Archives of Physical Medicine and Rehabilitation
Volume 89, Issue 10 , Pages 1948-1957 , October 2008

Impact of a Multifaceted Community-Based Falls Prevention Program on Balance-Related Psychologic Factors

  • Johanne Filiatrault, OT, PhD

      Affiliations

    • Institut national de santé publique du Québec, Montreal, QC, Canada
    • École de réadaptation, Université de Montréal, Montreal, QC, Canada
    • Groupe de recherche interdisciplinaire en santé, Montreal, QC, Canada
    • Corresponding Author InformationReprint requests to Johanne Filiatrault, OT, PhD, Université de Montréal, Faculté de médecine, École de réadaptation, CP 6128, succursale Centre-ville, Montreal, QC H3C 3J7, Canada
    • ,
  • Lise Gauvin, PhD

      Affiliations

    • Département de médecine sociale et préventive, Université de Montréal, Montreal, QC, Canada
    • Groupe de recherche interdisciplinaire en santé, Montreal, QC, Canada
    • Centre de recherche Léa-Roback sur les inégalités sociales de santé de Montréal, Montreal, QC, Canada
    • ,
  • Lucie Richard, PhD

      Affiliations

    • Faculté des sciences infirmières, Université de Montréal, Montreal, QC, Canada
    • Groupe de recherche interdisciplinaire en santé, Montreal, QC, Canada
    • Centre de recherche Léa-Roback sur les inégalités sociales de santé de Montréal, Montreal, QC, Canada
    • Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montreal, QC, Canada
    • ,
  • Yvonne Robitaille, PhD

      Affiliations

    • Institut national de santé publique du Québec, Montreal, QC, Canada
    • Département de médecine sociale et préventive, Université de Montréal, Montreal, QC, Canada
    • Department of Epidemiology and Biostatistics, McGill University, Montreal, QC, Canada
    • ,
  • Sophie Laforest, PhD

      Affiliations

    • Département de kinésiologie, Université de Montréal, Montreal, QC, Canada
    • Groupe de recherche interdisciplinaire en santé, Montreal, QC, Canada
    • Centre de santé et de services sociaux Cavendish-Centre affilié universitaire en gérontologie sociale, Montreal, QC, Canada
    • ,
  • Michel Fournier, MA

      Affiliations

    • Direction de santé publique de Montréal, Montreal, QC, Canada
    • ,
  • Hélène Corriveau, PT, PhD

      Affiliations

    • Département de réadaptation, Université de Sherbrooke, Sherbrooke, QC, Canada
    • Centre de recherche sur le vieillissement, Institut universitaire de gériatrie de Sherbrooke, Sherbrooke, QC, Canada

