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Background: Sarcopenia is the age-related loss of skeletal muscle mass and function; it is a risk factor for falls among older individuals. Few studies have focused on training such individuals to adopt a safe-landing strategy that would protect them from fall-related injuries. Ditangquan is a traditional Chinese martial art comprising movements that conform to the principles of safe landing. This study aims to investigate the effectiveness of Ditangquan in preventing fall-related injuries among older individuals with sarcopenia. Methods: A total of 70 participants (21 males and 49 females with sarcopenia) between 60 and 80 years of age were recruited from three local communities and randomly assigned to the Ditangquan exercise group (DG) or the control group (CG) in a 1:1 ratio. Three times a week for 24 weeks, both the DG and CG received an hour of conventional exercise and an hour of Ditangquan exercise based on safe landing. Primary outcomes were the modified falls efficacy scale (MFES), the number of falls, and fall injuries; the secondary outcome was the Timed Up & Go (TUG) test. Results: The DG had significantly fewer falls (1 vs. 8, P = 0.028) and fall injuries (0 vs. 6, P = 0.025) than the CG. Furthermore, at the end of the study, the DG had a significantly improved MFES (mean difference: 32.17 scores; 95% CI: 21.32, 43.02; P <0.001) and TUGT (mean difference: -4.94 s; 95% CI: -7.95, -1.93; P = 0.002) as compared with the CG. Conclusion: Ditangquan exercise based on the safe-landing strategy effectively improves the functional mobility of the elderly, reduces the occurrence of falls and injuries, and increases the individual's confidence in preventing falls.
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BACKGROUND: Fear of falling (FOF) is a very pervasive problem among older adults. Consequently, many scales have been developed for its assessment. The Modified Falls Efficacy Scale (MFES) is one of the most popular FOF scales. The MFES was originally developed for use in developed countries, and thus may not be entirely suitable for use in developing countries due to cultural and environmental differences between the two country categories. This study was therefore designed to cross-culturally adapt and validate the MFES to Igbo culture and environment among community-dwelling older adults in Nnewi community using established guidelines. METHODS: The original English version of the MFES (E-MFES) was translated, synthesized, back-translated, subjected to expert panel review, and pretested before producing the final Igbo version of the MFES (I-MFES). The I-MFES and the Short Falls Efficacy Scale International were randomly administered to consecutively recruited 109 consenting older adult residents of Nnewi (43.1% males; mean age = 74.45 ± 8.78 years). Convergent and structural validities and internal consistency of the I-MFES were assessed at 0.05 level of significance. RESULTS: All the 14 items on the E-MFES were retained on the I-MFES. The I-MFES exhibited the same structure as the E-MFES. The correlation between the total scores on the I-MFES and the Short Falls Efficacy Scale International was excellent (rho = - 0.93) indicating evidence of convergent validity of the I-MFES. The Cronbach's alpha value of the I-MFES was 0.97 showing evidence of excellent internal consistency of the items on the I-MFES. CONCLUSION: This study provides evidence of some aspects of validity and reliability of the I-MFES.
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Accidentes por Caídas/prevención & control , Miedo/psicología , Encuestas y Cuestionarios/normas , Anciano , Anciano de 80 o más Años , Comparación Transcultural , Femenino , Humanos , Vida Independiente/psicología , Masculino , Nigeria , Calidad de Vida , Reproducibilidad de los Resultados , TraduccionesRESUMEN
BACKGROUND: To investigate item-level measurement properties of the Modified Falls Efficacy (MFES) Scale among English- and Spanish-speaking urban-dwelling older adults as a means to evaluate language equivalence of the tool. METHODS: Secondary analysis of survey data from 170 English (n = 83) and Spanish (n = 87) speaking older adults who reported to the emergency department of a quaternary medical center in New York City between February 2010 and August 2011. The Rasch rating scale model was used to investigate item statistics and ordering of items, item and person reliability, and model performance of the Modified Falls Efficacy Scale. RESULTS: The Modified Falls Efficacy Scale, for English- and Spanish-speakers, demonstrated acceptable fit to the Rasch model of a unidimensional measure. While the range of the construct is more limited for the Spanish group, the interval between tasks are much closer, reflecting little to no construct under-representation. CONCLUSION: There is rationale for continued testing of a unidemsional English- and Spanish-MFES among urban community-dwelling older adults. Large-scale international studies linking the unidemsional MFES to patient outcomes will support the validity of this tool for research and practice.
