Rein Tideiksaar

Falls in the elderly: A literature review

Falls in older people are both common and assoclated with increased morbidity and mortality. The etiology of falls is due to a multiplicity of pathological diseases, medications and environmental hazards. To prevent falls, clinicians need to identify the underlying factors responsible for falls. This is achieved by obtaining a history and performing a physical evaluation that is specific for falling.

Alarm Devices Instead of Restraints

with high resistance training. This is in agreement with a recent study in men on the lower limbs, using similar training and testing methods.6 The increase in strength appears to vary according to the measuring technique used. Previous studies have reported similar variability, with strength gains ranging from 10% to 72%.3 This is not surprising considering the number of parameters that are likely to influence the results. In future studies, the experimental design, the specificity of training and testing, psychological and motivational factors etc. must be controlled and standardized as far as possible in order to make studies interpretable. The underlying mechanisms accounting for a traininginduced increase in muscle strength in the elderly are not known. In principle, it can be due to adaptation in the nervous system, hypertrophy of the muscle, or both. To provide a definite answer, future studies need to combine strength measurements with assessments of muscle structure and function in the same elderly subject. Furthermore, to distinguish the effects of the training regimen from that of the placebo effect, future investigations will have to use a much more controlled trial design, one in which subjects are randomly allocated to a training and control group. If an objective evaluation eventually can show that this type of uncomplicated training protocol can improve an elderly person’s muscular strength, any general rehabilitation or exercise program for the elderly is thereby likely to benefit from the inclusion of such a training regimen.