Feasible Intervention through Simple Exercise for Risk of Falls in Dementia Patients: A Pilot Study

Falls caused by balance disorders in the elderly with multiple systems involved: Pathogenic mechanisms and treatment strategies

Falls are the main contributor to both fatal and nonfatal injuries in elderly individuals as well as significant sources of morbidity and mortality, which are mostly induced by impaired balance control. The ability to keep balance is a remarkably complex process that allows for rapid and precise changes to prevent falls with multiple systems involved, such as musculoskeletal system, the central nervous system and sensory system. However, the exact pathogenesis of falls caused by balance disorders in the elderly has eluded researchers to date. In consideration of aging phenomenon aggravation and fall risks in the elderly, there is an urgent need to explore the pathogenesis and treatments of falls caused by balance disorders in the elderly. The present review discusses the epidemiology of falls in the elderly, potential pathogenic mechanisms underlying multiple systems involved in falls caused by balance disorders, including musculoskeletal system, the central nervous system and sensory system. Meanwhile, some common treatment strategies, such as physical exercise, new equipment based on artificial intelligence, pharmacologic treatments and fall prevention education are also reviewed. To fully understand the pathogenesis and treatment of falls caused by balance disorders, a need remains for future large-scale multi-center randomized controlled trials and in-depth mechanism studies.

Effects of Blood Flow Restriction Combined with Low-Intensity Resistance Training on Lower-Limb Muscle Strength and Mass in Post-Middle-Aged Adults: A Systematic Review and Meta-Analysis

We studied the effect of blood flow restriction (BFR) combined with low-intensity resistance training (LIRT) on lower-limb muscle strength and mass in post-middle-aged adults. The PubMed, OVID, ProQuest, Cochrane Library, EMBASE, Web of Science, and Scopus databases were used to obtain randomized controlled trials, and the effects of BFR and LIRT (BFRt) on muscle strength and mass in adults were examined. The Cochrane risk of bias tool assessed bias in the included trials. The combined effects of BFR and LIRT (BFRt) were calculated by meta-analysis, the association between muscle strength/mass and interventions was determined by meta-regression, and beneficial variables of intervention were explored by subgroup analysis. A total of 11 articles were included in the meta-analysis. The combined effects showed that BFRt significantly improved lower extremity muscle strength but not muscle mass gain. Meta-regression analysis indicated that the effect of BFRt on changes in muscle strength was correlated with frequency of the intervention. Subgroup analysis revealed that BFRt achieved greater muscle strength gains than normal activity, LIRT, and similar muscle strength gains compared to high-intensity resistance training. The increased muscle strength after BFRt was noticed with a frequency of three times a week, but not with a frequency of two times a week, and the difference between these subgroups was statistically significant. Our findings indicate that BFRt can increase lower-limb muscle strength in post-middle-aged adults. Frequency of intervention is a key variable; particularly, a schedule of three times a week is effective in improving muscle strength.