Fall prevention programs in Asia: systematic review
This review, focused on fall prevention in Asia, gives us insight into different approaches with regard to local Asian culture. There is strong evidence for falls prevention among the elderly in this continent, although most of the evidence is obtained by Western countries. Differences between countries (eg exposure to sunlight, diet, environment, preferences for exercises) can influence the success of reduce falls in Asian countries that have been shown to be effective elsewhere in the world. The purpose of this assessment is to evaluate the scope and effectiveness of randomized controlled studies on fall prevention (RCTs) from the Asian region.
Fall results were obtained from the Cochrane review (classified according to the ProFANE intervention classification) and international publications. From the Cochrane review, 26 of 159 RCTs from Asia were included. Patients from RCTs: median 160 participants, average age: 75.1, female: 71.9%). Exercise therapy (15 RCTs) and home exercise programs (n = 2) were the only separate interventions.
Intervention types with effective RCT in reducing dropout were exercise therapy (6 effective), home modification (1 effective) and medication (vitamin D) (1 effective). Meta-analysis of exercise interventions identified a significant advantage (number of dropouts: Odds Ratio 0.43 * (0.34 053), number of falls: 0.35 * (0.21.0.57) and number of injured fallers: 0.50 * (0.35.0.71), but multifactorial interventions did not reach a significant difference (number of fallers OR = 0.57 * (0.23.1.44).
The effective physiotherapeutic intervention in Asian studies can be attributed to exercise programs offered at home by a physiotherapist consisting of individual mobility, strength and balance exercises (40-60 min, 3 x / week x 4 months). The physiotherapist will pay a visit every two weeks.
There is a small but growing research evidence of fall prevention programs from Asian countries, where Tai Chi and exercise therapy (physiotherapy) are the most studied and effective. Tai Chi will have to be transculturally translated to be implemented within industrialized countries. The physiotherapeutic intervention researched in Asia largely corresponds to already known Western fall prevention programs.
Physical Therapy Science