A simple protocol for preventing falls and fractures in elderly individuals with musculoskeletal disease.
Our protocol resulted in a significant prevention of falls and fractures in addition to marked improvements in the balance function. Intervention comprised a new balance exercise and quadriceps femoris exercise. Subjects were outpatients aged >or=65 years old with musculoskeletal disorders who had a result of <or=15 s for the timed one-leg balance test.


BACKGROUND
A study on chronological changes in the level of required care revealed that the level of care increases markedly for older patients requiring non-intensive or intensive long-term care. The aim of the present study was to identify frail elderly patients among older patients with chronic pain of the musculoskeletal system and to assess the fracture prevention and fall prevention effects of exercise therapy using stratified analysis.


METHODS
This was a prospective cohort study consisting of 683 outpatients with chronic pain of the musculoskeletal system who were >or=65 years old and had a result of <or=15 s for the timed one-leg balance test with eyes open. Intervention consisted of a new balance exercise and quadriceps femoris exercise regimen. The main outcome was fall rate, while secondary outcomes were the results of the timed one-leg balance test with eyes open and fracture rate.


RESULTS
Fall rate was decreased by 44% (p < 0.001) and fracture rate by 47% (p < 0.05) by 8 months after the start of the intervention. The results of the timed one-leg balance testing with eyes open improved two- to threefold after intervention (p < 0.01).


CONCLUSIONS
Our protocol has been safely implemented at a large number of clinics in Japan, and the reductions in frequency of falls and fractures suggest that it provides effective preventive care.
Kita
K
K
Japanese Clinical Orthopaedic Association, Okachimachi, Tokyo, Japan. single-k@sweet.ocn.ne.jp
Hujino
K
K
Nasu
T
T
Kawahara
K
K
Sunami
Y
Y
D000058:Accidental Falls / Q000517:prevention & control* / Q000706:statistics & numerical data; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005081:Exercise Therapy / Q000379:methods; D005260:Female; D050723:Fractures, Bone / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control*; D006801:Humans; D008297:Male; D009140:Musculoskeletal Diseases / Q000150:complications* / Q000503:physiopathology / Q000534:rehabilitation; D010349:Patient Compliance; D004856:Postural Balance; D011446:Prospective Studies; D052097:Quadriceps Muscle / Q000503:physiopathology; D012008:Recurrence; D016896:Treatment Outcome