Physical Exercise Regime for Accidental Fall Prevention Among Older Adults

ASSESSMENT 32019 TEMPLATE
NSG2NMR (2019) Assessment 3: 2,000 individual report
Student First
Name:
Student Surname:
Student ID
Number:
Facilitator Name:
Site/Clinical School:
TOTAL Word Count: 2,000 +/- 10%
Excludes: reference list, appended search history
Includes: in-text citations
DUE DATE:
Identify a clinical issue and propose a research question about this
clinical issue
(approx. word count 100)
During the year 2014, 15% of the population residing in Australia was above 65
years of age. It is estimated that by the end of 2031, this percentage is going to
increase to 19% of the total population count with an average life-span increase
to 83 years from 65 years (Australian Commission on Safety and Quality in
Healthcare, 2009). According to the Public Health Association of Australia (2015)
risk factor of accidental fall leading to fatal injuries increases with age. Thus it is
important to implement effective intervention for the reduction of accidental fall
and fall related injury among the older adults.
The main research question that would be addressed in this essay include:
Is mild to moderate practice of physical exercise regime is helpful in reducing the
risk of encountering accidental fall among the older adults under the community
health care settings?
Conduct a literature search (using Medline AND CINAHL databases) and
identify literature relevant to the research question. APPEND THE
SEARCH HISTORY TO THE ASSIGNMENT
Write a Literature Review that describes what is already known about
your research question
(approx. word count 1,500)
A review of literature over the proposed topic revealed the following themes in
order to explain the effectiveness of the physical exercise interventions for the
effective prevention of the accidental fall among the older adults.
The first theme include: Multi-component exercise training for gait
balance
According to the policy named Preventing Falls and Harm From Falls in Older
People: Best Practice Guidelines for Australian Community Care 2009,
impairments of several physical functioning of the body with age increases the
risk of person towards encountering accidental fall. Nearly 50 to 70% of the older
people encounter fall while walking. In order to avoid the chances of accidental
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fall, an individual needs to control the body balance while maintaining the hand-
eye coordination. One of the important approaches for maintaining the body
balance is regular practice of the mild to moderate physical activity. Cadore,
Rodríguez-Mañas, Sinclair and Izquierdo (2013) conducted a review in order to
highlight training strategies that help in improving the body balance, functional
capacity among the physically frail older adults who are vulnerable in
encountering accidental fall. 20 studies were investigated in order to access the
multi-component exercise training over the older adults. The analysis of the 20
journal articles in this review stated that regular practice of resistance training,
endurance training and balance training helps in reducing the risk of accidental
fall by improving the gait ability and increasing the lower-body strength. The
author at the end concluded that the use of the multi-component exercise training
helps to increase the strength of the muscle while increasing the body balance
and thus reducing the risk of encountering accidental fall among the older adults.
However, Salzwedel et al. (2016) stated that multi-component exercise training is
not suitable for all the older adults who are suffering from cardio-vascular
problems or are obese. For example, resistance training is not permissible among
the older adults who have a previous case history of cardio-vascular stroke are
suffering from paralysis. Study conducted by Seco et al. (2013) also showed
similar results like Cadore, Rodríguez-Mañas, Sinclair and Izquierdo (2013). Seco
et al. (2013) conducted longitudinal prospective study with a convenience sample
of 227 older adults (of them 54 are men and 173 are women). These sample
population was asked to complete a 9-month training program along with 3-
month detraining follow-up. The results showed significant improvement in the
body strength, flexibility of the joints in the lower limbs and body balance, trunk
flexibility. Additionally the paper showed that practice of the physical activity
helps to increase the hand grip strength, triceps skin fold thickness while reducing
the body fat percentage and BMI index. It also helps in improving the overall body
balance while increasing the VO2 max of the body. This study helped in gaining
significant insight about the importance of physical activity in improving the body
balance while reducing the chances of encountering accidental fall among the
older adults. However, in this study, the percentage of women is much higher
than men and thus research validity is less while addressing the male population.
