Ava G Stechschulte, Andrea C Bakker, Jasmine Steele, Sara O Vargas
Large Malignant Testicular/Paratesticular Tumors in Adolescence: Assessment of Gross Tumor Size in a Vulnerable Age Group
Annals of clinical and laboratory science
approximately 30 people 65 years age living community fall year update cochrane review first published 2009to assess effects interventions designed reduce incidence falls older people living communitywe searched cochrane bone joint muscle trauma group specialised register february 2012 central cochrane library 2012 issue 3 medline 1946 march 2012 embase 1947 march 2012 cinahl 1982 february 2012 online trial registersrandomised trials interventions reduce falls communitydwelling older peopletwo review authors independently assessed risk bias extracted data used rate ratio rar 95 confidence interval ci compare rate falls eg falls per person year intervention control groups risk falling used risk ratio rr 95 ci based number people falling fallers group pooled data appropriatewe included 159 trials 79193 participants trials compared fall prevention intervention intervention intervention expected reduce falls common interventions tested exercise single intervention 59 trials multifactorial programmes 40 trials sixtytwo per cent 99159 trials low risk bias sequence generation 60 attrition bias falls 66110 73 attrition bias fallers 96131 38 60159 allocation concealmentmultiplecomponent group exercise significantly reduced rate falls rar 071 95 ci 063 082 16 trials 3622 participants risk falling rr 085 95 ci 076 096 22 trials 5333 participants multiplecomponent homebased exercise rar 068 95 ci 058 080 seven trials 951 participants rr 078 95 ci 064 094 six trials 714 participants tai chi reduction rate falls bordered statistical significance rar 072 95 ci 052 100 five trials 1563 participants tai chi significantly reduce risk falling rr 071 95 ci 057 087 six trials 1625 participantsmultifactorial interventions include individual risk assessment reduced rate falls rar 076 95 ci 067 086 19 trials 9503 participants risk falling rr 093 95 ci 086 102 34 trials 13617 participantsoverall vitamin reduce rate falls rar 100 95 ci 090 111 seven trials 9324 participants risk falling rr 096 95 ci 089 103 13 trials 26747 participants may people lower vitamin levels treatmenthome safety assessment modification interventions effective reducing rate falls rr 081 95 ci 068 097 six trials 4208 participants risk falling rr 088 95 ci 080 096 seven trials 4051 participants interventions effective people higher risk falling including severe visual impairment home safety interventions appear effective delivered occupational therapistan intervention treat vision problems 616 participants resulted significant increase rate falls rar 157 95 ci 119 206 risk falling rr 154 95 ci 124 191 regular wearers multifocal glasses 597 participants given single lens glasses falls outside falls significantly reduced subgroup regularly took part outside activities conversely significant increase outside falls intervention group participants took part little outside activitypacemakers reduced rate falls people carotid sinus hypersensitivity rar 073 95 ci 057 093 three trials 349 participants risk falling first eye cataract surgery women reduced rate falls rar 066 95 ci 045 095 one trial 306 participants second eye cataract surgery notgradual withdrawal psychotropic medication reduced rate falls rar 034 95 ci 016 073 one trial 93 participants risk falling prescribing modification programme primary care physicians significantly reduced risk falling rr 061 95 ci 041 091 one trial 659 participantsan antislip shoe device reduced rate falls icy conditions rar 042 95 ci 022 078 one trial 109 participants one trial 305 participants comparing multifaceted podiatry including foot ankle exercises standard podiatry people disabling foot pain significantly reduced rate falls rar 064 95 ci 045 091 risk fallingthere evidence effect cognitive behavioural interventions rate falls rar 100 95 ci 037 272 one trial 120 participants risk falling rr 111 95 ci 080 154 two trials 350 participantstrials testing interventions increase knowledgeeducate fall prevention alone significantly reduce rate falls rar 033 95 ci 009 120 one trial 45 participants risk falling rr 088 95 ci 075 103 four trials 2555 participantsno conclusions drawn 47 trials reporting fallrelated fracturesthirteen trials provided comprehensive economic evaluation three indicated cost savings interventions trial period homebased exercise 80yearolds home safety assessment modification previous fall one multifactorial programme targeting eight specific risk factorsgroup homebased exercise programmes home safety interventions reduce rate falls risk fallingmultifactorial assessment intervention programmes reduce rate falls risk falling tai chi reduces risk fallingoverall vitamin supplementation appear reduce falls may effective people lower vitamin levels treatment