• Dtsch Arztebl Int · May 2016

    Randomized Controlled Trial

    Fall Prevention in a Primary Care Setting.

    • Monika Siegrist, Ellen Freiberger, Barbara Geilhof, Johannes Salb, Christian Hentschke, Peter Landendoerfer, Klause Linde, Martin Halle, and Wolfgang A Blank.
    • Department of Prevention, Rehabilitation and Sports Medicine, Technische Universität München, Munich, Germany, Institute for Biomedicine of Aging, Universität Erlangen-Nürnberg, Nürnberg, Germany, Institute of Sport Science and Sport, Universität Erlangen-Nürnberg, Nürnberg, Germany, Institute of General Practice, Technische Universität München, Munich, Germany, DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany d Else Kröner-Fresenius-Zentrum, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
    • Dtsch Arztebl Int. 2016 May 27; 113 (21): 365-72.

    BackgroundFalls and fall-related injuries are common in community-dwelling elderly people. Effective multifactorial fall prevention programs in the primary care setting may be a promising approach to reduce the incidence rate of falls.MethodsIn a cluster randomized trial in 33 general practices 378 people living independently and at high risk of falling (65 to 94 years old; 285 women) were allocated to either a 16 week exercise-based fall prevention program including muscle strengthening and challenging balance training exercises, combined with a 12 week home-based exercise program (222 participants), or to usual care (156 participants). The main outcome was number of falls over a period of 12 months. Secondary outcomes were the number of fall-related injuries, physical function (Timed-Up-and-Go-Test, TUG, Chair-Stand-Test, CST, modified Romberg Test), and fear of falling.ResultsIn the intervention group (n=222 patients in 17 general practices) 291 falls occurred, compared to 367 falls in the usual care group (n=156 patients in 16 general practices). We observed a lower incidence rate for falls in the intervention group (incidence rate ratio/IRR: 0.54; 95% confidence interval (CI): [0.35; 0.84], p=0.007) and for fall-related injuries (IRR: 0.66; [0.42; 0.94], p=0.033). Additionally, patients in the intervention group showed significant improvements in secondary endpoints (TUG: -2.39 s, [-3.91; -0.87], p=0.014; mRomberg: 1.70 s, [0.35; 3.04], p=0.037; fear of falling: -2.28 points, [-3.87; -0.69], p=0.022) compared to usual care.ConclusionA complex falls prevention program in a primary care setting was effective in reducing falls and fall-related injuries in community dwelling older adults at risk.

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