Talk:Fall prevention

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This article was the subject of a Wiki Education Foundation-supported course assignment, between 5 April 2021 and 21 May 2021. Further details are available on the course page. Student editor(s): JoshGanesh.

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Untitled
This page seems duplicative of Falls in older adults. I would move this information to that page.

Wiki Education Foundation-supported course assignment
This article was the subject of a Wiki Education Foundation-supported course assignment, between 18 August 2020 and 3 December 2020. Further details are available on the course page. Student editor(s): Hannahstlcop, UrosRogan, Mansi829, Alvaro.montijano, Kennedybreak.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 21:08, 16 January 2022 (UTC)

External links modified (January 2018)
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I have just modified 5 external links on Fall prevention. Please take a moment to review my edit. If you have any questions, or need the bot to ignore the links, or the page altogether, please visit this simple FaQ for additional information. I made the following changes:
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Overall, the article itself is an easy read and have basic information. The article can be improved by more relevant research studies and sources. It can also go into more detail about how to prevent falls in the future. I would assess this article as underdeveloped for these reasons. Hannahstlcop (talk) 03:39, 24 September 2020 (UTC)

External links + refspam
Two things:

(1) I was considering adding https://www.sheffield.ac.uk/FRAX/index.aspx to the External links section of this article. However, I noticed the section was already packed with links. Do we really need all of these? Should we take a look at and clean up "External links"?

(2) On 5 February 2018, two users Yfriedma14 and MillieSchweky seem to have added the same reference and used some dubious edit comments + reverted ClueBot. Should these edits and accounts be looked at further, e.g. as refspam, COI, and/or sockpuppetry?

I'd like to ping User:Jytdog seeing you have contributed to this article substantially in the past year - hope you don't mind. --Treetear (talk) 01:35, 24 February 2018 (UTC)
 * oy, thanks. trimmed. Jytdog (talk) 01:40, 24 February 2018 (UTC)
 * Thank you. Furthermore, I've tried to trim primary sources from the article. Feels like it needs a cleanup/overhaul. Templated for More references. --Treetear (talk) 20:52, 27 February 2018 (UTC)

Strokes Recovery
I would like to add some information to this article. I like the idea of creating apps that help you (and especially the elderly) to understand better this problem that sooner or later all of us are going to face. I think it is interesting to have an app where you can have directions about how to act on different situations, exercises you can do in order to prevent these falls, experiences from other users, or even experts we could talk to that could help us with this. I know there are already some apps that are doing some of these that I just listed, but I truly think that not many people know about them and I think It would be a good idea to spread the word and make people discover this great tools for our loved elderly.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5422970

Alvaro Montijano GarciaAlvaro.montijano (talk) 00:43, 10 October 2020 (UTC)
 * Thanks for reaching out here. In order to add this information, we need a high-quality secondary source that summarizes or reviews the primary research you shared in PMC 5422970. Evidence from this secondary source can be paraphrased and added in (as appropriate) to improve the article. The Guideline WP:MEDRS summarizes the types of sources that would work for this. Does thisthis systematic review include apps? JenOttawa (talk) 01:30, 10 October 2020 (UTC)

Additions
Student editor(s): Hannahstlcop, UrosRogan, Mansi829, Alvaro.montijano, Kennedybreak will be making additions to this article using high quality review articles.Melanievandyke (talk) 16:25, 24 November 2020 (UTC) 1. Description of how the addition fills the content gap in the Wikipedia article. 2. Exact placement of addition in Wikipedia. 3. APA citation of your resource, including the doi 4. Addition

1. The content gap in this Wikipedia article about multifactorial methods of fall prevention was filled by my addition. Although the article already had information on multifactorial methods, my addition specifies other research studies that helps support the section. A fall prevention method that wasn’t mentioned by the original Wikipedia author was decreasing the fear of falling decreases falls itself. I added the research behind it as well. 2. My addition would go in the “Strategies and Interventions” section. I would want my addition to be the first thing in the section, as it would transition nicely with the other strategies that the author listed.