References 

  1. Barnett A, Smith B, Lord SR, Williams M, Baumand A. Community-based group exercise improves balance and reduces falls in at-risk older people: a randomised controlled trial. Age Ageing. 2003;32:407–414
  2. Campbell AJ, Robertson MC, Gardner MM, Norton RN, Tilyard MW, Buchner DM. Randomized controlled trial of a general practice programme of home based exercise to prevent falls in elderly women. BMJ. 1997;315:1065–1069
  3. Chang JT, Morton SC, Rubenstein LZ, et al. Interventions for the prevention of falls in older adults: systematic review and meta-analysis of randomised clinical trials. BMJ. 2004;328:680–683
  4. Day L, Fildes B, Gordo I, Fitzharris M, Flamer H, Lord S. Randomised factorial trial of falls prevention among older people living in their own homes. BMJ. 2002;325:128–131
  5. Gardner MM, Robertson MC, Campbell AJ. Exercise in preventing falls and fall-related injuries in older people: a review of randomised controlled trials. Br J Sports Med. 2000;34:7–17
  6. Province MA, Hadley EC, Hornbrook MC, et al. The effects of exercise on falls in elderly patients: a preplanned meta-analysis of the FICSIT trials. JAMA. 1995;273:1341–1347
  7. Robertson MC, Devlin N, Gardner MM, Campbell AJ. Effectiveness and economic evaluation of a nurse delivered home exercise programme to prevent falls, 1: randomised controlled trial. BMJ. 2001;322:697–701
  8. Robitaille Y, Laforest S, Fournier M, et al. Moving forward in fall prevention: an intervention to improve balance among older adults in real-world settings. Am J Public Health. 2005;95:2049–2056
  9. Filiatrault J, Gauvin L, Laforest S, Robitaille Y, Richard L, Corriveau H. Impact des interventions préventives destinées aux aînés sur les facteurs psychologiques associés aux chutes: à la recherche de données probantes. Abstract presented to La pratique factuelle en réadaptation, Journée scientifique du REPAR/FRSQ; 2008 May 9; Montreal (QC). Recueil des abrégés des affiches présentées par les étudiants et les cliniciens du Réseau, p 8.
  10. Zijlstra GA, van Haastregt JC, van Rossum E, van Eijk JT, Yardley L, Kempen GI. Interventions to reduce fear of falling in community-living older people: a systematic review. J Am Geriatric Soc. 2007;55:603–615
  11. Cumming RG, Salkeld G, Thomas M, Szonyi G. Prospective study of the impact of fear of falling on activities of daily living, SF-36 scores, and nursing home admission. J Gerontol A Biol Sci Med Sci. 2000;55:M299–M305
  12. Delbaere K, Crombez G, Vanderstraeten G, Willems T, Cambier D. Fear-related avoidance of activities, falls and physical frailty: a prospective community-based cohort study. Age Ageing. 2004;26:1–6
  13. Friedman SM, Munoz B, West SK, Rubin GS, Fried LP. Falls and fear of falling: which comes first? (A longitudinal prediction model suggests strategies for primary and secondary prevention). J Am Geriatr Soc. 2002;50:1329–1335
  14. Arfken CL, Lach HW, Birge SJ. The prevalence and correlates of fear of falling in elderly persons living in the community. Am J Public Health. 1994;84:565–570
  15. Gagnon N, Flint AJ, Naglie G, Devins GM. Affective correlates of fear of falling in elderly persons. Am J Geriatr Psychiatry. 2005;13:7–14
  16. Howland J, Peterson EW, Levin WC, Fried L, Pordon D, Bak S. Fear of falling among the community-dwelling elderly. J Aging Health. 1993;5:229–243
  17. Howland J, Lachman ME, Peterson EW. Covariates of fear of falling and associated activity curtailment. Gerontologist. 1998;38:549–555
  18. Li F, Fisher KJ, Harmer P, McAuley E, Wilson NL. Fear of falling in elderly persons: association with falls, functional ability, and quality of life. J Gerontol B Psychol Sci Soc Sci. 2003;58:P283–P290
  19. Mendes de Leon CF, Seeman TE, Baker DI, Richardson ED, Tinetti ME. Self-efficacy, physical decline, and change in functioning in community-living dwellers: a prospective study. J Gerontol B Psychol Sci Soc Sci. 1996;51:S183–S190
  20. Tinetti ME, Mendes de Leon CF, Doucette JT, Baker DI. Fear of falling and fall-related efficacy in relationship to functioning among community-living elders. J Gerontol A Biol Sci Med Sci. 1994;49:M140–M147
  21. Zijlstra GA, van Haastregt JC, van Eijk JT, van Rossum E, Stalenhoef PA, Kempen GI. Prevalence and correlates of fear of falling, and associated avoidance of activity in the general population of community-living older people. Age Ageing. 2007;36:304–309
  22. McCormack G, Lewin G, McCormack B, Helmes E, Rose E, Naumann F. Pilot study comparing the influence of different types of exercise intervention on the fear of falling in older adults. Aust J Ageing. 2004;23:131–135
  23. Fletcher PC, Hirdes JP. Restriction in activity associated with fear of falling among community-based seniors using home care services. Age Ageing. 2004;33:272–279
  24. Murphy SL, Williams CS, Gill TM. Characteristics associated with fear of falling and activity restriction in community-living older persons. J Am Geriatr Soc. 2002;50:516–520
  25. Downton JH, Andrews K. Postural disturbance and psychological symptoms amongst elderly people living at home. Int J Geriatr Psychiatry. 1990;5:93–98
  26. Lach HW. Fear of falling: an emerging public health problem. Generations. 2002;26:33–37
  27. Legters K. Fear of falling. Phys Ther. 2002;82:264–272
  28. Glasgow RE, Lichtenstein E, Marcus AC. Why don't we see more translation of health promotion research to practice? (Rethinking the efficacy-to-effectiveness transition). Am J Public Health. 2003;93:1261–1267
  29. Victora CG, Habicht JP, Bryce J. Evidence-based public health: moving beyond randomized trials. Am J Public Health. 2004;94:400–405
