Are interventions effective in improving the ability of older adults to rise from the floor independently? A mixed method systematic review.

Abstract

PURPOSE: To review available evidence on older people's ability to get up off the floor independently and determine the effectiveness of interventions to improve older adults' ability to rise from the floor. MATERIALS AND METHODS: Seven databases were searched between January 1975 and June 2018. Eligibility criteria included: people aged =60; interventions to improve strength/function including ability to get up off the floor (for intervention studies); comparison groups (for randomized and nonrandomized controlled trials); outcome: quantitative or qualitative evaluation of ability to get up off the floor. Selection of the studies was undertaken in three stages: (1) titles and abstracts were scanned by one reviewer, (2) full abstract screening by one reviewer, and (3) articles read in full by two reviewers. Results of all articles are summarized and randomized controlled trials (RCT) (where possible) were analyzed by meta-analysis to determine intervention effectiveness. RESULTS: Forty-one studies met inclusion criteria. For each of the RCTs that utilized resistance training and/or teaching the skill, a reduction in time to get up off the floor were reported. However, meta-analyses of all RCT interventions indicated no significant change in time for older people to get up off the floor independently with intervention (MD: -0.43[-1.38, 0.51]). Sub-analyses of interventions utilizing resistance training showed an improvement trending towards significance (MD: -0.81[-1.72, 0.09]). Heterogeneity between studies was high, therefore results should be viewed with some caution. CONCLUSIONS: Resistance training interventions may improve older people's ability to rise from the floor unassisted. However, knowledge of specific techniques to get up and the effect of simply practicing the task of getting off the floor need to be further explored. Implication for rehabilitation One in three older people living in the community fall each year One aspect of falling that is often overlooked is whether the older person can get themselves up off the floor independently or do they have to wait for assistance. Interventions that include resistance training may help the older person to be able to get up by themselves.