Journal of rehabilitation research and development
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Physical activity (exercise) serves primary, secondary, and tertiary roles in the prevention of falls among older adults. In its primary role, physical activity can prevent the onset of pathology and system impairments that lead to disability and increased risk for falls. Slowing the progression of disease and system impairments is its secondary role, while its tertiary role lies in the restoration of function to a level that allows for more autonomy in the performance of essential activities of daily living. ⋯ As the level of risk increases, however, more tailored and progressive exercise programs that target the physical risk factors associated with falls are more effective in lowering fall risk. Adopting a multifactorial intervention approach with exercise as an integral component may also be necessary at the highest levels of risk. Although more labor intensive, multifactorial approaches, if carefully staged, should still be considered the most effective intervention approach for older adults identified at high risk for falls.
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The objective of this study was to summarize the evidence on the accuracy of screening tools for predicting falling risk in community-living older adults. This study was designed as a systematic review. Prospective studies of clinical fall risk prediction tools that provided data on the number of participants who sustained falls during follow-up were included. ⋯ Most tools discriminated poorly between fallers and nonfallers. We found that existing studies are methodologically variable and the results are inconsistent. Insufficient evidence exists that any screening instrument is adequate for predicting falls.
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The Department of Veterans Affairs Veterans Health Administration cares for approximately 15% of persons with spinal cord injury (SCI) in the United States. However, the nature and characteristics of pain among veterans with SCI are not well understood. This study used a postal survey to compare veterans with SCI and nonveterans with SCI on pain intensity; pain interference; functioning; and other pain, demographic, and medical characteristics. ⋯ However, differences in functioning between veterans and nonveterans were attributable to age differences between the groups. In summary, differences between veterans with SCI and nonveterans with SCI were few and small in magnitude, suggesting that veterans with SCI are not at greater risk for pain and pain-related problems. However, pain-related catastrophizing may be a particular concern among veterans with SCI.