Effects of a falls exercise intervention on strength, power, functional ability and bone in older frequent fallers: FaME (Falls Management Exercise) RCT secondary analysis

OBJECTIVES: Falls Management Exercise (FaME) has been shown to reduce falls in frequent fallers and in lower risk sedentary older people. The effects of FaME on the strength, power, physical function and bone health of frequently falling older women are yet to be established. METHODS: This paper reports secondary analysis of data from the original randomised controlled trial of FaME in 100 community dwelling women aged ≥65 years with a history of ≥3 falls in the previous year. Intervention was group delivered, weekly one hour tailored dynamic balance and strength exercise classes and home exercise for nine months. OUTCOME MEASURES INCLUDED: strength (handgrip, quadriceps, hamstrings, hip abductors, ankles), lower limb explosive power and functional tests (timed up and go, functional reach, timed floor rise and balance), analysed using Linear Mixed Model analysis. Bone Mineral Density (BMD) at hip and spine was measured in a smaller sub-group and analysed using t-tests. RESULTS: Significant time*group interactions in all measures of strength, except isometric ankle dorsiflexion, concentric hamstring and eccentric quadriceps strength. These improvements in strength equated to average improvements of 7-45%. There were also significant improvements in explosive power (W/kg) (18%, p=0.000), timed up and go (16%, p=0.000), functional reach (17%, p=0.000), floor rise (10%, p=0.002) and eyes closed static balance (56%, p=0.000). There was a significant loss of hip BMD in the control group (neck of femur p<0.05; ward's triangle p<0.02). CONCLUSION: The FaME intervention improves lower limb strength, power and clinically relevant functional outcomes in frequently falling older women

Effectiveness of a community group and home based exercise intervention on the maintenance of vertebral body height and prevention of vertebral compression fractures in older adults: The ProAct65+bone study [Abstract]

Effectiveness of a community group and home based exercise intervention on the maintenance of vertebral body height and prevention of vertebral compression fractures in older adults: The ProAct65+bone study [Abstract

Can exercise protect against vertebral deformity? The proact65+bone study [Abstract]

Can exercise protect against vertebral deformity? The proact65+bone study [Abstract

Policy assessment and policy development for physical activity promotion: results of an exploratory intervention study in 15 European Nations

<p>Abstract</p> <p>Background</p> <p>Purpose of the study was to test a theoretical model to assess and develop policies for the promotion of physical activity among older people as part of an international intervention study.</p> <p>Methods</p> <p>248 semi-standardized interviews with policy-makers were conducted in 15 European nations. The questionnaire assessed policy-makers' perceptions of organizational goals, resources, obligations, as well as organizational, political and public opportunities in the area of physical activity promotion among older people. In order to develop policies, workshops with policy-makers were conducted. Workshop outputs and outcomes were assessed for four nations nine months after the workshops.</p> <p>Results</p> <p>Policy assessment: Results of the policy assessment were diverse across nations and policy sectors. For example, organizational goals regarding actions for physical activity promotion were perceived as being most favorably by the sports sector. Organizational obligations for the development of such policies were perceived as being most favorably by the health sector.</p> <p>Policy development: The workshops resulted in different outputs: a national intersectoral action plan (United Kingdom), a national alliance (Sweden), an integrated policy (the Netherlands), and a continuing dialogue (Germany).</p> <p>Conclusions</p> <p>Theory-driven policy assessment and policy-maker workshops might be an important means of scientific engagement in policy development for health promotion.</p

Lasten ja nuorten kenkien valinta : verkko-ohjausmateriaali lastenneuvolan ja kouluterveydenhuollon henkilökunnalle