3. Phelan, E. A., & Ritchey, K. (2018). Fall Prevention in Community-Dwelling Older Adults. Annals of Internal Medicine, 169(11), ITC81-ITC96. http://doi.org/10.7326/aitc201812040

4. Multifactorial preventative methods are shown to be much more effective at preventing falls in elderly adults. A research study including 41,596 subjects in 54 trials drew the conclusion that a combination of common ways to prevent falls are much more effective than the individual method itself. These multifactorial method benefits apply to patients in hospitals as well, not just the elderly at home. Individual methods include exercise, facing fears of falling, regular consultations, removing medications, and vitamin supplements. With a combination of these methods, an elderly can have significantly less falls than if they just implement one method of prevention. Research studies show that these individual methods are successful in reducing the number of falls. Yet, when these methods are used synchronously, there is a significant decrease in the number of falls.

One of the ways to prevent future falls is to have a medication review, as certain medications can compromise the balance of an elderly who struggles with frequent falls. A meta-analysis with 22 research studies and 79,081 subjects concluded that there are certain medications that increased the risk of falls such as antidepressants and neuroleptics. A doctor would suggest either switching medications or removing the medication entirely to prevent future falls.

Another way to prevent future falls is to exercise more frequently. Exercise, specifically focusing on balance and strength, is the method that is proven to be the most beneficial intervention method, according to the same trial mentioned above. Doctors suggest combining exercise with vision assessment or home modifications to further reduce the potential for falls.

Fear of falling increases the chances of falling in the future. The reason behind this is because when elderly is afraid of falling, they avoid as much physical activity as possible. The disuse of muscles results in detrimental changes in posture and balance, which increases the chance of falling. A way to prevent this is to understand that a fear of falling only increases the chance of falling. The fear can be reduced by therapy, self-assurances, and frequent movement. Once the elderly take steps to recover from their fear, they will have less falls. Hannahstlcop (talk) 20:03, 2 December 2020 (UTC)

1. I believe my addition fills the content gap regarding the occupational therapy aspect of fall prevention in older adults. I believe it gives general information regarding the various interventions that have been used in order to try to prevent falls in the elderly. These various interventions include single-component interventions, group-based multicomponent interventions, multifactorial interventions that are uniquely tailored, and population-based interventions. It also gives insight into some particular strategies that each intervention uses such as medication review, building balance confidence, home modification, multitask activities, etc. I think it allows readers to see the variety of interventions as an overview but also allows readers to understand specific strategies that are used as well. It also gives information regarding what intervention studies have proven to be most effective, which is the group-based multicomponent intervention. 2. I would like my addition in the Fall Prevention article under the “Occupational and physical therapy” heading and then under the subheading “Older adults.” 3. Elliot, S., & Leland, N.E. (2018). “Occupational Therapy Fall Prevention Interventions for Community-Dwelling Older Adults: A Systematic Review.” The American Journal of Occupational Therapy: Official Publication of the American Occupational Therapy Association, 72 (4), 1-11. https://doi.org/10.5014/ajot.2018.030494 4. Different approaches to occupational therapy fall-prevention interventions were studied and reviewed, and it was found that many were proven to be effective but the group-based multicomponent intervention was proven to be most effective. Those approaches included single-component interventions, group-based multicomponent interventions, multifactorial interventions that are uniquely tailored, and population-based interventions. When utilizing the single-component intervention, they individually focused on areas such as balance, exercise, guided imagery, and relaxation. They assessed the home and functional abilities as well as educated patients on fall risks. Some areas that were focused on were a variety of functional, water-based, and multitasking exercises. When reviewing the group-based, there was a variety of strategies used but included both exercise and education. The strategies focused on strength, balance, functional tasks, gait speed, and even included training with fall techniques and obstacle courses. Through this, they worked on reducing Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) impairments. Education included footwear risks, how to use assistive devices, and how to modify home risks, fall recovery, and the management of medication. When assessing the multifactorial interventions that were uniquely tailored, some techniques included assessing fall risk for each individual, developing goals, training, and group activities. They also included vision and hearing screenings, environmental interventions, and the review of medications. The population-based intervention focused on group-based exercises such as eight 2-hour group sessions that focused on decreasing fear, building balance confidence, and increasing activity levels. They also emphasized cognitive-behavioral interventions and safe behavior programs. The systematic review concluded that when analyzing the varying approaches, the group-based multicomponent intervention proved to be the most effective. It had the strongest evidence showing an increase in balance confidence, reduction in fall rate, increased gait speed, and a decrease in ADL and IADL impairments. The interventions that provided the most supportive data were balance, strength, functional tasks, walking, multitask activities, and education such as footwear risk, assistive device use, home modification, medication review, and nutrition and hydration. Overall, each multicomponent approach used a mixture of both exercises and education. Ultimately, the group-based multicomponent intervention provided the strongest data in decreasing the rate of falls in the elderly. Kennedybreak (talk) 21:30, 2 December 2020 (UTC)

