Deans' stroke musings

Changing stroke rehab and research worldwide now.Time is Brain!Just think of all the trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 493 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It's quite disgusting that this information is not available from every stroke association and doctors group.
My back ground story is here:http://oc1dean.blogspot.com/2010/11/my-background-story_8.html

Thursday, February 2, 2017

Exercise to prevent falls in older adults: An updated systematic review and meta-analysis

What is your protocol for fall prevention and testing your recovery from perturbations?  With nothing from your medical team they have effectively sentenced you to die.

Falls are leading cause of injury and death in older Americans


Exercise to prevent falls in older adults: An updated systematic review and meta-analysis

British Journal of Sports Medicine, 02/02/2017
Sherrington C, et al. – This study was performed to test whether this impact is still present when new trials are included, and it investigates whether qualities of the trial design, sample or intervention are related to greater fall prevention impacts. This work suggested that the exercise as a single intervention can prevent falls in community–dwelling older people. Exercise programmes that challenge balance and are of a higher dose have larger impacts. The effect of exercise as a single intervention in clinical groups and aged care facility residents requires advance examination, however, promising results are evident for people with Parkinson's disease and cognitive impairment.

Methods

  • Update of a systematic review with random effects meta-analysis and meta-regression.
  • From January 2010 to January 2016, Cochrane Library, CINAHL, MEDLINE, EMBASE, PubMed, PEDro and SafetyLit were searched.
  • Inclusion of randomised controlled trials were performed to compare fall rates in older people randomised to receive exercise as a single intervention with fall rates in those randomised to a control group.

Results

  • 99 comparisons from 88 trials with 19478 members were available for meta-analysis.
  • Exercise lessened the rate of falls in community-dwelling older people by 21% (pooled rate ratio 0.79, 95% CI 0.73 to 0.85, p<0.001, I2 47%, 69 comparisons) with greater impacts observed from exercise programmes that challenged balance and included more than 3 hours/week of exercise.
  • These variables explained 76% of the between-trial heterogeneity in association with a 39% reduction in falls (incident rate ratio 0.61, 95% CI 0.53 to 0.72, p<0.001).
  • Exercise had a fall prevention impact in community-dwelling people with Parkinson's disease (pooled rate ratio 0.47, 95% CI 0.30 to 0.73, p=0.001, I2 65%, 6 comparisons) or cognitive impairment (pooled rate ratio 0.55, 95% CI 0.37 to 0.83, p=0.004, I221%, 3 comparisons).
  • No evidence was suggestive of a fall prevention effect of exercise in residential care settings or among stroke survivors or people recently discharged from hospital.
Go to PubMed Go to Abstract Print Article Summary Cat 2 CME Report

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