English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Tools annual

Global: Zendy Free Plan

Global: Zendy Tools monthly

Global: Zendy Plus monthly

Despite the high risk of falls for older people with vision impairment, adherence to exercise-based fall prevention programs is low. We investigated the attitudes of older people with vision impairment to fall prevention programs as well as home modifications. This was completed through focus group and semi-structured interviews with 19 community-dwelling people aged ≥63 years with vision impairment. The results indicated that participants did not attribute falls to vision impairment, nor consider themselves appropriate candidates for a fall prevention program. Participants also reported such barriers as competing priorities, transport issues and comorbidities. It is recommended that exercise-based fall prevention programs cater to the unique challenges of this population, such as delivery in home by Orientation and Mobility Specialists. Lisa Dillon,1,2 Patricia Duffy,2 Anne Tiedemann,3 and Lisa Keay4 1Injury Division, The George Institute for Global Health, Sydney Medical School, The University of Sydney; Australia. 2Orientation & Mobility Specialist, Guide Dogs NSW/ACT, Australia. 3Senior Research Fellow, Musculoskeletal Division, Career Development Fellow, National Health and Medical Research Council, Principal Research Fellow, Sydney Medical School, The University of Sydney, Australia. 4Senior Research Fellow, Deputy Director, Injury Division, The George Institute for Global Health, Associate Professor, Sydney Medical School, University of Sydney, Australia. E-mail: ldillon@georgeinstitute.org.au; atiedemann@georgeinstitute.org.au; lkeay@georgeinstitute.org.au. This article was edited by Dr Mike Steer and Dr Desiree Gallimor. Falls are a major health concern for older people (Clarke et al. 2015), with a third of those over the age of 65 years likely to experience a fall each year (Campbell et al. 1990). Older people with vision impairment are at a higher risk of falls estimated as eight times more likely to experience a fall, as well as a fall that results in a fracture (Ivers et al. 2002). This demographic are at a higher risk of falls because of difficulty detecting hazards (Legood et al. 2002), but it is also likely that impaired strength and balance (Lamoureux et al. 2004; Chen et al. 2011), sedentary lifestyle (Loprin zi et al. 2014) and exercise avoidance (Clemson et al. 2008) contribute to risk. With an ever-increasing population of older people with vision impairment (Taylor et al. 2005), the need for effective fall prevention strategies has never been so crucial. The 2012 Cochrane Review on interventions for preventing falls in community-dwelling older people (Gillespie et al. 2012) concluded that group and home-based exercise programs, as well as home safety and medication management, reduce the rate and risk of falling in older people. Furthermore, exercise programs that include the optimal dose and include exercises that provide a high challenge to balance can reduce the rate of falls by around 30% to 40% (Sherrington et al. 2011). However, of the 159 included trials, few trails included participants with vision impairment, and only one trial included participants with severe vision impairment (Gillespie et al. 2012). Consequently, it remains unclear how these findings can be generalized to older people with vision impairment. INTERNATIONAL JOURNAL OF ORIENTATION & MOBILITY 24 23 Results of a meta-analysis within a recent systemic review by Gleeson et al. (2014) found that multimodal exercise positively impacts on physical functioning in residential-dwelling older people with vision impairment. However, although the Otago Exercise Programme has been shown to reduce falls by up to 35% in the general population (Thomas et al. 2010), one trial in the systematic review found no significant effect on risk of falls for those with vision impairment after completion of the program (Campbell et al. 2005). Only one of the four trials included in the systematic review was completed in community-dwelling people, and none of the trials measured the attitudes of participants in order to help explain their findings. An individual’s attitude toward the benefits and disadvantages of exercise has been demonstrated to influence intention to participate (Yardley et al. 2007). However, few studies have investigated how the attitudes of community-dwelling older people with vision impairment influence adherence to fall prevention programs. The current study aimed to investigate attitudes towards fall prevention interventions in community-dwelling older people with vision impairment. A qualitative approach (Vaismoradi et al. 2013) was used to examine the ways that two types of exercise-based fall prevention programs (The Otago Programme and Tai Chi), as well as home modifications, would be considered acceptable to people in this vulnerable demographic. To our knowledge, this is the first study which has focused on the attitudes of community-dwelling older people with vision impairment to fall prevention strategies.

Acceptability of fall prevention strategies for older people with vision impairment