A one-year proprioceptive exercise programme reduces the incidence of falls in community-dwelling elderly people: A before-after non-randomised intervention study.
BACKGROUND
The risk of falls increases with age. Balance alteration and polypharmacy are independent contributors to an increased risk of falls.


OBJECTIVE
The primary aim was to assess whether a proprioceptive exercise programme reduces the incidence of falls. A secondary aim was to assess the association between drugs and falls.


METHODS
This was a before-after non-randomised intervention study.


METHODS
The study recruited independent and cognitively intact community-dwelling people aged over 69 years, from December 2012 to May 2014.


METHODS
The intervention was done by a nurse and consisted of a monthly supervised group session of proprioceptive training for 1 year, supplemented by a home diary exercise. Daily medication was reviewed.


RESULTS
We included 572 subjects (63.3% women), mean age 76.1±3.9 years. The mean number of drugs prescribed at the start of the study was 4.7±3.0and 353 of the participants (61.7%) were taking four or more drugs a day. The elderly who fell were more dependent in their activities of daily living (Barthel index), and their balance was worse (determined using the Tinetti scale), as were their results on a cognitive scale (the MEC). After the intervention, an increase in self-perceived quality of life (EQ5D) was reported. The incidence of falls was reduced from 37.5% in the 12 months prior to the intervention to 25.7% in the 12 months after the intervention. During the follow-up, beta-blocker use was associated with an increased incidence of falls (OR=2.05; 95%IC: 1.24-3.39; p=0.005). In contrast, antiplatelet/anticoagulation drugs were associated with a lower risk of falls (OR=0.7; 95%IC: 0.55-0.88; p=0.003).


CONCLUSIONS
The proprioceptive exercise programme reduced the incidence of falls in community-dwelling older people. Multiple drug use was an independent predictor of an increased risk of falls, and specific drug groups were associated with falls.
Nursing Faculty, Universidad Católica de Valencia San Vicente Mártir, Valencia, Spain. Electronic address: pilar.perez@ucv.es.
Pilar
P
Pérez-Ros
Nursing Faculty, Universidad Católica de Valencia San Vicente Mártir, Valencia, Spain; Department of Physiotherapy, Universitat de Valencia, Spain.
Francisco M
FM
Martinez-Arnau
Department of Geriatrics, Complejo Hospitalario de Navarra, Pamplona, Spain; Department of Nutrition, Food Science and Physiology, School of Pharmacy, Universidad de Navarra, Pamplona, Spain.
Vincenzo
V
Malafarina
Nursing Faculty, Universidad Católica de Valencia San Vicente Mártir, Valencia, Spain; Department of Geriatrics, Hospital Universitario de la Ribera, Valencia, Spain.
Francisco J
FJ
Tarazona-Santabalbina
D000058:Accidental Falls / Q000517:prevention & control* / Q000706:statistics & numerical data; D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D004856:Postural Balance / Q000502:physiology*; D011434:Proprioception / Q000502:physiology*; D011788:Quality of Life; D016896:Treatment Outcome
Community dwelling; Elderly; Falls; Polypharmacy; Proprioceptive exercises