BMJ  2008;336:847 (19 April), doi:10.1136/bmj.39549.489896.3A

Letters

Preventing falls among older people in hospital

Results are not surprising

The first 150 words of the full text of this article appear below.

The fact that an intervention of about seven days’ duration was ineffective in improving fall resistance should not be a surprise.¹ All falls have a mechanical cause that accelerates the centre of mass in a way that the subject is unable to counter effectively to maintain balance. There are indications that the hip abductor and adductor muscles have a major role in controlling the pelvis during balance perturbing events, and that improving strength and endurance in these muscles could improve fall resistance (A Walmsley, M A Brodie, Biomechanics of the lower limb in health, disease, and rehabilitation, Salford, September 2007). However, strength gains take several weeks to manifest, and the early gains are largely an expression of improved neuromotor coordination. As a consequence, patients would be no better able to combat the mechanical events that trigger falls after a short intervention, even though it included some strength training.

¹ Massey University, Wellington 6013, New Zealand

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Competing interests: . . . [Full text of this article]

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