Thesis (D.W.S.)--Institute for Worship Studies, 2002. / Abstract. Includes bibliographical references (leaves 128-139).

published_or_final_version / Medical Sciences / Master / Master of Medical Sciences

published_or_final_version / Medical Sciences / Master / Master of Medical Sciences

published_or_final_version / Sports Science / Master / Master of Science in Sports Science

In six experiments, the relationships between history of falls, reinvestment, fear of falling, perception, balance ability and walking ability of community-dwelling older adults was investigated. In addition, the Movement Specific Reinvestment Scale (MSRS) (Masters, Polman, & Hammond, 1993; Masters, Eves, & Maxwell, 2005) was further validated, using a Chinese version (MSRS-C). In the first experiment (Chapter 2), it was shown that elder fallers scored significantly higher than non-fallers on both the movement self-consciousness and the conscious motor processing components of the MSRS-C. The conscious motor processing component of the MSRS-C was found to discriminate previous faller from non-faller status. In the second experiment (Chapter 3), findings demonstrated that internal focus of attention was greater in elder repeat fallers and increased as task demands increased. However, external focus of attention increased in both elder repeat fallers and elder non-fallers as task demands increased. Elder repeat fallers scored significantly higher than elder non-fallers on the MSRS-C. In the third and fourth experiments (Chapter 4), it was revealed that elder fallers demonstrated greater fear of falling and a higher propensity for movement specific reinvestment than non-fallers. Elderly people perceived stairs as steeper than they were and judged stairs as steeper when making visual-matching and verbal-report estimates that required conscious involvement compared to haptic estimates that are thought to require little conscious involvement. Overestimations when making explicit, conscious judgments were reduced by carrying out a concurrent secondary task during estimation, but there was little effect of the secondary task on implicit, non-conscious judgments of steepness. In Chapter 5, focus group work was conducted to investigate whether (1) elderly people respond differently when asked to complete the MSRS-C in respect of contexts that are not directly related to balance or locomotion and (2) elderly people are better able to differentiate a 4-point Likert response format when completing the MSRS-C than the original 6-point format. Experiment five (Chapter 6) further validated the MSRS-C based on the findings from Chapter 5. Results revealed that both the MSRS-C (general) and MSRS-C (walking) can be used with a six-point or a four-point response format to differentiate elderly Chinese fallers from non-fallers. The overall findings were discussed in the context of theories of motor learning and reinvestment. Implications for rehabilitation training were elucidated. / published_or_final_version / Human Performance / Doctoral / Doctor of Philosophy

Objective: To evaluate the effectiveness of exercises on fall prevention among community-dwelling elderly. Design: Systematic review of randomized controlled trials. Method: The literature search of articles was conducted through the electronic databases of PubMed, Medline and EMBASE and manual search, and was confined to articles in English language with full text and publications from 2002 to 2012. Randomized controlled trials with exercise as the only intervention which aimed at reducing falls in older people aged 60 or above in community i.e. community-dwelling elderly were included. The primary outcomes were number of fallers, fall rate, time to the first and subsequent falls. Data Extraction: A total of 145 articles were retrieved through the electronic data bases (137 articles) and manual search (8 articles) of which 10 were selected after applying the inclusion criteria. According to the checklist developed by National Institute for Health and Clinical Excellence (NICE) for randomized controlled trials, the overall methodological quality of the 10 studies was rated as good as they had fulfilled 79%-93% of the assessment criteria in the NICE checklist. Results: The studies involved a sample size of 3,138 at the median age of 69 to 83. All the subjects were ambulatory and able to mobilize independently. The duration of exercise interventions ranged from 1.5 months to 12 months at a total of 11-156 hours. Eight studies showed that exercises were effective in fall prevention whereas two studies found no evidence of such effectiveness. The effect of exercises on fall prevention was multifactorial including the duration, frequency and continuity of the exercise programs, the health status of the target population and the individuals’ adherence to the exercise programs. Shorter exercise programs and make-up class arrangement resulted in higher adherence rate. Tailor-made (based on the functional capabilities of the subjects) and progressive (gradual increase of the intensity and challenge of the exercises during the intervention period) nature of the exercise programs also enhanced their effectiveness on the elderly. For the studies in which exercise did not have any positive effect on fall prevention, the subjects were generally older (median age at 81) and frailer (with 3-7 frail attributes). Conclusions: This review suggests exercise may be an effective intervention for fall prevention among community-dwelling elderly. Different types of exercise including strengthening, balance, endurance and weight-bearing exercises as well as Tai Chi may prevent falls. The elderly’s age and health status must be taken into consideration when designing exercise intervention programs for the elderly. Further researches are recommended to determine the optimal type, intensity, frequency and duration of exercises in fall prevention. Observations from the studies provide insights for future researches, such as the fall prevention effect of group and home exercises, tailor-made and progressive exercise programs. In Hong Kong, no randomized controlled trial studies have been conducted to examine different intervention programs on fall prevention. To achieve generalizabilty of the studies in the review, further local researches, particularly well designed and powered randomized controlled trials have to be conducted to assess the effect of different kinds of exercise interventions on fall prevention among the community-dwelling elderly. / published_or_final_version / Public Health / Master / Master of Public Health