1.	My addition for Fall Prevention Wikipedia article will focus on balance exercises and how effective they are. There is not a lot of information on the page regarding balance, and I believe that it is important for readers to be informed about how balance exercises work and that they can prevent older adults from falling. 2.	In Falls Prevention under Strategies and Interventions section, make a new sub-heading called Exercise starting with their sentence “Exercise as a single intervention has been shown to prevent falls in community-dwelling older adults” and replace “A systematic review suggests that having an exercise regimen that includes challenging balance workouts for three or more hours per week results in a lesser chance of falling.” with my addition. 3.     Sherrington, C., Michaleff, Z. A., Fairhall, N., Paul, S. S., Tiedemann, A., Whitney, J., Cumming, R. G., Herbert, R. D., Close, J., & Lord, S. R. (2017). Exercise to prevent falls in older adults: an updated systematic review and meta-analysis. British journal of sports medicine, 51(24), 1750–1758. https://doi-org.stlcopisa.stlcop.edu/10.1136/bjsports-2016-096547 4.	Programs that include physical exercises can prevent falls in older adults. Those programs include balance, strength, and flexibility exercises. Studies have shown that balance exercises are the most effective types of exercises in reducing the risk of falls in older adults, especially when older individuals are consistently active. Exercise programs include 3 types of balance exercises: 1.	 Reducing the base of support – Exercises that focus on standing and maintaining balance. The main goal is to improve an individual’s stability (e.g., standing still while feet are close together, one leg stands, etc.) 2.	Moving the center of gravity and controlling body position while standing – Exercises that focus on maintaining balance during movement. (e.g., transferring body weight from one leg to another, step-ups on a higher surface, etc.) 3.	Standing without using the arms for support (e.g., keeping the balance on an unstable surface while using one or no hands) Being active and consistent with an exercise routine/schedule can reduce the number of falls in older adults. Balance exercises are most effective when combined with more than 3 hours per week of regular exercise. A meta-analysis with approximately 19 000 participants showed that older adults who combined balance exercises with more than 3 hours of regular exercise had positive results, reducing falls by 21%.UrosRogan (talk) 21:34, 2 December 2020 (UTC)

1. New Addition Recommendations: I went back and added more information on the exact placement of the information in the original Wikipedia Falls Prevention article. And elaborated more of each of the sub-sections. Where I am exactly putting this information at. This content fills in Wikipedia article, because in patients being in wheelchairs, or being in a wheelchair due to their condition of some sort is really common. And with that falls in patients in wheelchairs is very common as well. So, it is important to find factors that can be avoided, and patients can prevent falls while in wheelchairs. So, I think this paragraph particularly fills in the content gap that was missing and this information can be really useful for the audience as well.

2. I would put this information under the section of Environmental modification. Since the use of a wheelchair would part of a home environment and could potentially cause many hazards if not taken precautions. Include data from research study I would specifically put this information between the subsections of Lighting and Eyeglasses selection and usage.

