title: Fall Prevention in a Primary Care Setting.
abstract: BACKGROUND
  Falls and fall-related injuries are common in community-dwelling elderly people. Effective multifactorial fall prevention programs in the primary care setting may be a promising approach to reduce the incidence rate of falls.
  
  
  METHODS
  In a cluster randomized trial in 33 general practices 378 people living independently and at high risk of falling (65 to 94 years old; 285 women) were allocated to either a 16 week exercise-based fall prevention program including muscle strengthening and challenging balance training exercises, combined with a 12 week home-based exercise program (222 participants), or to usual care (156 participants). The main outcome was number of falls over a period of 12 months. Secondary outcomes were the number of fall-related injuries, physical function (Timed-Up-and-Go-Test, TUG, Chair-Stand-Test, CST, modified Romberg Test), and fear of falling.
  
  
  RESULTS
  In the intervention group (n=222 patients in 17 general practices) 291 falls occurred, compared to 367 falls in the usual care group (n=156 patients in 16 general practices). We observed a lower incidence rate for falls in the intervention group (incidence rate ratio/IRR: 0.54; 95% confidence interval (CI): [0.35; 0.84], p=0.007) and for fall-related injuries (IRR: 0.66; [0.42; 0.94], p=0.033). Additionally, patients in the intervention group showed significant improvements in secondary endpoints (TUG: -2.39 s, [-3.91; -0.87], p=0.014; mRomberg: 1.70 s, [0.35; 3.04], p=0.037; fear of falling: -2.28 points, [-3.87; -0.69], p=0.022) compared to usual care.
  
  
  CONCLUSIONS
  A complex falls prevention program in a primary care setting was effective in reducing falls and fall-related injuries in community dwelling older adults at risk.
authors: Department of Prevention, Rehabilitation and Sports Medicine, Technische Universität München, Munich, Germany, Institute for Biomedicine of Aging, Universität Erlangen-Nürnberg, Nürnberg, Germany, Institute of Sport Science and Sport, Universität Erlangen-Nürnberg, Nürnberg, Germany, Institute of General Practice, Technische Universität München, Munich, Germany, DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany d Else Kröner-Fresenius-Zentrum, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
authors: Monika
authors: M
authors: Siegrist
authors: Ellen
authors: E
authors: Freiberger
authors: Barbara
authors: B
authors: Geilhof
authors: Johannes
authors: J
authors: Salb
authors: Christian
authors: C
authors: Hentschke
authors: Peter
authors: P
authors: Landendoerfer
authors: Klause
authors: K
authors: Linde
authors: Martin
authors: M
authors: Halle
authors: Wolfgang A
authors: WA
authors: Blank
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control* / Q000706:statistics & numerical data*; D000369:Aged, 80 and over; D005081:Exercise Therapy / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006707:Homes for the Aged / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D057187:Independent Living / Q000706:statistics & numerical data*; D008297:Male; D064797:Physical Conditioning, Human / Q000379:methods / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012307:Risk Factors; D016896:Treatment Outcome