Thesis (Ph.D.) - University of Queensland, 2006. / Includes bibliography.

Thesis (Sc. D.)--Louisiana Tech University, 2003. / Includes bibliographical references (leaves 246-257).

Thesis (M.S.)--Oregon State University, 2003. / Includes bibliographical references (leaves 53-56).

Thesis (M.S.)--Oregon State University, 2005. / Includes bibliographical references.

Thesis (M. Sc.)--University of Oregon, 2006. / Includes bibliographical references.

Thesis (M.S.)--University of Oregon, 2006. / Includes bibliographical references (leaves 77-81). Also available online (PDF file) by a subscription to the set or by purchasing the individual file.

Magister Scientiae (Physiotherapy) - MSc(Physio) / Falls among elderly people have been identified as a significant and serious medical problem confronting a growing number of older people. Falls have been found to be a leading cause of disability, distress, admission to supervised care and death among older persons that pose a serious problem to public health. The purpose of this study was to determine the prevalence of and risk factors for falls in the community-dwelling elderly persons in the Umutara province of Rwanda. / South Africa

Context: There is a paucity of information on well-designed exercise programs for the Primary Falls Prevention. Objective: This study aimed to evaluate a tailor-made exercise program for improving balance and balance-related fitness among older adults without history of falls but who were at risk of falling. Design, Setting, and Participants: A single-blind and randomized controlled trial for 61 older adults (age = 70 ± 3 years, males = 25%) with no history of falls but who were at risk of falling enrolled at the local senior center. Intervention: Participants were randomly allocated into three groups. An intervention group receiving a tailor-made Exercise for Balance Improvement Program (ExBP; n = 20), an active control group receiving the 8-form Yang-style Tai Chi (TC; n = 20), and a no-treatment concurrent control group (CON; n = 21). The ExBP was developed based on demographic and clinical characteristics of old adults as well as on the most reported deficits in balance and balance-related systems. The movements chosen in ExBP were those used in previous studies for older adults. The movements were integrated with considerations of movement specificity, movement complexity and organization, movement safety, feasibility and gracefulness, as well as the transfer of exercise learning. Modifications of these movements were made following experts and end-users’ evaluations. Training dosage was set at “90 minutes per session x 3 sessions per week x 16 weeks with an 8-week follow-up. Outcome Measurements: The primary outcome was a composite measure of balance capacities, including Fall Risk Test (FRT), Postural Stability Test (PST), Limits of Stability Test (LOS), and a modified Clinical Test of Sensory Organization and Balance (m-CTSIB). The secondary outcomes referred to those balance-related fitness including 30s Chair Stand Test (CS), Chair Sit-and-Reach Test (SR), 8ft Up and Go Test (UG), 2min Step Test (Step), Choice Stepping Response Time (CSRT), as well as Fear of Falling (FF). All the testing parameters were collected one week before the intervention (pre-test), at the end of 12th week (mid-test), at the end of 16th week (post-test), and at the end of 24th week (follow-up test). Analysis of variance with pre-test data as covariance and repeated measures analysis of variance were conducted to examine Group effect and Time effect, respectively. Results: All testing parameters in the ExBP group demonstrated an improvement trend from pre-test to post-test, especially in FRT, m-CTSIB, CS, SR, UG, and FF (p < .05). In comparison with the CON group at post-test, there were significant improvements in the ExBP group in FRT, m-CTSIB with compromised somatosensation, m-CTSIB with compromised vision and somatosensation, CS, UG, Step, and FES (p < .05), while the improvements at mid-test were only shown in UG and FF. There were no significant differences on any of the testing parameters between post-test and follow-up test. In addition, continuous improvements were shown in FRT, PST, m-CTSIB, SR, UG, CSRT, and FF during the follow-up period. In comparison with the TC group at mid-test, ExBP showed significantly more improvements in FRT, UG, Step and FF. Although without statistically significant group difference at post-test except in Step, improvements in FRT, PST in anterior-and-posterior direction, m-CTSIB with compromised somatosensation, m-CTSIB with compromised vision and somatosensation, SR, UG, Step, and CSRT were more pronounced in the ExBP group. The losses of training effect from post-test to follow-up test in ExBP was lower than the Tai Chi especially in FRT, m-CTSIB with compromised vision and somatosensation, Step, and CSRT. Conclusion: The ExBP can be applied as an effective exercise program for improving balance and balance-related fitness among older adults at risk of falling. In comparison with Tai Chi, training effects from ExBP occurred earlier and lasted longer.