3. Sutton, D., & McCormack, S. (2019). Fall Prevention Guidelines for Patients in Wheelchairs or Patients with Delirium: A Review of Evidence-Based Guidelines. Canadian Agency for Drugs and Technologies in Health. Retrieved From: https://www.ncbi.nlm.nih.gov/books/NBK546784/

4. New Addition: These are some of the basic changes that I would make with patients on wheelchairs. With patients in a wheelchair, I want to specifically talk about the proper transfer method for patients on a wheelchair. A patient should go through some sort of a training assessment, especially from a trained professional if they are not aware of the basics of a regular wheelchair. It is important to go over the basics of a wheelchair with the patient and their caregiver as well. Some of the safety precautions would include, that the wheelchair is in a good working condition/maintenance and should be in the appropriate height for the patient. Wheelchairs that are too short or tall compared to the patient’s height, would make it challenging for the patient to appropriately adjust to it. Patients need to communicate well with someone in order to understand all the pros and cons of a wheelchair. Especially if they are going to be on their own, they need to know the proper methods of how they can move themselves around in specific environments. Including the importance making sure there is no problem with slippage from the floors; and making sure they can see better during the day and nighttime while moving from one place to another. In the Falls Prevention article, I would put this information under the section of Environmental modification. Since the use of a wheelchair would part of a home environment and could potentially cause many hazards if not taken precautions. Include data from research study I would specifically put this information between the sub-sections of Lighting and Eyeglasses selection and usage. Where it talks about turning on the max amounts of lights as possible, especially during nighttime to make sure patients can see and avoid and possible fall hazards. It is important to make sure the patient has a good stable movement, so they don’t lose their balance. Especially if the patient is utilizing a front-wheeled walker; the friction of the floors should help prevent slippage. With the eyeglass’s selection and usage, it is important to wear any type of eye wear that will help them see better. They need to be ideal for safe walk or be able to see properly while in wheelchair. Overall, patients need to be as cautious as they can, in order for them to prevent any difficulties in a wheelchair and to prevent falls. — Preceding unsigned comment added by Mansi829 (talk • contribs) 17:56, 3 December 2020 (UTC)

1. As I am going to state in the following lines, I think my additions and the final content of the article fill Wikipedia's content gap as the information is detailed and linked to the title (Fall Prevention). I added a lot of information regarding stroke recovery exercises, as well as about the section about support from friends and family. I think those topics were not spoken at all and I consider they both are an important fact when it comes to falls and help. About sections that were not there before, I removed some content that was unnecessary because it did not add anything new or it was just not linked to the topic. I used more than 15 new sources to rely on the information I add and I added pictures to exemplify what I wrote. Everything in the article has a reliable backup source and compares it all to other information previously written.

2. -	I added the "Fear of falling (Basophobia)" and cited it, located first on the "Risk factors of falls". -	Added citations on the "Healthy young individuals", under the "Fear of falling (Basophobia)". -	Added the "Limitations in mobility" citations and content to the "older adults" section, under “Gait deviations”. -	Added “Reduced muscle strength" citation and content to the "older adults" section, under “Limitations in mobility”. -	Added "Poor reaction time" citation and comment to the "older adults" section, under “Reduced muscle strength”. -	Added the whole section and citations of the "Stroke recovery", on the “Occupational and physical therapy” section. -	- Added the section of "Support from close people", under the “Long term care facilities and hospitals” section. -	Added all citations and last paragraph of the "Safety Technology" section. -	I removed the “Lighting” section as I think it is not important information. Normally accidents happen at home and the elderly already know where everything is and always have the lights on. -	I wanted to add a picture of a senior park but it had copyright and I could not get a legit image to post. -	Added the "exercises for prevention" paragraph, under “Stroke recovery exercises” section. -	Added citations #32, #34, #37, #38 #44 #45, #46, #47, 48, #55. Those were original information on the article that I added reliable sources. -	Corrected many spelling mistakes that were in the original article.

