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Impact d'un programme de prevention multidisciplinaire de la chute chez le sujet age autonome vivant a domicile, avec analyse avant-apres des performances physiques (Effectiveness of falls prevention strategies for elderly subjects who live in the community with performance assessment of physical activities (before-after)) [French]
Cornillon E, Blanchon MA, Ramboatsisetraina P, Braize C, Beauchet O, Dubost V, Blanc P, Gonthier R
Annales de Readaptation et de Medecine Physique 2002 Dec;45(9):493-504
clinical trial
5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: No. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVES: The development of falls prevention strategies is an essential health concern in elderly people. However, a global consensus does not exist for elderly subjects who live independently in the community. The aim of the study was to evaluate the benefit of an exercises program. MATERIALS AND METHODS: A control group (153 subjects) and an "intervention" group (150 subjects) were tested before and after a 1-year prospective study. The "intervention" group performed ten training sessions of physical activity, based on balance, muscular activity and coordination. We compared the incidence of falls, and the performances in several tests between the two groups. RESULTS: The clinical features were similar between the two groups: mean age 71 years, 83% of females, subjects who were independent for activities of daily living. However, all subjects presented risk for factors for falls: 38% were not able to maintain the unipodal position more than five seconds, 29% had already fallen during the previous year. For the "intervention" group, the comparison of the performances before and after the physical activity program showed significant increases (p < 0.001) for all the tests, and specifically for the unipodal position and for the exercises performed with eyes closed. After one year follow-up, the incidence rate of falls was lower in the "intervention" group compared with the control group, but the difference was not significant (p = 0.32). However, falls occurred significantly latter in the "intervention" group (p = 0.02). CONCLUSION: Ten training sessions of physical activity allowed to improve the performance of elderly people in several tests. This result suggests that a fall prevention program based on collective and regular exercises, may be efficient for elderly subjects who still have an active and independent way of live.

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