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Background: Falls and fall-related injuries remain a global challenge and threat to the health of older adults. Specific strength and balance exercises are effective in preventing falls among community-dwelling older adults. Nevertheless, provision of evidence-based fall prevention interventions to a broad population represents a healthcare challenge, indicating that new models for promoting exercise among community-dwelling older adults need to be addressed. Here, we aimed to evaluate the effects of a peer-led group-based exercise intervention provided using the train-the-trainer approach and targeting physical performance, activity level, handgrip strength, quality of life, fall-related self-efficacy, fear of falling, and falling techniques compared with a control group at 8-week follow-up.

Methods: This randomized controlled trial (RCT) included trainers and participants who were recruited from four collaborating regional organizations for retired persons. The intervention was planned to be provided in five municipalities in Sweden, depending on the location of the registered trainers. Eligible participants included adults aged ≥ 60 years who could walk independently and understand written and oral information in Swedish. The FallFitness multicomponent exercise program delivered weekly strength, balance, and falling techniques over eight weeks. It was evaluated using the train-the-trainer approach. Fourteen older adults were eligible for trainer education, and 101 participants were randomly allocated for the FallFitness exercise (n = 50) or a control group (n = 51).

Results: After 8 weeks of peer-led training, the short multicomponent exercise program significantly improved the physical activity levels (p = 0.036) and backward and sideways falling techniques (p < 0.001) compared to those in the control group. Fear of falling significantly decreased in the exercise group (p = 0.009). Other outcomes in this study showed to be non-significant.

Conclusions: The multicomponent exercise program provided in eight sessions using the train-the-trainer approach may be effective in promoting physical activity and the learning of motor skills and safe landing strategies. Furthermore, the FallFitness exercise program may reduce the fear of falling and may be both time- and cost-effective.

There is limited research on optimal exercise programs that effectively decrease falls and fall-related injuries in older populations. This randomized controlled trial (RCT) aimed to explore the effects of a 12-week Judo4Balance program on falling techniques, physical and psychological functions, health status, and physical activity levels among 200 community-dwelling older adults (79% women and 21% men) with a mean age of 72 years. The 200 participants were randomly allocated for the Judo4Balce program (n = 100) or control group (n = 100). The RCT intervention started in mid-January 2020 and was abruptly interrupted because of the COVID-19 pandemic. A restart of the RCT was initiated in September 2021, and the 12-week intervention was offered to two groups. This study reports the results from three points of assessment: baseline, 20-month follow-up, and 12-week postintervention. At 20 months follow-up, the control group had significantly decreased physical activity levels (summer p = 0.002 and winter p = 0.003); similar changes were not seen in the exercise group. In the exercise group, learning falling techniques in 6-9 weeks led to sustained fall competence at 20 months follow-up. Further, significant improvements in physical function (exercise group p = 0.009 and control group p &lt; 0.001) and learning falling techniques (p &lt; 0.001 for both groups) were noted in both groups after the 12-week intervention. This effective, supervised, group-based, high-challenge multicomponent exercise program needs to be further evaluated for possible impact on falls and fall-related injuries. 

This study investigated whether strength, balance, body mass index, falls self-efficacy, activity levels, self-rated health, and participation in a multicomponent exercise intervention could predict physical activity levels after 5 months of self-quarantine due to the COVID-19 pandemic. This study included baseline data of 200 community-dwelling older adults (79% women, 21% men) with a mean age of 72 years who participated in a randomized controlled trial investigating a multicomponent exercise program, with 7-month follow-up survey data of their physical activity levels. The results showed significant associations with the activity levels at the 7-month follow-up. The activity levels (odds ratio (OR): 2.83, 95% CI: 1.20-6.71), the self-rated health score (2.80, 1.42-5.53), and being allocated to a specific multicomponent group-based exercise program (2.04, 1.04-4.00) showed a significant association with the activity habits at the 7-month follow-up. As this study suggests, besides the physical activity levels and the self-rated health score, participation in a high challenge multicomponent exercise program was significantly associated with physical activity levels at the 7-month follow-up. This study indicates that a relatively short multicomponent group exercise program (6-9 weeks) can motivate individuals to sustain their own training and activity levels even several months after the program has been paused or terminated. Identifying older adults' physical activity levels and self-rated health scores and prescribing multicomponent group-based exercise programs to promote sustained physical activity habits may be a successful alternative to provide for older adults in the future.

Asthma is common in cross-country skiers and is often treated with ß2-agonists and inhaled corticosteroids (ICS). Exhaled nitric oxide is often used to guide ICS treatment in asthma. This study investigated the change in the pulmonary NO dynamics before and after a maximum oxygen uptake (V̇O2-max) test.An extended NO analysis was performed among Swedish elite junior cross-country skiers (n=25), with and without declared asthma, before and after a V̇O2-max test using roller skis. Asthma was declared by six boys and two girls among whom five occasionally used ICS.There were no differences in the baseline NO parameters between those with and without declared asthma. The diffusion capacity over airway wall (DawNO) was 21 (17,25) mL·s−1 (median, quartiles), which is much increased for this age group. After the V̇O2-max test, there were statistically significant differences from the baseline fraction of exhaled nitric oxide (FENO50), NO-flux from airways, DawNO and alveolar NO values; but not in the NO content in airway wall (CawNO) for all subjects together as one group. However, in the asthma group, differences were only seen in the FENO50 and in CawNO.Interestingly, a majority of the subjects had an increase in the DawNO. An increase in DawNO has been found with allergic asthma together with elevated CawNO. The skiers did not have elevated CawNO, which indicates an absence of inflammation in the airway wall. Modelling of lung NO production clearly shows that the asthma among our skiers is distinct from the allergic asthma in non-athletes.

Är fallolyckor en naturlig följd av åldrandet? Vilka möjligheter finns det för trygg rörelse och aktivitet även i hög ålder? Går det att förebygga fall och fallskador genom specifik och målinriktad träning?

Denna bok har som ambition att täcka såväl teoretiska som praktiska aspekter på de specifika fallrisker som följer med åldrandet. Författarna beskriver det aktuella kunskapsläget kring förekomst, konsekvenser, riskanalys och prevention av fallolyckor. Dessutom presenteras tydligt, i såväl bild som text, praktiska träningsprogram och övningar inriktade på att förebygga fall och fallskador.

Fall, fallrisk och fallprevention vänder sig till studerande inom fysioterapi, arbetsterapi, omvårdnad, medicin och omsorg samt till kliniskt verksamma som arbetar med äldre personer. Boken kan även vara intressant för äldre personer som vill stärka sin hälsa och sitt välbefinnande samt minska risken för en fallolycka.