3.	Team, A. A. V. E. (2020, November 30). What's the Difference Between Bifocals & Trifocals? All About Vision. https://www.allaboutvision.com/lenses/multifocal.htm. Institute of Medicine (US) Division of Health Promotion and Disease Prevention,. (1992, January 1). Falls in Older Persons: Risk Factors and Prevention. The Second Fifty Years: Promoting Health and Preventing Disability. https://www.ncbi.nlm.nih.gov/books/NBK235613/. Segev-Jacubovski, O., Herman, T., Yogev-Seligmann, G., Mirelman, A., Giladi, N., & Hausdorff, J. M. (2011, July). The interplay between gait, falls and cognition: can cognitive therapy reduce fall risk? Expert review of neurotherapeutics. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3163836/. Olavide, P. (2018). Los Parques de Mayores. UPO. https://www.upo.es/export/portal/com/bin/portal/fdep/alumnos/Muestra_Trabajo_Fin_Grado/1424431349597_mod-tfg_8_20122013_calificacion_9.20.pdf. Prevent Accidents in the Bathroom with These Toilet Safety Rails: Updated for 2020. AgingInPlace.org. (2019, March 4). https://aginginplace.org/prevent-accidents-in-the-bathroom-with-these-toilet-safety-rails/. McKinney, R. (2020, July 1). Exciting Advancements in Fall Prevention Technology. Safesite. https://safesitehq.com/fall-prevention-technology/. ME. Tinetti, M. S., L. Clemson, L. M., TM. Gill, C. S. W., MC. Nevitt, S. R. C., RW. Sattin, J. G. R., M. Speechley, M. T., … AZ. Monson, J. P. (1988, January 1). A need to improve the assessment of environmental hazards for falls on stairs and in bathrooms: results of a scoping review. BMC Geriatrics. https://bmcgeriatr.biomedcentral.com/articles/10.1186/s12877-018-0958-1. .ORG, N. C. O. A. FALLS PREVENTION CONVERSATION GUIDE FOR CAREGIVERS. NCOA. https://www.ncoa.org/wp-content/uploads/Falls-Prevention-Conversation-Guide-for-Caregivers_Final.pdf. Rasche, P., Mertens, A., Bröhl, C., Theis, S., Seinsch, T., Wille, M., … Knobe, M. (2017, May 8). The "Aachen fall prevention App" - a Smartphone application app for the self-assessment of elderly patients at risk for ground level falls. Patient safety in surgery. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5422970. Tricarea, G. (2016, March 16). Caídas en personas mayores: riesgo, causas y prevención. Geriatricarea. https://www.geriatricarea.com/2016/03/16/caidas-en-personas-mayores-riesgos-causas-y-prevencion/. Medline, P. (2019). Caídas: MedlinePlus en español. MedlinePlus. https://medlineplus.gov/spanish/falls.html. S. M. S. S. W. J. R. K. H. E. W. (2017). The impact of mobility limitations on health outcomes amongolder adults. ELSEVIER. https://doi.org/https://reader.elsevier.com/reader/sd/pii/S0197457217302057?token=273BB4BC86581725ECC92E10C6A80776EB12E00C6406F5D1428BABCF1F003957B95162D153C52693B6FAEC4122FE8FFC

4.	Before my edition, there was a lot of information that was not cited, so its reliability was not shown and that could potentially lead to false information and have bad consequences. In addition, there were some sections that were not following the topic or did not add anything. to the article such as the illumination, which I removed to add more information about stroke recovery exercises and the support from close people. After I edited it, there was a lot of information about how it happens, how to avoid them, and how to recover from it. The conclusion that I take out of this article is that the elderly need to be protected by themselves, and for us, their close ones. Thanks to the different accommodations, resources, and various help that society brings to the elderly, they have all they need to be prepared to go through their elderly with enough safety and potential knowledge to avoid this accident.

From this article, I have learned many things. I really did not know about the topic and I learned why it actually happens, and the several risk everybody takes, but especially the elderly. I also did not ever think that physical condition would be such an important fact in these circumstances. Overall, this article made me give it more importance than the one I gave at the beginning. I have understood that this is a circumstance we all are going to face in our lives so I am glad I am more prepared for it now.

Alvaro Montijano GarciaAlvaro.montijano (talk) 09:13, 3 December 2020 (UTC)