the Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan (C-HL, H-CC, T-HL, S-CC); Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Taipei, Taiwan (C-HL, WL, S-CC); and Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan (H-CC, T-HL).
Am J Phys Med Rehabil. 2019 Oct;98(10):921-930. doi: 10.1097/PHM.0000000000001247.
Fall prevention requires a multifaceted approach that should include individual risk assessment and intervention strategies. Exercise interventions may mitigate most risk factors for falls (eg, balance impairment, gait impairment, and muscle weakness). Numerous systematic reviews or meta-analyses have assessed the effectiveness of exercise interventions among people with various types of neurological disorders; however, the evidence obtained has not been synthesized into an overview. Therefore, the present systematic review assessed systematic reviews of exercise intervention for fall prevention among people with neurological disorders. The research sources were the Cochrane Database of Systematic Reviews, PubMed, and Embase. Eligible studies were selected, and data were extracted independently by two reviewers. A total of 15 studies (six systematic reviews and nine meta-analyses) were included. These systematic reviews examined in this study have demonstrated that exercise interventions reduced the number, frequency, and rate of falls among people with neurological disorders, including cognitive impairment, dementia, and Parkinson disease. Furthermore, the current study presented insufficient evidence regarding the effectiveness of exercise interventions for fall prevention among people with stroke, multiple sclerosis, and diabetes mellitus with polyneuropathy. Therefore, additional investigations are necessary to evaluate the effectiveness of exercise for fall prevention among people with multiple sclerosis, stroke, and diabetes mellitus with polyneuropathy.
预防跌倒需要采取多方面的方法，其中应包括个体风险评估和干预策略。运动干预可能会减轻大多数跌倒风险因素（例如，平衡障碍、步态障碍和肌肉无力）。许多系统评价或荟萃分析评估了运动干预对各种神经障碍患者跌倒预防的有效性；然而，所获得的证据尚未综合为概述。因此，本系统评价评估了针对神经障碍患者跌倒预防的运动干预的系统评价。研究来源是 Cochrane 系统评价数据库、PubMed 和 Embase。合格的研究由两名评审员独立选择和提取数据。共有 15 项研究（6 项系统评价和 9 项荟萃分析）入选。本研究中检查的这些系统评价表明，运动干预可减少神经障碍患者（包括认知障碍、痴呆和帕金森病）的跌倒次数、频率和发生率。此外，目前的研究对于运动干预预防卒中、多发性硬化症和糖尿病多发性神经病患者跌倒的有效性提供的证据不足。因此，需要进一步的研究来评估运动对多发性硬化症、卒中以及糖尿病多发性神经病患者跌倒预防的有效性。
