Falls exercise interventions and reduced falls rate: always in the patient's interest?

Age and Ageing
A H LaybourneF C Martin

Abstract

Falls are a leading cause of mortality and morbidity in older adults. Physical, psychological and social consequences include injury, fall-related fear and loss of self-efficacy. In turn, these may result in decreased physical activity, reduced functional capacity, and increased risk of institutionalisation. Falls prevention exercise programmes (FPEP) are now widespread within the National Health Service, often part of multifactorial interventions, and are designed to minimise impairments that impact physical function, such as strength and balance. Assessment of the clinical efficacy of FPEPs has therefore focused on the measurement of physical function and rate of falls. Whilst important, this approach may be too narrow to capture the highly variable and multidimensional responses that individuals make to a fall and to a FPEP. We argue that the current focus may miss a paradoxical lack of or even deleterious impact on quality of life, despite a reduction in physical performance-related falls risk. We draw upon the Selective Optimisation and Compensation (SOC) model, developed by Paul and Margret Baltes, to explore how this paradox may be a result of the coping strategies adopted by individuals in response to a fall.

Citations

Mar 2, 2011·Canadian Journal on Aging = La Revue Canadienne Du Vieillissement·Samuel R Nyman
Jan 10, 2014·International Journal of Environmental Research and Public Health·Sebastien F M ChastinNatalie DiCroce
Mar 15, 2014·American Journal of Public Health·Steven M AlbertAnne B Newman
Jan 31, 2008·International Journal of Geriatric Psychiatry·Dawn M DalbyColleen J Maxwell
Aug 26, 2010·Clinical Nursing Research·Kathy L RushJanice Stanbury
Jun 28, 2014·Qualitative Health Research·James A ShawCarol L McWilliam
May 25, 2013·Global Health Promotion·Patricia Dargent-MolinaBernard Cassou
Nov 25, 2017·British Journal of Health Psychology·Phillip GrayEllen Elizabeth Anne Simpson
Jun 1, 2011·Scandinavian Journal of Caring Sciences·Marianne Mahler, Anneli Sarvimäki
Feb 26, 2010·Journal of Aging and Physical Activity·Simone NicolaiUlrich Lindemann
Jul 6, 2011·Journal of Aging and Physical Activity·Anne H LaybourneFinbarr C Martin

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