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A simple protocol for preventing falls and fractures in elderly individuals with musculoskeletal disease

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Abstract

Summary

Our protocol resulted in a significant prevention of falls and fractures in addition to marked improvements in the balance function. Intervention comprised a new balance exercise and quadriceps femoris exercise. Subjects were outpatients aged ≥65 years old with musculoskeletal disorders who had a result of ≤15 s for the timed one-leg balance test.

Introduction

A study on chronological changes in the level of required care revealed that the level of care increases markedly for older patients requiring non-intensive or intensive long-term care. The aim of the present study was to identify frail elderly patients among older patients with chronic pain of the musculoskeletal system and to assess the fracture prevention and fall prevention effects of exercise therapy using stratified analysis.

Methods

This was a prospective cohort study consisting of 683 outpatients with chronic pain of the musculoskeletal system who were ≥65 years old and had a result of ≤15 s for the timed one-leg balance test with eyes open. Intervention consisted of a new balance exercise and quadriceps femoris exercise regimen. The main outcome was fall rate, while secondary outcomes were the results of the timed one-leg balance test with eyes open and fracture rate.

Results

Fall rate was decreased by 44% (p < 0.001) and fracture rate by 47% (p < 0.05) by 8 months after the start of the intervention. The results of the timed one-leg balance testing with eyes open improved two- to threefold after intervention (p < 0.01).

Conclusions

Our protocol has been safely implemented at a large number of clinics in Japan, and the reductions in frequency of falls and fractures suggest that it provides effective preventive care.

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Acknowledgements

This study was partially supported by Health and Labour Sciences Research Grants (2004, 2005) and a grant for Comprehensive Research on Aging and Health (2005). The authors wish to thank the Committee on Musculoskeletal Rehabilitation and members of the Japanese Clinical Orthopedic Association for their collaboration over a long period of time. Finally, the authors offer their sincere thanks to Prof. Nishibayashi and Prof. Yoshiya for their cooperation in the revision of this paper.

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Authors and Affiliations

  1. Japanese Clinical Orthopaedic Association (JCOA), Okachimachi, Tokyo, Japan

    K. Kita, K. Hujino, T. Nasu & Y. Sunami

  2. Department of Health Policy Science, Tokyo Medical and Dental University, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, Yushima, Bunkyo-ku, Tokyo, Japan

    K. Kawahara

  3. Kita Orthopaedic Clinic, Asagiri KM Building 3F, 165-5 Ookuradani-azakariguti, Akasi City, Hyogo, Japan

    K. Kita

Authors
  1. K. Kita
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  2. K. Hujino
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  3. T. Nasu
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  4. K. Kawahara
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  5. Y. Sunami
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Consortia

Japanese Clinical Orthopaedic Association, Committee on Musculoskeletal Rehabilitation

Corresponding author

Correspondence to K. Kita.

Additional information

This investigation was partially supported by Health and Labour Sciences Research Grants (2004, 2005) and a grant for Comprehensive Research on Aging and Health (2005).

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Kita, K., Hujino, K., Nasu, T. et al. A simple protocol for preventing falls and fractures in elderly individuals with musculoskeletal disease. Osteoporos Int 18, 611–619 (2007). https://doi.org/10.1007/s00198-006-0288-6

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  • DOI: https://doi.org/10.1007/s00198-006-0288-6

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