  30. Prohaska T, Belansky E, Belza B, et al. Physical activity, public health, and aging: critical issues and research priorities. J Gerontol B Psychol Sci Soc Sci. 2006;61:S267–S273
  31. Sanson-Fisher RW, Bonevski B, Green LW, D'Este C. Limitations of the randomized controlled trial in evaluating population-based health interventions. Am J Prev Med. 2007;33:155–161
  32. Filiatrault J, Parisien M, Laforest S, et al. Implementing a community-based falls prevention program: from drawing board to reality. Can J Aging. 2007;26:213–226
  33. Berg KO, Kairy D. Balance interventions to prevent falls. Generations. 2002;26:75–78
  34. Trickey F, Parisien M, Laforest S, Genest C, Robitaille Y. Stand Up! A fall prevention programme for seniors: programme guide. Montreal: Direction de santé publique de Montréal; 2003;
  35. Trickey F, Parisien M, Laforest S, Genest C, Robitaille Y. Programme intégré d'équilibre dynamique – PIED: guide d'animation. Montréal: Direction de santé publique de Montréal; 2002;
  36. Powell LE, Myers AM. The Activities-specific Balance Confidence (ABC) Scale. J Gerontol A Biol Sci Med Sci. 1995;50:M28–M34
  37. Filiatrault J, Gauvin L, Fournier M, et al. Evidence of the psychometric qualities of a simplified version of the Activities-specific Balance Confidence Scale for community-dwelling seniors. Arch Phys Med Rehabil. 2007;88:664–672
  38. Filiatrault J, Robitaille Y, Gauvin L, et al. L'auto-évaluation de l'équilibre: utile en prévention des chutes? Abstract presented to Conférence internationale Vers une nouvelle perspective: du vieillir au bien-vieillir; 2004 Oct 3–5; Montreal (QC). Recueil des résumés de communications, p 49.
  39. O'Loughlin JL, Robitaille Y, Boivin JF, Suissa S. Incidence of and risk factors for falls and injurious falls among the community-dwelling elderly. Am J Epidemiol. 1993;137:342–354
  40. Ware JJ, Sherbourne CD. The MOS 36-item short-form health survey (SF-36), I: conceptual framework and item selection. Med Care. 1992;30:473–483
  41. Gehlson GM, Whaley MH. Falls in the elderly, part II: balance, strength and flexibility. Arch Phys Med Rehabil. 1990;71:739–741
  42. Heitman DK, Gossman MR, Shaddeau SA, Jackson JR. Balance performance and step width in non institutionalized elderly female fallers and non fallers. Phys Ther. 1989;69:923–931
  43. Duncan PW, Weiner DK, Chandler J, Studenski S. Functional reach: a new clinical measure of balance. J Gerontol Bio Sci Med Sci. 1990;45:192–197
  44. Brauer S, Burns Y, Galley P. Lateral reach: a clinical measure of medio-lateral postural stability. Physiother Res Int. 1999;4:81–88
  45. Baloh RW, Fife TD, Zwerling L, et al. Comparison of static and dynamic posturography in young and older normal people. J Am Geriatr Soc. 1994;42:405–412
  46. Franchignoni F, Tesio L, Martino MT, Ricupero C. Reliability of four simple, quantitative tests of balance and mobility in healthy elderly females. Aging Clin Exp Res. 1998;10:26–31
  47. MacKight C, Rockwood K. Assessing mobility in elderly people: a review of performance-based measures of balance, gait and mobility for bedside use. Rev Clin Gerontol. 1995;5:464–486
  48. Hatch J, Gill-Body KM, Portney LG. Determinants of balance confidence in community-dwelling elderly people. Phys Ther. 2003;83:1072–1079
  49. Zhang J-G, Ischikawa-Takata K, Yamazaki H, Morita T, Ohta T. The effects of Tai Chi Chuan on psychological function and fear of falling in the less robust elderly: an intervention study for preventing falls. Arch Gerontol Geriatr. 2005;42:107–116
  50. Li F, Harmer P, Fisher KJ, et al. Tai Chi and falls reductions in older adults: a randomized controlled trial. J Gerontol A Biol Sci Med Sci. 2005;60:M187–M194
  51. Sattin RW, Easley KA, Wolf SL, Chen Y, Kutner MH. Reduction in fear of falling through intense Tai Chi exercise training in older, transitionally frail adults. J Am Geriatr Soc. 2005;53:1168–1178
  52. Weerdesteyn V, Rijken H, Geurts AC, Smits-Engelsman BC, Mulder T, Duysens J. A five-week exercise program can reduce falls and improve obstacle avoidance in the elderly. Gerontology. 2006;52:131–141
  53. Ebrahim S, Thompson PW, Baskaran V, Evans K. Randomized placebo-controlled trial of brisk walking in the prevention of postmenopausal osteoporosis. Age Ageing. 1997;26:253–260
  54. Devereux K, Robertson D, Briffa NK. Effects of a water-based program on women 65 years and over: a randomised controlled trial. Aust J Physiother. 2005;51:102–108
  55. Liu-Ambrose T, Khan KM, Eng JJ, Lord SR, McKay HA. Balance confidence improves with resistance or agility training. Gerontology. 2004;50:373–382
  56. Feder G, Cryer C, Donovan S, Carter Y. Guidelines for the prevention of falls in people over 65. BMJ. 2000;321:1007–1011
  57. American Geriatrics Society, British Geriatrics Society, and American Academy of Orthopaedic Surgeons Panel on Falls Prevention. Guideline for the prevention of falls in older persons. J Am Geriatr Soc. 2001;49:664–672

 Supported by the Canadian Institutes of Health Research (grant no. MOP 53123); the Regional Health and Social Services Boards of Montreal, Laval, and Montérégie, QC; the Fonds de la recherche en santé du Québec (doctoral fellowship); the Ordre des ergothérapeutes du Québec (doctoral fellowship); and the Faculté des études supérieures, Université de Montréal (doctoral fellowship).

 No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.

PII: S0003-9993(08)00463-2

doi: 10.1016/j.apmr.2008.01.031

Archives of Physical Medicine and Rehabilitation
Volume 89, Issue 10 , Pages 1948-1957 , October 2008

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