Study of Tarazona-Santabalbina et al. (2019) also proposed in accordance with
the both the studies explained under this theme. This randomised control study
showed that multi-component exercise training helps in reducing accidental fall
among the older adults by improving gait. The study also showed that multi-
component exercise training helps in improving the cognitive functioning of the
older adults while helping to promote social networking thus helping to provide a
psychological aspect of physical exercise regime.
Second theme that is highlighted from the review include: Physical exercise
helps in improving bone and physical functioning of post-menopausal
women
Moreira et al. (2014) conducted a review in order to elucidate whether regular
practice of the physical activity session among the post-menopausal women helps
in improving bone health and thus helping the improve the physical functioning of
the body (function of the joints) and thereby helping to reduce the chances of
encountering accidental fall. The review showed that moderate to intense
exercise performed under high speed during short intervals of time in water or on
the ground water
Helps in improving micro-architecture of the bones and thus helping to reduce the
joint pain and reducing the chances of encountering accidental fall. The study also
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showed that exercise also helps in improving the muscle strength, muscle
contraction among women thus reducing the chances of encountering accidental
fall. However, the review focused on water exercises only and many women might
not be comfortable in conducting physical exercise and thus reducing the
acceptability of the overall exercise planning. Hita-Contreras et al. (2013)
conducted a cross-sectional observational study over 100 post-menopausal
women between the age group of 50 to 60 years with in order to analyse the
association of the body weight and fat disposition in maintaining the postural
balance and its association with fall. The analysis of the study conducted with a
follow-up period of 12 months highlighted that obesity along in un-uniform
deposition of fat in the body hampers the body balance and also decreases the
bone health of the post-menopausal women. This increases the chances of the
accidental fall. Regular practice of the physical activity at a mild to moderate level
helps in uniform distribution of the body fat and at the same time helps to reduce
the body weight and thereby reducing the chances of encountering accidental.
The study also showed that decrease in the BMI of the body helps to reduce the
stress over the bone health and thus helping to decrease the chances of fall.
However, the study is conducted over women who are obese and thus the
interventions might fetch different outcomes. Bergamin et al. (2015) conducted a
study in order to evaluate the effect of pilates exercise program over the strength
of the muscle, postural control of the body posture and the composition of the
body over the post-menopausal women. The analysis of the results highlighted
that regular practice of the physical activity for 3 months helps to improve the
body balance and at the same time helps to reduce the body fat composition and
muscle strength and thus decreasing the chances of encountering accidental fall.
The results showed that practice of pilates help to increase the strength of both
upper and the lower muscle of the body along with the abdominal muscle and ths
increasing the body stamina of withstanding the risk of accidental fall. However,
many women might not have the required fitness for conducting Pilates for
example post-menopausal with osteoporosis and thus the intervention might not
be suitable for all.
The third theme of the review is: The efficacy of Tai Chi test on the reduction of
accidental fall prevention among the older adults
Tousignant e al. (2013) conducted a study in compare the effectiveness of the
supervised Tai Chi test verses the conventional physical activity session in order
to reduce the severity of the accidental fall among the frail older adults in the
rehabilitation unit. The randomised control trial was conducted over 152 older
adults over a tenure of 15-week (76 older adults practice conventional physical
exercise and 76 older adults performed Tai Chi exercise). The analysis of the
result highlighted that both the interventions were effective in reducing the
chances of the accidental fall among the frail older adults. However, rate of
adoption of the Tai Chi exercises is highlighter in the rehabilitation unit in
comparison to the conventional physical activity session. Taylor-Piliae et al.
(2014) conducted the study in order to evaluate the effect of the Tai Chi test on
the overall physical functioning of the body and fall prevention over the older
adults. They focused on the stroke survivors as the main target population. The
results showed that practice of the tai chi test helps in improving the aerobic
endurance and thus helping to promote stroke recovery and reducing the level of
accidental fall among the older adults. Huang and Liu (2015) systematic review
highlighted that tai chi test is beneficial for improving the balance control ability
of the older adults and thus helping to reduce the risk of the accidental fall
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