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Accidentes por Caídas , Lenguaje , Accidentes por Caídas/prevención & control , Anciano , Humanos , Ciudad de Nueva York/epidemiología , Psicometría , Reproducibilidad de los Resultados , Encuestas y CuestionariosRESUMEN
Background/aim: The factors associated with fall-related self-efficacy should be addressed, especially in the elderly. The Modified Falls Efficacy Scale (MFES) is a simple instrument with good scaling properties and reliability. The aim of the present study was to determine the reliability and the validity of the Turkish version of the MFES from the viewpoint of balance. Materials and methods: In this study, 164 participants aged >65 years were included. The use of walking aids and assistive devices, history and frequency of falls in the previous year, living environment, and exercise habits were noted. Balance and risk of falling were assessed with the Berg Balance Scale (BBS). A forward-backward translation procedure was used for the Turkish version of the MFES. Results: None of the 14 items in the MFES were modified. The Turkish version of the MFES has excellent internal consistency (Cronbach's alpha, 0.978) and reliability (interclass correlation coefficient, 0.9280.982), and its construct validity was supported by its ability to distinguish between the groups with respect to fall-risk factors and balance. According to the BBS scores, the high-fall-risk group had lower MFES scores than the moderate- and low-fall-risk groups (χ2 = 34.153, P = 0.001). Conclusion: The Turkish version of the MFES is a sensitive instrument for evaluation of fall-related confidence while carrying out indoor/outdoor activities. It also predicts falls, reduced physical activity, balance and mobility problems, and restricted social participation and daily living activities.
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Accidentes por Caídas/estadística & datos numéricos , Equilibrio Postural , Anciano , Ejercicio Físico , Femenino , Humanos , Masculino , Reproducibilidad de los Resultados , Factores de Riesgo , Encuestas y Cuestionarios , Traducción , Turquía , AndadoresRESUMEN
RATIONALE, AIMS AND OBJECTIVES: Falls in hospital are costly and may impact psychologically on fallers causing them to avoid mobilization, thereby affecting recovery rate and hospital length of stay. The study aim was to investigate the relationships between fear of falling, falls risk, in-hospital falls and hospital length of stay. METHOD: A convenience sample (n=141) of patients from a large tertiary hospital was recruited. Data were collected over 6 months using the Modified Falls Efficacy Scale (MFES) on ward admission, prior to discharge, and in the event of a fall. RESULTS: A third of the sample (n=44) was admitted to hospital following a fall. The majority (65%) was categorized as medium falls risk. Twenty-five participants sustained a total of 30 falls during their hospital admission of which 13 sustained a total of 15 falls on the study wards. The mean admission MFES score was 5.5, which increased to 6.1 on hospital discharge. Fallers scored significantly lower admission MFES scores than non-fallers (P=0.003). Receiver-operating curve analysis indicated that admission MFES score was a 'fair' predictor of sustaining a fall (area under curve=0.71, P=0.013). With a cut-off score of 5, admission MFES sensitivity was 77% and specificity was 55%. Study ward fallers had significantly longer hospital length of stay (49 days) than non-fallers (27 days; P=0.037). Furthermore, regardless of whether the participant was a faller or not, significantly longer hospital stay was associated with an admission MFES score of less than 5. CONCLUSIONS: An admission MFES score of less than 5 is an effective predictor of patient falls and is associated with a significantly longer hospital length of stay.