Objective To retrieve and summarize the best evidence for fall prevention after total hip arthroplasty in elderly patients. Methods BMJ Best Practice, UpToDate, JBI evidence-based healthcare center database, National Institute for Health and Clinical Excellence, Scottish Intercollegiate Guidelines Network, Cochrane Library, PubMed, Web of Science, EBSCO, International Collaboration of Orthopaedic Nurisng website, American Academy of Orthopaedic Surgeons website, European Society for Trauma and Emergency Surgery website, Medlive, China National Knowledge Infrastructure, Wanfang, Chongqing VIP, and SinoMed were systematically searched. The retrieval time was from the establishment of the databases to June 30, 2024. The quality of literature was evaluated, and evidence was extracted, evaluated, and summarized. Results A total of 12 articles were included, including 4 guidelines, 2 randomized controlled trials, 2 cohort studies, and 4 expert consensus studies. A total of 18 pieces of evidence were extracted, including 13 A-level recommendations and 5 B-level recommendations. The evidence covers six major themes of risk factors, assessment, multidisciplinary team support, health education, medication management, safety environment, and assistive devices. Conclusions The fall prevention after total hip arthroplasty in elderly patients involves multiple factors, and the fall prevention should be based on multidisciplinary team cooperation, achieving linkage between the hospital and the family to jointly ensure patient safety. In the future, it is recommended to combine individual patient differences with actual clinical scenarios when applying evidence.
Objective To integrate the falling experience and coping styles of stroke home patients with falls through Meta synthesis, summarize existing problems based on the integration results, and propose suggestions. Methods We searched databases including PubMed, Medline, Embase, Web of Science, etc., from database establishment to January 2023, to collect qualitative studies on stroke patients’ falling experience at home. The quality of included studies was evaluated by “JBI Australian Evidence-based Health Care Centre (2008) Qualitative Research Quality Assessment Criteria”. The results were integrated by integrating methods. Results A total of 6 references were included, and 18 clear research results were extracted. Similar results were summarized and combined to form 6 new categories, and integrated into 3 main themes. The integration results showed that stroke patients with falls had severe psychological problems, poor coping styles, and unmet needs for fall prevention, resulting in reduced social participation and exercise. Conclusions It is necessary to improve the content of fall assessment and provide corresponding fall prevention health education based on the assessment results. It helps stroke patients and caregivers at home to establish correct coping strategies, thereby avoiding the occurrence of falls.
ObjectiveTo systematically review studies investigating the rate of falls among Chinese elderly. MethodsThe CNKI, VIP, CBM, WanFang Data, EMbase, The Cochrane Library and PubMed databases were electronically searched to identify cross-sectional studies on the rate of falls in Chinese elderly published from January 1st, 2000 to December 31st, 2021. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was then performed using Stata 16.0 software. Results A total of 54 cross-sectional studies, involving 111 098 cases were included. The results of meta-analysis showed that the rate of falls among Chinese elderly was 19.3% (95%CI 16.9% to 21.6%). Subgroup analyses showed that the fall rates were 16.1% and 21.9% for males and females, respectively. The rates for 60-69, 70-79, and >80 years age groups were 16.3%, 21.7%, and 27.3%, respectively. The rates for the North, South, East, Southwest, and Central parts of China were 16.6%, 17.9%, 18.7%, 22.0%, and 25.8%, respectively. For the urban and rural elderly, the rates were 16.4% and 23.1%, respectively. The rates for those with or without spouses were 24.2% and 26.8%, respectively, while for the solitary and non-solitary elderly were 21.1% and 17.8%, respectively. The rates for elderly with or without exercise habits were 22.1% and 27.1%, respectively. ConclusionThe rate of falls is high among Chinese elderly, especially among females, older individuals, those in Southwest China, rural individuals, those without spouse, solitary individuals and those without exercise habits.
Under the new era background of actively advocating the " active health” in the elderly, the prevention methods of falls not only include environmental modification, reasonable drugs, emotional support, disease prevention and control, etc., but exercise should also be integrated into them. Exercise training can significantly improve muscle strength, balance, and mobility in the elderly, thereby reducing the risk of falls. This paper reviews the biomechanical causes of falls in the elderly, the sports training prescriptions for fall prevention in the elderly, and the research prospects of sports training for fall prevention in the elderly. It is hoped that the elderly population could establish an active healthy lifestyle based on sports training, elevate the physical fitness continuously, reduce the fall injury, and improve the quality of life through strength, balance, and endurance training.
