Scenario 3: Falls Prevention Research Question: What is the effectiveness of exercise-based interventions in reducing falls in older adults living in residential care facilities?

Paper 1 (300 words):

The study by Lim, Cho, Kim, Kim and Yoon (2017) focuses on the role that virtual reality exercise training can play in the lives of elderly patients to help reduce falls. The researchers sought to compare the effectiveness of balance training to the effectiveness of complex exercise training, both using the medium of virtual reality in order to receive the training. The researchers conducted a randomized trial that took place over the course of 5 weeks with 20 elderly participants over the age of 65.

The 20 participants were placed in two groups—one receiving virtual reality complex exercise training and the other receiving virtual reality basic balance exercise training. There were ten sessions of one hour each. The complex exercise group practiced exercises including “strengthening, flexibility, endurance, and balance exercises” (p. 64). The basic balance exercise group simply practiced balance techniques. The researchers measured knee extension torque and dynamic balance.

The study showed that when elderly patients received virtual reality training using the complex exercises protocol, they displayed improvements in their balance as well as in their muscle strength. The complex exercise regimen was found to be more beneficial than the basic balance training. The researchers thus concluded that in order to effectively reduce the risk of falls in the elderly population, care providers should focus more on using the complex exercise regimen with strengthening exercises, flexibility exercises, endurance exercises and balance exercises. The researchers show that virtual reality tools can help elderly patients obtain not only better balance but also better mobility, agility, and all strength. The study makes some connection to residential care facilities, but it mainly shows that when it comes to exercise training, muscle strengthening exercises are best for preventing falls.

Paper 2 (300 words):

Faber, Bosscher, Paw and van Wieringen (2006) find that group exercise programs are effective in preventing falls among elderly population who are not frail. If the elderly are frail, the study shows that no amount of exercise is going to make a difference. Frailty is thus the determining factor with regard to whether an elderly person is at greater risk of falling. However, if the person is elderly but pre-frail and engaged in an exercise program, that person’s risk of falling becomes even less.

The researchers indicate that the degree of frailty is important to consider and they show that “exercise interventions may be effective in preventing, delaying, or reversing the frailty process” (p. 886), but the problem that they encountered in their research was that the condition of the elderly persons played a major role in determining the risk level for that individual with respect to falls. To gather evidence for their research, Faber et al. (2006) turned to 15 long term care facilities in Amsterdam. 278 participants were randomly selected....

Two exercise programs were selected for the intervention. The first focused on functional walking and the second on balance.
The study explicitly explains its statistical analysis methods and provides numerous charts to show how all the information was assessed. In the methodology section, the researchers explain how they measured for the physical performance score of the patients to determine whether the training they received was effective. In the discussion section of the study, the researchers focus on examining the results of the study, and discussing the meaning and implications of the evidence. The researchers conclude that falls prevention programs can benefit from challenging but safe exercise training programs, though only for pre-frail participants.

Paper 3 (300 words):

Ye?ilyaprak, Y?ld?r?m, Tomruk, Ertekin and Algun (2016) conducted a study to compare conventional exercise training on balance for elderly patients in a nursing home to virtual reality-based training on balance. The study took place across several nursing homes in the nation of Turkey. 18 participants in total between the ages of 65 and 82 were selected for the study. The researchers found that it made no difference whether the training in balance was conducted using conventional training methods or virtual reality-based methods. In both instances, the Berg balance score improved, as did left leg stance and tandem stance duration. The researchers concluded that balance training can help elderly patients—but patients with a history of falls or who have entered into a frail stage are less likely to benefit from balance training.

That is why it is important to consider the sample used for this study. While the researchers noted that “balance and gait impairments” are important factors to consider when attempting to understand what leads to falls for elderly patients (Ye?ilyaprak et al., 2016, p. 191), they wanted to see if one method of balance training was preferable to another. The study’s approach to the problem was to use a relatively small sample size, however. The sample consisted of 7 participants in the virtual reality-based training in balance program and 11 participants in the conventional training in balance program. To make any conclusive remarks on the subject of balance training after only testing the program on 7 or on 11 participants would be to make the mistake of premature conclusiveness. The sample size should be enlarged to enhance the study’s external validity.

Paper 4 (300 words): 

Fu, Gao, Tung, Tsang and Kwan (2015) examine the role that exergaming can play in training elderly patients to avoid falls. Exergaming is a type of video game playing in which the participant physically exercises along with the game. The Nintendo Wii Fit was used by the researchers as a training tool to help elderly patients with a history of falls to learn better balance technique. The Wii Fit is a game that allows the user to be actively engaged—i.e., standing, moving, balancing, reaching, swinging as is required for the game. For their study, they conducted a randomized controlled clinical trial in a nursing home for the elderly. The participants numbered 60…