This thesis is focused on frailty in old age. The frailty syndrome is the newest geriatric syndrome and can be aptly called the ultimate geriatric syndrome due to the complexity of its causes and the wide range of adverse outcomes it may lead to in older persons. Several of the important correlates of frailty, namely falls, underweight and sarcopenia, are discussed in the context of their relationship with frailty. These entities are geriatric syndromes in their own rights, sharing many common risk factors and arriving at adverse health outcomes either directly or via the pathway of frailty. In the publications that arose from this work, the risk factors of falls, in particular the relationship between medications and chronic diseases in causing falls; risk factors and outcomes of sarcopenia, in particular its relation to diabetes mellitus and other chronic diseases; and how underweight poses survival risks in both community-living and institutionalized older people, are discussed. The final publication of this series of studies demonstrated the reversibility of the frailty syndrome, showing that not all who were in the pre-frailty stage will decline. Risk factors associated with improvement or decline in the pre-frail stage were identified in the local population, and a period of relative stability opened for possible interventions was observed. This thesis thus examines the complex interplay of these syndromes in old age. It is hoped that these publications will enable further research into the underlying mechanisms of frailty and to elucidate modifiable risk factors, hence enabling older people, in particular those in the pre-frail stage, to live healthier and longer lives. / Lee Shun Wah Jenny. / Thesis (M.D.)--Chinese University of Hong Kong, 2015. / Includes bibliographical references. / Title from PDF title page (viewed on 15, September, 2016).