ObjectiveTo assess the methodological quality of systematic reviews of Tai Chi for preventing falls in the elderly and the quality of evidence for outcome indicators.MethodsPubMed, Web of Science, The Cochrane Library, EMbase, CNKI, WanFang Data, CBM and VIP databases were electronically retrieved. According to the inclusion criteria and exclusion criteria, the final articles were selected and the relevant literature information was extracted by reading the abstract and the full text. The methodological quality of the included systematic reviews was evaluated using AMSTAR 2 tool, and the quality of the outcome indicators of the included systematic reviews was further graded according to the GRADE system.ResultsA total of 11 systematic reviews/meta-analyses were included. The AMSTAR 2 evaluation showed that 10 studies were in critically-low methodological quality, and 1 study was in low methodological quality. The GRADE evaluation results showed that among the 36 outcome indicators included, there were 10 intermediate quality indicators, 20 low-level quality indicators and 6 extremely low-level quality indicators. Among the indicators of intermediate quality, single-leg stand test (MD = 5.33, 95%CI 3.35 to 7.32, P< 0.01; WMD = 1.76, 95%CI −7.00 to 10.52, P< 0.01), time up and go test (MD = 1.04, 95%CI 0.67 to 1.41, P< 0.01), the berg balance scale (MD = 2.18, 95%CI 0.93 to 3.43, P< 0.01), number of falls (RR = 0.82, 95%CI 0.73 to 0.92), P< 0.01), the incidence of 2-falls (OR = 0.69, 95%CI 0.49 to 0.97, P< 0.01) and the incidence of 3-falls (OR = 0.39, 95%CI 0.21 to 0.73, P< 0.01). The results of the above indicators were statistically significant, indicating that Tai Chi was better than control group.ConclusionsAt present, the methodological quality of relevant systematic reviews of Tai Chi for preventing falls in the elderly was relatively low and the quality of the evidence was not good, so it can’t be proved that Tai Chi can effectively prevent falls in the elderly, which needs to be further studied at a high level.
ObjectiveThis study aimed to systematically review the quality of psychometric properties and methodological quality of the Chinese versions of fear of falling assessment tools for the elderly, providing evidence-based guidance for medical staff in selecting high-quality assessment tools. MethodsWe systematically searched CNKI, WanFang Data, VIP, CBM, PubMed, Embase, and Web of Science databases for studies related to the evaluation of psychometric properties and methodological quality of fear of falling assessment tools for the elderly. The search spanned from the inception of the databases to January 19, 2024. Two researchers independently screened literature and extracted data using the consensus-based standards for the selection of health measurement instruments. The COSMIN risk of bias checklist and quality criteria were employed to evaluate instrument measurement characteristics and formulate final recommendations. ResultsFifteen studies involving 11 Chinese versions of fear of falling assessment tools for the elderly were included. None of the studies reported measurement error, cross-cultural validity, or responsiveness. Due to insufficient or uncertain content validity and low or below-quality evidence, all 11 tools received a recommendation of level B. ConclusionAmong the 11 instruments, the Chinese version of IFES demonstrates the most balanced measurement characteristics, along with good reliability and validity. However, further verification of other measurement characteristics of this instrument is warranted.
Objective To evaluate the effect of Otago exercise program (OEP) on fear of falling in central hemiplegia patients in communities. Methods We collected the clinical data of 61 central hemiplegia patients in the Department of Neurology of Pangang General Hospital from January to June 2014. They were randomly divided into treatment group (n=30) and control group (n=31) after discharge. The treatment group had OEP, while the control group had not. After 20 weeks of follow-up, we evaluated fall self-efficacy, balance and mobility of patients in the two groups. Results The OEP adherence rate was 73.3% for the treatment group. In the treatment group, modified fall efficacy scale (MFES) score and Berg balance scale (BBS) score were significantly higher than those before intervention (P<0.05); time up and go test (TUGT) score was significantly lower than that before intervention (P<0.05). In the control group, MFES score, BBS score and TUGT score were not significantly changed (P>0.05). After intervention, MFES score and BBS score of the treatment group were significantly higher than those of the control group (P<0.05), but TUGT score was not significantly different (P>0.05). Conclusion OEP for central hemiplegia patients after discharge can reduce fall self-efficacy and increase balance ability of the patients.
Objective To construct an intervention program for postoperative fear of falling in elderly patients with hip fracture based on cognitive behavioral theory. Methods Based on cognitive behavioral theory and literature review, an initial draft of intervention plan for postoperative fear of falling in elderly patients with hip fracture was constructed. From January to March 2025, after two rounds of expert consultations and revisions, the final plan was formed. Results A total of 16 experts across the country were invited to participate in two rounds of Delphi expert consultations, covering areas such as orthopedic clinical nursing, orthopedic clinical medicine, nursing education, nursing management, rehabilitation therapy, and psychological therapy. The active participation rates for the two rounds of consultations were 94.12% and 100.00%, respectively. The expert authority coefficients were 0.860 and 0.907, respectively, and the Kendall harmony coefficients were 0.369 and 0.524, respectively. Ultimately, a program composed of 5 primary indicators (fall fear management team, fall fear management goals, fall fear assessment, fall fear intervention measures, and post-intervention effect evaluation), 17 secondary indicators, and 31 tertiary indicators was constructed. Conclusion The intervention program for postoperative fear of falling in elderly patients with hip fracture based on cognitive behavior theory constructed in this study is scientific and operable, which can provide reference and guidance for clinical nursing staff.