Opinnäytetyön tarkoituksena oli tuottaa Suomen Terveydenhoitajaliiton verkkosivuille jä-senten käyttöön materiaalia kengistä lasten ja nuorten jalkaterveyden edistämiseksi. Opin-näytetyö tehtiin yhteistyössä Suomen Terveydenhoitajaliitto ry:n kanssa. Tutkimuksellinen lähestymistapa verkkomateriaalin kehittämisessä oli sekä laadullinen että määrällinen. Aineistona käytettiin kattavaa kirjallisuuskatsausta sekä terveydenhoitajille kohdennettuja kyselyjä. Kirjallisuuskatsausaineisto kerättiin PubMed-, Medline- ja Chinal-tietokannoista. Kyselyn kohderyhmä koostui Suomen Terveydenhoitajaliitto ry:n Helsingin alueen neuvola- ja kouuluterveydenhenkilöstöstä. Kirjallisuuskatsauksen artikkelit analysoi-tiin teoriaohjaavan sisällönanalyysin avulla. Kyselylomakkeiden avoimiin kysymyksiin tulleet vastaukset analysoitiin aineistolähtöistä sisällön analyysia käyttäen. Tulosten mukaan lasten ja nuorten kenkien tulisi olla sopivat kooltaan, mukailla jalkaterän mallia, materiaaliltaan hengittävät, korottomat, joustavat, kevyet ja pohjaltaan ohuet ja taipuisat. Kengillä kävelyn tulisi mukailla paljasjaloin kävelyä, jolloin jalkaterät saavat toimia luonnollisella tavalla. Kyselyn perusteella terveydenhoitajat tarvitsevat työssään tietoa ken-gän hyvistä ominaisuuksista: muun muassa koon arvioimisesta, pohjan ja lestin malleista ja materiaalista. Kyselyyn vastanneet halusivat enemmän tietoa pihtipolvista, ylipainon merki-tyksestä sekä kenkien vaikutuksista alaraajojen kasvuun ja kehitykseen. Verkko-ohjausmateriaali kehitettiin terveydenhoitajien työn apuvälineeksi. Palautekyselyn perusteella terveydenhoitajat olivat tyytyväisiä verkko-ohjausmateriaaliin. Muutoksia toivot-tiin palstojen jäsentelyyn, fonttiin, otsikoiden numerointiin sekä taulukoiden selkiyttämi-seen. Verkkomateriaalia voivat hyödyntää kaikki Suomen Terveydenhoitajaliitto ry:n jäsenet. Verkko-ohjausmateriaali antaa tietoa lasten ja nuorten jalkaterveyttä edistävien kenkien valinnasta ja alaraajoihin vaikuttavista tekijöistä. Tulostettava ohjausmateriaali antaa tukea vanhemmille lasten ja nuorten kenkien valintaan. Kaikki moniammatillisissa työyhteisöissä työskentelevät saavat uusinta tieteellistä tietoa lasten kengistä ja niiden vaikutuksista ala-raaja- ja jalkaterveyteen ja voivat hyödyntää sitä lasten vanhempien ohjauksessa.The aim of this study, carried out in cooperation with the National Union of Public Health Nurses, was to promote children’s and young people’s foot health by producing material about shoes for the web pages of National Union of Public Health Nurses. The online material was developed using both qualitative and quantitative methodological approaches. The data was collected from a literature review and a questionnaire to public health nurses. The literature was gathered from the following databases: PubMed-, Med-line and Chinal. The questionnaire was targeted at family centre and school health service personnel in the Helsinki area. The literature review articles were analyzed using theory-based content analysis whereas the answers to open questions in the questionnaire were analyzed using data-based content analysis. The results show that shoes for children and young people should be well-fitting, adapt to each foot form, made of breathable material, heelless, flexible, light and with thin and flexible soles. Walking with shoes should imitate walking barefoot allowing the natural functions of the foot. According to the survey, in their work public health nurses need information on the properties of a good shoe; for instance on the designs and materials of the sole and last and also how to estimate correct shoe size. The respondents wanted more information on knock-knees, the significance of overweight and the effect shoes have on the growth and development of lower limbs. The online guidance material was developed to help public health nurses in their work and feedback shows it was met with satisfaction. The nurses suggested changes in the column structure, the font, the numbering of titles and the clarity of tables. The material, available to all members of the National Union of Public Health Nurses, gives information on factors that influence the lower limbs and on choosing shoes which pro-mote children’s and young people’s foot health. The material can be printed out to help parents choose shoes for their children. Podiatrists can benefit from the newest scientific information on children’s shoes and their effect on lower limbs and foot health by using the information to give advice to parents and in practice with multiprofessional work communities

RESEARCH Open Access

Policy assessment and policy development for physical activity promotion: results of an exploratory intervention study in 15 Europea