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降低跌倒风险的老年人跌倒相关伤害的策略:安全跌倒训练研究

Strategies to Minimize Fall-related Injuries in Older Adults at Risk of Falls: The Falling Safely Training Study.

作者信息

Zanotto Tobia, Chen Lingjun, Fang James R, Tabatabaei Abbas, He Jianghua, Bhattacharya Shelley B, Alexander Neil B, Sosnoff Jacob J

机构信息

Department of Occupational Therapy Education, School of Health Professions, University of Kansas Medical Center, Kansas City, Kansas, USA.

Landon Center on Aging, University of Kansas Medical Center, Kansas City, Kansas, USA.

出版信息

J Gerontol A Biol Sci Med Sci. 2025 Jun 10;80(7). doi: 10.1093/gerona/glaf076.


DOI:10.1093/gerona/glaf076
PMID:40243432
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12199160/
Abstract

BACKGROUND: Falls are the leading cause of accidental injury among older adults. Current fall prevention programs are useful but do not target the key variable for injury (ie, impact force). An approach, which has shown promise in robust older adults, is to teach safe-falling strategies to reduce impact forces. In this single-anonymized, pilot randomized controlled trial, we explored the feasibility and preliminary efficacy of a safe-falling program. METHODS: Twenty-four older adults at risk of injurious falls were randomly assigned either to Falling Safely Training (FAST), a standardized progressive training of safe-falling strategies, or an active control group consisting of evidence-based balance training. Participants underwent a series of experimentally induced falls at baseline, after the 4-week intervention, and 3 months after the intervention. Hip and head acceleration (proxies of impact force) and the number of head impacts experienced during the falls were collected. RESULTS: No adverse events were reported, and 11 of 12 FAST participants completed the intervention. The FAST group had a greater reduction in the number of fall-related head impacts following the intervention (odds ratio = 0.10, 95% CI: 0.02, 0.61, p = .012). This improvement coincided with a significant reduction in head acceleration in the FAST group compared to control (between-group mean difference = -9.54 m/s2, p = .028). Hip acceleration decreased significantly in both groups (ps < .001). CONCLUSIONS: Teaching older adults at risk of falls safe-falling strategies is safe and feasible and has the potential to minimize fall-related head impacts and reduce fall morbidity.

摘要

背景:跌倒是老年人意外伤害的主要原因。目前的预防跌倒计划很有用,但并未针对损伤的关键变量(即冲击力)。一种在身体健壮的老年人中已显示出前景的方法是教授安全跌倒策略以降低冲击力。在这项单盲、试点随机对照试验中,我们探讨了安全跌倒计划的可行性和初步疗效。 方法:24名有跌倒致伤风险的老年人被随机分配到安全跌倒训练(FAST)组,即一种标准化的安全跌倒策略渐进式训练,或由循证平衡训练组成的积极对照组。参与者在基线、4周干预后以及干预后3个月接受了一系列实验诱导的跌倒。收集跌倒期间的髋部和头部加速度(冲击力的替代指标)以及头部撞击次数。 结果:未报告不良事件,12名FAST参与者中有11名完成了干预。干预后,FAST组与跌倒相关的头部撞击次数减少得更多(优势比=0.10,95%CI:0.02,0.61,p=0.012)。与对照组相比,FAST组头部加速度显著降低,这一改善与之相符(组间平均差异=-9.54m/s²,p=0.028)。两组的髋部加速度均显著降低(p<0.001)。 结论:向有跌倒风险的老年人教授安全跌倒策略是安全可行的,并且有可能将与跌倒相关的头部撞击降至最低并降低跌倒发病率。

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引用本文的文献

[1]
Fall Injury Avoidance Strategy Scale (FIAS) - Development and Validation of a Scale to Quantify Fall-Related Protective Movements.

medRxiv. 2025-7-23

本文引用的文献

[1]
Role of the Upper Limb in Limiting Head Impact During Laboratory-Induced Falls in at Fall-Risk Older Adults.

J Gerontol A Biol Sci Med Sci. 2024-12-11

[2]
Views and experiences of older people taking part in a safe-falling training program: Lessons learned from the FAlling Safely Training (FAST) trial.

BMC Geriatr. 2024-10-11

[3]
Interventions to Prevent Falls in Community-Dwelling Older Adults: US Preventive Services Task Force Recommendation Statement.

JAMA. 2024-7-2

[4]
Population-based interventions for preventing falls and fall-related injuries in older people.

Cochrane Database Syst Rev. 2024-1-5

[5]
Minimizing fall-related injuries in at-risk older adults: The falling safely training (FAST) study protocol.

Contemp Clin Trials Commun. 2023-4-11

[6]
Protective responses of older adults for avoiding injury during falls: evidence from video capture of real-life falls in long-term care.

Age Ageing. 2022-12-5

[7]
High Challenge Exercise and Learning Safe Landing Strategies among Community-Dwelling Older Adults: A Randomized Controlled Trial.

Int J Environ Res Public Health. 2022-6-16

[8]
Injuries from falls by older adults in long-term care captured on video: Prevalence of impacts and injuries to body parts.

BMC Geriatr. 2022-4-19

[9]
Fall arrest strategy training improves upper body response time compared to standard fall prevention exercise in older women: A randomized trial.

Clin Rehabil. 2022-7

[10]
Evaluation of Clinical Practice Guidelines on Fall Prevention and Management for Older Adults: A Systematic Review.

JAMA Netw Open. 2021-12-1

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