Falls among the elderly population continue to be a growing concern in the healthcare industry and are marked by staggeringly high social and economic costs. The incidence of falls is known to increase with age, and currently the elderly population is growing at an astounding rate as baby-boomers are now entering this age group. Also, recovery following fall-related injuries decreases with increased age. These confounding factors currently make falls a very important area of research. Of the injuries typically seen in falls among the elderly, head injuries are one of the most debilitating. Death due to head trauma among the elderly is gaining national attention; head trauma is now considered the number one cause of death among elders who fall1. Among other technologies, medical helmets are often employed to protect against such injuries, but patient compliance with these helmets remains an issue. Current helmets use foams and cotton as padding, contributing to clumsy designs. Dilatent and honeycomb materials may be the future of this industry as their low weight and high efficacy per thickness make them ideal materials for thinner, lighter, less cumbersome head protection devices. This study outlines various modes of head injury and then highlights several head protection measures. The newer materials are tested using various methods to determine the most promising candidates for prototype designs. Next, three prototypes are assembled from the newer materials and compared directly based on the protection measures established. Finally, the top-performing prototype is compared against two existing medical helmets in a similar fashion. The results show that the best prototype significantly outperforms one of the existing medical helmets, and shows slight improvement over the other. These results establish the promise of these newer materials in the application of head protection devices.

published_or_final_version / Gerontology / Master / Master of Social Sciences

The aim of this study was to investigate fall risk and predisposing factors for fall among the residents in long-term care institutions. Methods. Elderly care homes residents 48 men (mean ± SD, 78,6±7,0) and 101 women (mean ± SD, 81,6±6,4), all 149 residents, participated in the study. For investigation a questionnaire was used, which was made according literature and including following instruments: Environmental Falls Audit Tool – Individual, Falls Risk Assessment Tool and Risk Factor Checklist, Mini Mental State Examination. Results. The most frequently diseases among men and women were heart and vascular (89,6 % and 92,1 %) and eyes diseases (70,8 % and 75,2 %). Ambulatory aid was needed for a half of all residents (54,4 %); ambulatory aid, which respondents didn’t want to used were three times common for women than men (p=0,007). Most residents had low fall risk (72,5 %), but high fall risk was more common in women (14,9 %) than men group (4,2 %); there were no significant difference between groups. High fall risk significantly dominated among the residents older than 85 year in comparison with 65-74 and 75-84 year age groups. Residents who had lower education (p<0,001), were older (p=0,005) and took more medications (p=0,002) had higher fall risk scores evaluated by Fall Risk Assessment Tool. Residents who had such risk factors as unsafe mobility, over-reaches transfer, forgot gait aids, observed behavioural agitation, disorientation had more medium-high fall risk... [to full text]

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