Bárbara Santos Lobo, Maynara do Amaral Alfonsi, Camila Astolphi Lima, Sarah Giulia Bandeira Felipe, Morten Tange Kristensen, Lauren A Beaupre, Catherine Sherrington, Andrea M Bruder, Monica Rodrigues Perracini
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引用次数: 0
Abstract
Objective: The objective was to identify and describe fall prevention strategies in upper limb fracture rehabilitation for older people using recent fall prevention guidelines as a standard.
Methods: A systematic search was conducted in 9 electronic databases (PubMed/MEDLINE, EBSCOhost, Cochrane Library, Lilacs, SPORTDiscus, CINAHL, Web of Science, AgeLine, and SciELO), gray literature, and in bibliographic and citation searching of selected articles between May and December 2022 and updated between February and March 2024. Two independent reviewers screened citations for inclusion. Data extraction was performed by 1 reviewer and verified by a second reviewer. A frequency of strategies and content analysis syntheses were conducted.
Results: A broad search strategy was used, initially identifying 25,945 articles and including 6 randomized clinical trials. The gray literature search identified 18 records. Five studies included forearm fractures, 1 upper limb fracture, and no study exclusively on rehabilitation after humerus fractures. None of the studies provided comprehensive multifactorial fall risk assessments to guide tailored interventions. Assessments mainly focused on gait and balance. Exercise was the most offered intervention alone or in combination with education. Exercise programs were aligned with recommendations to include progressive balance and functional exercises overall. However, the frequency of ≥3 times weekly was less frequently offered. The gray literature showed a lack of fall prevention-specific information after upper limb fractures and mostly called attention to fall prevention after hip fractures.
Conclusion: Upper limb fracture rehabilitation in older adults, considered at high risk of falling, did not include comprehensive and tailored multifactorial fall assessment and intervention. Unequivocally, exercise programs were overall aligned with recent recommendations and were the most frequent intervention. There is a crucial gap for humerus fractures. This study can help align the treatment of upper limb fractures with updated fall prevention recommendations and impact future research, guiding and influencing implementation in clinical practice.
Impact: There is an urgent need to implement comprehensive and tailored multifactorial fall assessments and interventions in rehabilitation programs for older adults recovering from upper limb fractures. Guidelines should direct this work to enhance clinical practice.
目的：目的是确定和描述以最近的跌倒预防指南为标准的老年人上肢骨折康复中的跌倒预防策略。方法：系统检索9个电子数据库（PUBMED/MEDLINE、EBSCOhost、Cochrane Library、Lilacs、SPORTDiscus、CINAHL、Web of Science、AgeLine和SciELO）、灰色文献，并检索2022年5月至12月、2024年2月至3月更新的精选文章的书目和引文。两名独立审稿人筛选了纳入的引文。数据提取由一名审稿人进行，并由另一名审稿人进行验证。进行了策略频率和内容分析综合。结果：采用了广泛的检索策略，最初确定了25,945篇文章，包括6项随机临床试验。灰色文献检索确定了18条记录。5项研究包括前臂骨折，1项上肢骨折，没有专门研究肱骨骨折后的康复。没有一项研究提供全面的多因素跌倒风险评估来指导量身定制的干预措施。评估主要集中在步态和平衡方面。运动是最常用的单独干预或与教育相结合的干预。锻炼计划与建议一致，包括渐进式平衡和整体功能锻炼。然而，每周3次或更多的频率很少被提供。灰色文献显示缺乏上肢骨折后预防跌倒的具体信息，大多呼吁关注髋部骨折后的预防跌倒。结论：老年人上肢骨折的康复，被认为是跌倒的高风险人群，没有包括全面和量身定制的多因素跌倒评估和干预。毫无疑问，锻炼计划总体上与最近的建议一致，是最常见的干预措施。肱骨骨折有一个关键的间隙。该研究有助于将上肢骨折的治疗与最新的跌倒预防建议结合起来，并影响未来的研究，指导和影响临床实践的实施。影响：迫切需要在上肢骨折的老年人康复项目中实施全面和量身定制的多因素跌倒评估和干预措施。指导方针应指导这项工作，以加强临床实践。
期刊介绍：
Physical Therapy (PTJ) engages and inspires an international readership on topics related to physical therapy. As the leading international journal for research in physical therapy and related fields, PTJ publishes innovative and highly relevant content for both clinicians and scientists and uses a variety of interactive approaches to communicate that content, with the expressed purpose of improving patient care. PTJ"s circulation in 2008 is more than 72,000. Its 2007 impact factor was 2.152. The mean time from submission to first decision is 58 days. Time from acceptance to publication online is less than or equal to 3 months and from acceptance to publication in print is less than or equal to 5 months.
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