Fall prevention in community-dwelling older adults.

Clinical Question: Which types of interventions reduce falls in older people living in the community?

Bottom Line: Fall-prevention exercise programs, usually including muscle strengthening and balance retraining, were associated with lower fall rates in community-dwelling older people whether or not individuals were selected on the basis of fall risk. Home safety interventions, vitamin D supplementation in people with lower vitamin D levels, and individually targeted multifactorial interventions were associated with fewer falls in community-dwelling people with risk factors for falling.

Interventions for preventing falls in older people in care facilities and hospitals.

Background: Falls in care facilities and hospitals are common events that cause considerable morbidity and mortality for older people. This is an update of a review first published in 2010.

Objectives: To assess the effectiveness of interventions designed to reduce falls by older people in care facilities and hospitals.

Interventions for preventing falls in older people living in the community.

Background: Approximately 30% of people over 65 years of age living in the community fall each year. This is an update of a Cochrane review first published in 2009.

Objectives: To assess the effects of interventions designed to reduce the incidence of falls in older people living in the community.

Interventions for preventing lower limb soft-tissue running injuries.

Background: Overuse soft-tissue injuries occur frequently in runners. Stretching exercises, modification of training schedules, and the use of protective devices such as braces and insoles are often advocated for prevention. This is an update of a review first published in 2001.

Reporting of complex interventions in clinical trials: development of a taxonomy to classify and describe fall-prevention interventions.

Background: Interventions for preventing falls in older people often involve several components, multidisciplinary teams, and implementation in a variety of settings. We have developed a classification system (taxonomy) to describe interventions used to prevent falls in older people, with the aim of improving the design and reporting of clinical trials of fall-prevention interventions, and synthesis of evidence from these trials.

Methods: Thirty three international experts in falls prevention and health services research participated in a series of meetings to develop consensus.

Hip protectors for preventing hip fractures in older people.

Background: Hip fracture in older people usually results from a fall on the hip. Hip protectors have been advocated as a means to reduce the risk of hip fracture.

Objectives: To determine if external hip protectors reduce the incidence of hip fractures in older people following a fall.

Interventions for preventing falls in older people in nursing care facilities and hospitals.

Background: Falls in nursing care facilities and hospitals are common events that cause considerable morbidity and mortality for older people.

Objectives: To assess the effectiveness of interventions designed to reduce falls by older people in nursing care facilities and hospitals.

Search Strategy: We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (January 2009); the Cochrane Central Register of Controlled Trials (The Cochrane Library 2008, Issue 2); MEDLINE, EMBASE, and CINAHL (all to November 2008); trial registers and reference lists of articles.

Interventions for preventing falls in older people living in the community.

Background: Approximately 30% of people over 65 years of age living in the community fall each year.

Objectives: To assess the effects of interventions to reduce the incidence of falls in older people living in the community.

Search Strategy: We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register, CENTRAL (The Cochrane Library 2008, Issue 2), MEDLINE, EMBASE, CINAHL, and Current Controlled Trials (all to May 2008).

WITHDRAWN: Interventions for preventing falls in elderly people.

Background: Approximately 30 per cent of people over 65 years of age and living in the community fall each year; the number is higher in institutions. Although less than one fall in 10 results in a fracture, a fifth of fall incidents require medical attention.

Objectives: To assess the effects of interventions designed to reduce the incidence of falls in elderly people (living in the community, or in institutional or hospital care).

Vitamin D and vitamin D analogues for preventing fractures associated with involutional and post-menopausal osteoporosis.

Background: Vitamin D and related compounds have been used to prevent osteoporotic fractures in older people.

Objectives: To determine the effects of vitamin D or related compounds, with or without calcium, for preventing fractures in older people.

Search Strategy: We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register, the Cochrane Central Register of Controlled Trials (The Cochrane Library 2007, Issue 3), MEDLINE, EMBASE, CINAHL, and reference lists of articles.

The Cochrane Collaboration: a leading role in producing reliable evidence to inform healthcare decisions in musculoskeletal trauma and disorders.

Systematic reviews are a key component of evidence-based practice. A valuable and accessible source of good quality systematic reviews on topics in musculoskeletal trauma and disorders is the Cochrane Database of Systematic Reviews, published in The Cochrane Library. These reviews are produced by members of The Cochrane Collaboration, an international not-for-profit organization that aims to make up-to-date, accurate information about the effects of healthcare readily available worldwide.

Moving towards evidence-based healthcare for musculoskeletal injuries: featuring the work of the Cochrane Bone, joint and Muscle Trauma Group.

Due to their high incidence and associated morbidity and mortality, musculoskeletal injuries place an enormous burden on society. For example, in the 2004 to 2005 period 62,000 people with hip fracture accounted for 2.9% of the total number of hospital bed days in England.

Effectiveness of hip protectors for preventing hip fractures in elderly people: systematic review.

Objectives: To present the updated results of systematic review of the current evidence for the effectiveness of hip protectors from reports of completed randomised trials, and to explore the evolution of that evidence.

Design: Systematic review with meta-analysis.

Data Sources: Cochrane Bone, Joint, and Muscle Trauma Group trials register (January 2005), Cochrane central register of controlled trials (Cochrane Library Issue 1, 2005), Medline (1966 to January 2005), Embase (1988 to January 2005), and CINAHL (1982 to December 2004).

Finding current evidence: search strategies and common databases.

With more than 100 orthopaedic, sports medicine, or hand surgery journals indexed in MEDLINE, it is no longer possible to keep abreast of developments in orthopaedic surgery by reading a few journals each month. Electronic resources are easier to search and more current than most print sources. We provide a practical approach to finding useful information to guide orthopaedic practice.