Critical Appraisal on Randomized Factorial Trial of Falls Prevention Among Older People Living in Their Own Homes

Nadia Mahmoud Ali Abuzied

doi:doi:10.11648/j.rs.20180301.14

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Critical Appraisal on Randomized Factorial Trial of Falls Prevention Among Older People Living in Their Own Homes

Nadia Mahmoud Ali Abuzied

Published in Rehabilitation Science (Volume 3, Issue 1)

Received: 12 November 2017 Accepted: 2 January 2018 Published: 23 February 2018

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Abstract

Objective To test the effectiveness of, and explore interactions between, three interventions to prevent falls among older people. Design a randomized controlled trial with a full factorial design. Setting Urban community in Melbourne, Australia. Participants1090 aged 70 years and over and living at home. Most were Australian born and rated their health as good to excellent; just over half lived alone. Interventions Three interventions (group based exercise, home hazard management, and vision improvement) delivered to eight groups defined by the presence or absence of each intervention. Main outcome measure Time to first fall ascertained by an 18 month falls calendar and analyzed with survival analysis techniques. Changes to targeted risk factors were assessed by using measures of quadriceps strength, balance, vision, and number of hazards in the home. Results the rate ratio for exercise was 0.82 (95% confidence interval 0.70 to 0.97, P=0.02), and a significant effect (P < 0.05) was observed for the combinations of interventions that involved exercise. Balance measures improved significantly among the exercise group. Neither home hazard management nor treatment of poor vision showed a significant effect. The strongest effect was observed for all three interventions combined (rate ratio 0.67 (0.51 to 0.88, P=0.004)), producing an estimated 14.0% reduction in the annual fall rate. The number of people needed to be treated to prevent one fall a year ranged from 32 for home hazard management to 7 for all three interventions combined. Conclusions group based exercise was the most potent single intervention tested, and the reduction in falls among this group seems to have been associated with improved balance. Falls were further reduced by the addition of home hazard management or reduce division management, or both of these. Cost effectiveness is yet to be examined. These findings are most applicable to Australian born adults aged 70-84 years living at home who rate their health as good.

Published in	Rehabilitation Science (Volume 3, Issue 1)
DOI	10.11648/j.rs.20180301.14
Page(s)	17-22
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2018. Published by Science Publishing Group

Keywords

Critical Appraisal, Falls Prevention, Older People, Own Homes

References

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Nadia Mahmoud Ali Abuzied. (2018). Critical Appraisal on Randomized Factorial Trial of Falls Prevention Among Older People Living in Their Own Homes. Rehabilitation Science, 3(1), 17-22. https://doi.org/10.11648/j.rs.20180301.14

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Nadia Mahmoud Ali Abuzied. Critical Appraisal on Randomized Factorial Trial of Falls Prevention Among Older People Living in Their Own Homes. Rehabil. Sci. 2018, 3(1), 17-22. doi: 10.11648/j.rs.20180301.14

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AMA Style

Nadia Mahmoud Ali Abuzied. Critical Appraisal on Randomized Factorial Trial of Falls Prevention Among Older People Living in Their Own Homes. Rehabil Sci. 2018;3(1):17-22. doi: 10.11648/j.rs.20180301.14

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@article{10.11648/j.rs.20180301.14,
  author = {Nadia Mahmoud Ali Abuzied},
  title = {Critical Appraisal on Randomized Factorial Trial of Falls Prevention Among Older People Living in Their Own Homes},
  journal = {Rehabilitation Science},
  volume = {3},
  number = {1},
  pages = {17-22},
  doi = {10.11648/j.rs.20180301.14},
  url = {https://doi.org/10.11648/j.rs.20180301.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.rs.20180301.14},
  abstract = {Objective To test the effectiveness of, and explore interactions between, three interventions to prevent falls among older people. Design a randomized controlled trial with a full factorial design. Setting Urban community in Melbourne, Australia. Participants1090 aged 70 years and over and living at home. Most were Australian born and rated their health as good to excellent; just over half lived alone. Interventions Three interventions (group based exercise, home hazard management, and vision improvement) delivered to eight groups defined by the presence or absence of each intervention. Main outcome measure Time to first fall ascertained by an 18 month falls calendar and analyzed with survival analysis techniques. Changes to targeted risk factors were assessed by using measures of quadriceps strength, balance, vision, and number of hazards in the home. Results the rate ratio for exercise was 0.82 (95% confidence interval 0.70 to 0.97, P=0.02), and a significant effect (P < 0.05) was observed for the combinations of interventions that involved exercise. Balance measures improved significantly among the exercise group. Neither home hazard management nor treatment of poor vision showed a significant effect. The strongest effect was observed for all three interventions combined (rate ratio 0.67 (0.51 to 0.88, P=0.004)), producing an estimated 14.0% reduction in the annual fall rate. The number of people needed to be treated to prevent one fall a year ranged from 32 for home hazard management to 7 for all three interventions combined. Conclusions group based exercise was the most potent single intervention tested, and the reduction in falls among this group seems to have been associated with improved balance. Falls were further reduced by the addition of home hazard management or reduce division management, or both of these. Cost effectiveness is yet to be examined. These findings are most applicable to Australian born adults aged 70-84 years living at home who rate their health as good.},
 year = {2018}
}

