Department of Community Health Sciences Rady Faculty of Health Sciences, University of Manitoba, 379- 753 McDermot Avenue, Winnipeg, MB, R3E 0W3, Canada.
George and Fay Yee Centre for Healthcare Innovation, 379- 753 McDermot Avenue, Winnipeg, MB, R3E 0W3, Canada.
BMC Geriatr. 2019 Jul 29;19(1):201. doi: 10.1186/s12877-019-1224-x.
Effective fall prevention exercise for community-dwelling older adults requires (i) challenging balance exercise, (ii) offered at least 3 hrs/ week, and (iii) on an ongoing basis, to reduce falls. Community exercise programs are a potential implementation strategy for fall prevention exercise; however, the extent to which they address balance and include effective fall prevention exercise is unknown. Study objectives were to describe program delivery, exercise design, and assessment characteristics of older adult community exercise programs in Winnipeg, Canada; determine if they included effective fall prevention exercise; determine the balance challenge and components of postural control addressed in the most- and least-frequently reported exercises.
A public inventory of older adult community exercise programs served as the sampling frame for cross-sectional telephone questionnaires exploring program, exercise, and assessment characteristics. Exercises were coded independently by two investigators for balance challenge level and components of postural control. Programs were categorized by number of effective fall prevention exercise components established by evidence-based recommendations. Descriptive statistics were calculated.
Thirty-three eligible programs were identified and nine individuals participated. Most programs (n = 5, 56%) identified as general exercise, and two (22%) as fall prevention exercise. Most programs (n = 5, 56%) were offered two or more times/ week and reported exercise intensity as somewhat challenging. Exercise time offered ranged between 1 and 3 h/ week. Assessments were conducted in two programs (22%). Only one program (general exercise) included all components of effective fall prevention exercise. Two programs (22%) included the component of being offered at least 3 hrs/ week. Three programs (33%) included the component of being offered on an ongoing basis. Seven programs (78%) prescribed mostly moderate challenge balance exercise, and one program (11%) prescribed mostly high challenge exercise. Most of the 19 most-frequently prescribed exercises (n = 17, 89%) targeted static stability and none targeted reactive postural control.
Most of the older adult community exercise programs participating in this study did not focus on fall prevention, and did not include all components of effective fall prevention exercise. Future studies should focus on fall prevention programs and explore factors influencing implementation of effective fall prevention exercise components to facilitate planning.
有效的社区居住老年人防跌锻炼需要（i）具有挑战性的平衡锻炼，（ii）每周至少 3 小时，以及（iii）持续进行，以减少跌倒。社区锻炼计划是预防跌倒锻炼的一种潜在实施策略；然而，它们在多大程度上解决平衡问题并包含有效的防跌锻炼尚不清楚。研究目的是描述加拿大温尼伯市老年人社区锻炼计划的方案交付、运动设计和评估特点；确定它们是否包含有效的防跌锻炼；确定在报告最多和最少的练习中涉及的平衡挑战和姿势控制的组成部分。
老年人社区锻炼计划的公共清单作为横断面电话问卷调查的抽样框架，调查计划、运动和评估特点。两名调查员独立对运动的平衡挑战水平和姿势控制的组成部分进行编码。根据循证建议确定的有效防跌锻炼成分数量对方案进行分类。计算描述性统计数据。
确定了 33 个符合条件的方案，有 9 人参加。大多数方案（n=5，56%）被确定为一般锻炼，2 个（22%）为防跌锻炼。大多数方案（n=5，56%）每周提供两次或更多次，报告运动强度为有点挑战性。提供的锻炼时间在每周 1 至 3 小时之间。有两个方案（22%）进行了评估。只有一个方案（一般锻炼）包含所有有效的防跌锻炼组成部分。有两个方案（22%）包含每周至少提供 3 小时的组成部分。有三个方案（33%）包含持续提供的组成部分。有七个方案（78%）规定了主要是中等挑战的平衡运动，一个方案（11%）规定了主要是高挑战的运动。19 个最常规定的运动中的大多数（n=17，89%）针对静态稳定性，没有一个针对反应性姿势控制。
参与本研究的大多数老年人社区锻炼计划并不关注防跌，也不包含所有有效的防跌锻炼组成部分。未来的研究应侧重于防跌计划，并探讨影响有效防跌锻炼组成部分实施的因素，以促进计划的制定。
