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Screening and assessment of risk of falling: basis for exercise prescription

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Abstract(s)

Introduction: Falls are currently considered one of the most common and serious public health problems (Gschwind et al 2013). Faced with this problem, it becomes necessary to explore which factors can better predict the risk of falls in individuals living in the community, so that, preventive measures can be considered. Objectives: To identify fall risk indicators and to relate them to exercise prescription levels; to relate the history of fall, the functional capacity (measured through the Timed Up & Go, 10-meter walking speed test, Step test) and the fall risk factors and propose a guide based on those relations to address exercise prescription. Material and Methods: Descriptive and exploratory study. Two hundred community dwelling adults aged 55 or older were assessed, integrating two sub-samples, a Portuguese and a Polish. Study participants were assessed for socio-demographic data, history of falls, fear of falling, exercise, sedentary lifestyle, hearing problems and/or dizziness, visual problems, alcohol consumption, exercise self-efficacy and confidence in activities of the daily life (FES-Portuguese version). They were also subjected to three functional tests, golden measures in the assessment of fall risk, Timed Up and Go (TUG), 10-meter walking speed test and Step Test (15s).The statistical design included descriptive analyses, inferential analyses (bivariate: t-test for independent samples, One-Way ANOVA and Pearson’s correlation coefficient. Results: The percentage of fall in the population was 39.5% and 45.3% in total and Portuguese samples, respectively. TUG, 10-meter walking speed test and step test could distinguish those with history of fall and those without, with statistically significant differences (p≤0.05). Taking more than 4 different medications per day, fear of falling, hearing problems and/or dizziness and the need for help getting up from a chair were related to the history of falls, TUG, walking speed and step test (p≤0.05).The sedentary lifestyle and the use of assistive devices were associated to worst results of the functional tests(p <0.05) in the Portuguese population. TUG, 10-meter walking speed test, step test were correlated with self-efficacy for the exercise. Conclusions: The incidence of falls are higher than literature have reported and it is inversely associated with the functional capacity of the community dwelling adults aged over 55 years old. Data from this study is a valuable basis for exercise prescription, taking into account the levels of risk and the levels of exercise prescription.

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risk of fall functional capacity prevention of falls exercise self-efficacy

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