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TY - JOUR
T1 - Critical Appraisal on Randomized Factorial Trial of Falls Prevention Among Older People Living in Their Own Homes
AU - Nadia Mahmoud Ali Abuzied
Y1 - 2018/02/23
PY - 2018
N1 - https://doi.org/10.11648/j.rs.20180301.14
DO - 10.11648/j.rs.20180301.14
T2 - Rehabilitation Science
JF - Rehabilitation Science
JO - Rehabilitation Science
SP - 17
EP - 22
PB - Science Publishing Group
SN - 2637-594X
UR - https://doi.org/10.11648/j.rs.20180301.14
AB - Objective To test the effectiveness of, and explore interactions between, three interventions to prevent falls among older people. Design a randomized controlled trial with a full factorial design. Setting Urban community in Melbourne, Australia. Participants1090 aged 70 years and over and living at home. Most were Australian born and rated their health as good to excellent; just over half lived alone. Interventions Three interventions (group based exercise, home hazard management, and vision improvement) delivered to eight groups defined by the presence or absence of each intervention. Main outcome measure Time to first fall ascertained by an 18 month falls calendar and analyzed with survival analysis techniques. Changes to targeted risk factors were assessed by using measures of quadriceps strength, balance, vision, and number of hazards in the home. Results the rate ratio for exercise was 0.82 (95% confidence interval 0.70 to 0.97, P=0.02), and a significant effect (P < 0.05) was observed for the combinations of interventions that involved exercise. Balance measures improved significantly among the exercise group. Neither home hazard management nor treatment of poor vision showed a significant effect. The strongest effect was observed for all three interventions combined (rate ratio 0.67 (0.51 to 0.88, P=0.004)), producing an estimated 14.0% reduction in the annual fall rate. The number of people needed to be treated to prevent one fall a year ranged from 32 for home hazard management to 7 for all three interventions combined. Conclusions group based exercise was the most potent single intervention tested, and the reduction in falls among this group seems to have been associated with improved balance. Falls were further reduced by the addition of home hazard management or reduce division management, or both of these. Cost effectiveness is yet to be examined. These findings are most applicable to Australian born adults aged 70-84 years living at home who rate their health as good.
VL - 3
IS - 1
ER -

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Nadia Mahmoud Ali Abuzied

Federal Ministry of Health, Khartoum, Sudan

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Nadia Mahmoud Ali Abuzied. (2018). Critical Appraisal on Randomized Factorial Trial of Falls Prevention Among Older People Living in Their Own Homes. Rehabilitation Science, 3(1), 17-22. https://doi.org/10.11648/j.rs.20180301.14

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ACS Style

Nadia Mahmoud Ali Abuzied. Critical Appraisal on Randomized Factorial Trial of Falls Prevention Among Older People Living in Their Own Homes. Rehabil. Sci. 2018, 3(1), 17-22. doi: 10.11648/j.rs.20180301.14

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AMA Style

Nadia Mahmoud Ali Abuzied. Critical Appraisal on Randomized Factorial Trial of Falls Prevention Among Older People Living in Their Own Homes. Rehabil Sci. 2018;3(1):17-22. doi: 10.11648/j.rs.20180301.14

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@article{10.11648/j.rs.20180301.14,
  author = {Nadia Mahmoud Ali Abuzied},
  title = {Critical Appraisal on Randomized Factorial Trial of Falls Prevention Among Older People Living in Their Own Homes},
  journal = {Rehabilitation Science},
  volume = {3},
  number = {1},
  pages = {17-22},
  doi = {10.11648/j.rs.20180301.14},
  url = {https://doi.org/10.11648/j.rs.20180301.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.rs.20180301.14},
  abstract = {Objective To test the effectiveness of, and explore interactions between, three interventions to prevent falls among older people. Design a randomized controlled trial with a full factorial design. Setting Urban community in Melbourne, Australia. Participants1090 aged 70 years and over and living at home. Most were Australian born and rated their health as good to excellent; just over half lived alone. Interventions Three interventions (group based exercise, home hazard management, and vision improvement) delivered to eight groups defined by the presence or absence of each intervention. Main outcome measure Time to first fall ascertained by an 18 month falls calendar and analyzed with survival analysis techniques. Changes to targeted risk factors were assessed by using measures of quadriceps strength, balance, vision, and number of hazards in the home. Results the rate ratio for exercise was 0.82 (95% confidence interval 0.70 to 0.97, P=0.02), and a significant effect (P < 0.05) was observed for the combinations of interventions that involved exercise. Balance measures improved significantly among the exercise group. Neither home hazard management nor treatment of poor vision showed a significant effect. The strongest effect was observed for all three interventions combined (rate ratio 0.67 (0.51 to 0.88, P=0.004)), producing an estimated 14.0% reduction in the annual fall rate. The number of people needed to be treated to prevent one fall a year ranged from 32 for home hazard management to 7 for all three interventions combined. Conclusions group based exercise was the most potent single intervention tested, and the reduction in falls among this group seems to have been associated with improved balance. Falls were further reduced by the addition of home hazard management or reduce division management, or both of these. Cost effectiveness is yet to be examined. These findings are most applicable to Australian born adults aged 70-84 years living at home who rate their health as good.},
 year = {2018}
}

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