Yeung, Pui Yee. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2009. / Includes bibliographical references (leaves 131-145). / Abstract and some appendixes also in Chinese. / ABSTRACT --- p.i / ABSTRACT (in Chinese) --- p.iii / DECLARATION OF ORIGINALITY --- p.iv / ACKNOWLEDGEMENTS --- p.v / RESEARCH-RELATED PRESENTATIONS AND AWARD --- p.vi / TABLE OF CONTENTS --- p.vii / LIST OF ABBREVIATIONS --- p.xi / LIST OF FIGURES --- p.xii / LIST OF TABLES --- p.xiii / Chapter CHAPTER 1 --- INTRODUCTION --- p.1 / Chapter CHAPTER 2 --- LITERATURE REVIEW --- p.3 / Chapter 2.1 --- Incidence and prevalence of falls in older people --- p.4 / Chapter 2.1.1 --- Incidence and prevalence in western countries --- p.4 / Chapter 2.1.2 --- Incidence and prevalence in Hong Kong --- p.4 / Chapter 2.2 --- Causes and risk factors for falls --- p.5 / Chapter 2.2.1 --- Causes for falls --- p.5 / Chapter 2.2.2 --- Risk factors for falls --- p.6 / Chapter 2.3 --- Consequences of falls --- p.7 / Chapter 2.3.1 --- Individual perspective --- p.7 / Chapter 2.3.2 --- Impact on health service and society --- p.9 / Chapter 2.4 --- Intervention and prevention strategies --- p.10 / Chapter 2.4.1 --- Effective interventions and preventive approaches --- p.10 / Chapter 2.4.2 --- Areas of uncertainty for interventions and prevention approaches --- p.19 / Chapter 2.5 --- Existing efforts in intervention and prevention --- p.20 / Chapter 2.5.1 --- Worldwide levels and collaborations among various countries --- p.20 / Chapter 2.5.2 --- Current services for falls prevention in Hong Kong --- p.23 / Chapter 2.6 --- Criteria contributing to successful intervention and risks modification --- p.27 / Chapter 2.6.1 --- Identification of elderly fallers at Accident & Emergency Department --- p.28 / Chapter 2.6.2 --- Selection of the proved effective programme to those likely to benefit --- p.29 / Chapter 2.6.3 --- Uptake and adherence of the target fallers to the selected programmes --- p.30 / Chapter 2.7 --- Current gaps in study of services for elderly fallers in Hong Kong --- p.31 / Chapter CHAPTER 3 --- METHODOLOGY --- p.32 / Chapter 3.1 --- Research objectives --- p.33 / Chapter 3.2 --- Operational definition of falls --- p.33 / Chapter 3.3 --- Study design --- p.34 / Chapter 3.3.1 --- Diagrammatic illustration of the study design --- p.35 / Chapter 3.3.2 --- "Subjects, assessors and setting" --- p.37 / Chapter 3.3.3 --- Sources of data collection --- p.38 / Chapter 3.3.4 --- Questionnaire and assessment instruments --- p.39 / Chapter 3.3.5 --- Referrals and interventions --- p.49 / Chapter 3.4 --- Plan of data analysis --- p.52 / Chapter CHAPTER 4 --- RESULT --- p.55 / Chapter 4.1 --- Progression of elderly fallers --- p.56 / Chapter 4.2 --- Characteristics of all elderly fallers presented to A&E --- p.58 / Chapter 4.2.1 --- Demographics --- p.58 / Chapter 4.2.2 --- Rate of hip fracture --- p.58 / Chapter 4.2.3 --- Seasonal variation for occurrence of falls --- p.58 / Chapter 4.2.4 --- Subsequent one-year mortality --- p.59 / Chapter 4.2.5 --- Subsequent one-year occurrence of falls with presentation to A&E --- p.59 / Chapter 4.2.6 --- Subsequent one-year hospitalization and length of stay --- p.59 / Chapter 4.3 --- Profile of elderly fallers who received comprehensive falls assessment --- p.63 / Chapter 4.3.1 --- Demographics --- p.63 / Chapter 4.3.2 --- "Circumstances, consequences and past history of falls" --- p.67 / Chapter 4.3.3 --- Health and functional profile --- p.75 / Chapter 4.4 --- Uptake of interventions or referrals by elderly fallers --- p.89 / Chapter 4.4.1 --- Uptake rate of various interventions or referrals --- p.89 / Chapter 4.4.2 --- Reasons for refusing interventions or referrals --- p.89 / Chapter 4.5 --- Comparison between recurrent fallers and non-recurrent fallers --- p.91 / Chapter 4.5.1 --- Co-morbidity between recurrent fallers and non-recurrent fallers --- p.91 / Chapter 4.5.2 --- Functional profile between recurrent fallers and non-recurrent fallers --- p.91 / Chapter 4.6 --- Comparison between injurious falls and non-injurious falls --- p.93 / Chapter 4.6.1 --- Co-morbidity between fallers with resultant injury and fallers without injury --- p.93 / Chapter 4.6.2 --- Functional profile between fallers with resultant injury and fallers without injury --- p.93 / Chapter 4.7 --- Comparison of the profiles between the elderly fallers and the general older population in Hong Kong --- p.95 / Chapter 4.7.1 --- Comparison in demographics --- p.95 / Chapter 4.7.2 --- Comparison in self-perceived health --- p.95 / Chapter 4.7.3 --- Comparison in lifestyle factors --- p.95 / Chapter 4.7.4 --- Comparison in BMI --- p.96 / Chapter 4.7.5 --- Comparison in morbidity --- p.96 / Chapter 4.7.6 --- Comparison in number of disease --- p.97 / Chapter 4.7.7 --- Comparison in medication use --- p.97 / Chapter 4.8 --- Comparison between fallers attended and those who did not attend the falls assessment clinic in terms of the subsequent one-year results --- p.102 / Chapter 4.8.1 --- Comparison in subsequent one-year mortality --- p.102 / Chapter 4.8.2 --- Comparison in subsequent one-year recurrent falls with presentation to A&E --- p.102 / Chapter 4.8.3 --- Comparison in subsequent one-year hospitalization and LOS --- p.103 / Chapter 4.9 --- Validation of a simple screening tool adopted from the Mr. Os (Hong Kong) study by the result of this study --- p.106 / Chapter CHAPTER --- 5 DISCUSSION --- p.108 / Chapter 5.1 --- Profile of elderly fallers presenting to A&E and its implications to health care planning for the elderly --- p.110 / Chapter 5.1.1 --- Profile of fallers in terms of subsequent one-year results --- p.110 / Chapter 5.1.2 --- Profile of fallers compared with general older population --- p.111 / Chapter 5.1.3 --- Implications on health care planning for the elderly --- p.113 / Chapter 5.2 --- Acceptability of various interventions and referrals by fallers and its implications to health care planning for the elderly --- p.116 / Chapter 5.2.1 --- Uptake rates for various interventions and referrals --- p.116 / Chapter 5.2.2 --- Views towards various interventions and referrals by fallers --- p.117 / Chapter 5.2.3 --- Implications on health care planning for the elderly --- p.117 / Chapter 5.3 --- Discussion of other findings --- p.120 / Chapter 5.3.1 --- Seasonal variation in occurrence of falls --- p.120 / Chapter 5.3.2 --- "Circumstances, consequences and past history of falls" --- p.122 / Chapter 5.3.3 --- Comparison between recurrent fallers and non-recurrent fallers in terms of co-morbidity and functional profile --- p.123 / Chapter 5.3.4 --- Comparison between fallers with resultant injury and fallers without injury in terms of co-morbidity and functional profile --- p.123 / Chapter 5.3.5 --- Comparison between fallers attended and those who did not attend the falls assessment clinicin terms of subsequent one-year results --- p.124 / Chapter 5.3.6 --- Usefulness of the risk profile of recurrent falling adopted from Mr. Os (Hong Kong) Studyin screening the fallers with high risk of falling --- p.125 / Chapter 5.4 --- Limitations --- p.126 / Chapter 5.5 --- Recommendations for further research --- p.128 / Chapter CHAPTER 6 --- CONCLUSION --- p.129 / REFERENCES --- p.131 / APPENDICES / Appendix 1 Assessment Form used in Falls Assessment Clinic --- p.146 / Appendix 2a Scale for Subjective Socioeconomic Status -English version --- p.151 / Appendix 2b Scale for Subjective Socioeconomic Status -Chinese version --- p.152 / Appendix 3a Simple Physical Activity Questionnaire -English version --- p.153 / Appendix 3b Simple Physical Activity Questionnaire -Chinese version --- p.155 / Appendix 4 Modified Barthel Index --- p.157 / Appendix 5 Rating Form for Impairment in IADL --- p.159 / Appendix 6 Mini-Mental State Examination -Cantonese version (CMMSE) --- p.160 / Appendix 7 Geriatric Depression Scale - Four-item short form (GDS-4) --- p.162 / Appendix 8 Berg Balance Scale - short form (BBS short form) --- p.163