Abstract:
OBJECTIVES:No intervention has been shown to prevent falls poststroke. We aimed to determine if perturbation-based balance training (PBT) can reduce falls in daily life among individuals with chronic stroke. DESIGN:Assessor-blinded randomised controlled trial. SETTING:Two academic hospitals in an urban area. INTERVENTIONS:Participants were allocated using stratified blocked randomisation to either 'traditional' balance training (control) or PBT. PBT focused on improving responses to instability, whereas traditional balance training focused on maintaining stability during functional tasks. Training sessions were 1 hour twice/week for 6 weeks. Participants were also invited to complete 2 'booster' training sessions during the follow-up. PARTICIPANTS:Eighty-eight participants with chronic stroke (>6 months poststroke) were recruited and randomly allocated one of the two interventions. Five participants withdrew; 42 (control) and 41 (PBT group) were included in the analysis. PRIMARY AND SECONDARY OUTCOME MEASURES:The primary outcome was rate of falls in the 12 months post-training. Negative binomial regression was used to compare fall rates between groups. Secondary outcomes were measures of balance, mobility, balance confidence, physical activity and social integration. RESULTS:PBT participants reported 53 falls (1.45 falls/person-year) and control participants reported 64 falls (1.72 falls/person-year; rate ratio: 0.85(0.42 to 1.69); p=0.63). Per-protocol analysis included 32 PBT and 34 control participants who completed at least 10/12 initial training sessions and 1 booster session. Within this subset, PBT participants reported 32 falls (1.07 falls/person-year) and control participants reported 57 falls (1.75 falls/person-year; rate ratio: 0.62(0.29 to 1.30); p=0.20). PBT participants had greater improvement in reactive balance control than the control group, and these improvements were sustained 12 months post-training. There were no intervention-related serious adverse effects. CONCLUSIONS:The results are inconclusive. PBT may help to prevent falls in daily life poststroke, but ongoing training may be required to maintain the benefits. TRIAL REGISTRATION NUMBER:ISRCTN05434601; Results.
journal_name
BMJ Openjournal_title
BMJ openauthors
Mansfield A,Aqui A,Danells CJ,Knorr S,Centen A,DePaul VG,Schinkel-Ivy A,Brooks D,Inness EL,Mochizuki Gdoi
10.1136/bmjopen-2018-021510subject
Has Abstractpub_date
2018-08-17 00:00:00pages
e021510issue
8issn
2044-6055pii
bmjopen-2018-021510journal_volume
8pub_type
杂志文章相关文献
BMJ Open文献大全abstract:INTRODUCTION:Approximately 5%-20% of reproductive women suffer from polycystic ovary syndrome (PCOS). Auricular points acupressure (AA) may serve as alternative management for PCOS for its benefits in both physical and psychological well-being. However, the effects of AA for insulin resistance (IR) in overweight/obese ...
journal_title:BMJ open
pub_type: 杂志文章,随机对照试验
doi:10.1136/bmjopen-2018-027498
更新日期:2019-05-28 00:00:00
abstract:OBJECTIVE:To compare the long-term economic impact of melanoma prevention by sun protection, with the corresponding impact of early detection of melanoma to decrease melanoma deaths. DESIGN:Cost-effectiveness analysis using Markov cohort model. Data were primarily from two population-based randomised controlled trials...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-034388
更新日期:2020-02-26 00:00:00
abstract:OBJECTIVES:Treatment patterns for patients with myelodysplastic syndromes (MDS) outside clinical trials are not well described. Our objective was to evaluate treatment patterns and patient characteristics that influence time to disease-modifying therapy in patients with MDS in the USA. DESIGN, PARTICIPANTS AND OUTCOME...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2017-019955
更新日期:2018-07-23 00:00:00
abstract:OBJECTIVES:This study aimed to identify intrauterine growth differences according to infertility treatment compared with spontaneous conception and to describe intrauterine growth trajectories. DESIGN:Retrospective cohort study. SETTING:A single primary and tertiary medical centre in Japan. PARTICIPANTS:This study i...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-033675
更新日期:2020-04-28 00:00:00
abstract:OBJECTIVE:Perioperative shivering (POS) is a common complication in patients undergoing spinal anaesthesia. The present study investigated the efficacy of 5-HT3 receptor antagonists in preventing POS following spinal anaesthesia. DESIGN:Systematic review and meta-analysis. DATA SOURCES:Pubmed, Embase, the Web of Scie...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2020-038293
更新日期:2020-10-05 00:00:00
abstract:OBJECTIVE:To obtain the views of bereaved parents about their interactions with healthcare staff when their baby died just before or during labour. DESIGN:Qualitative in-depth interview study, following an earlier national survey. All interviews took place during 2011, either face-to-face or on the telephone. Data ana...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2012-002237
更新日期:2013-02-14 00:00:00
abstract:OBJECTIVES:To explore the views and experiences of patients on the care they have received while enrolled on the Northumberland High Risk Patient Programme (NHRPP). This programme involved case finding of frail patients using a multidisciplinary team (MDT)-led community case management programme, and support of patient...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2016-012019
更新日期:2016-09-09 00:00:00
abstract:OBJECTIVES:To investigate leftover antibiotics and their influence on self-medication with antibiotics (SMA) for Chinese children, and further explore the different influences of leftovers from two main sources: previous prescriptions and pharmaceutical purchases. DESIGN:A cross-sectional questionnaire study. SETTING...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-033679
更新日期:2019-12-15 00:00:00
abstract:BACKGROUND:Migration is a major global driver of population change. Certain migrants may be at increased risk of infectious diseases, including tuberculosis (TB), HIV, hepatitis B and hepatitis C, and have poorer outcomes. Early diagnosis and management of these infections can reduce morbidity, mortality and onward tra...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-029188
更新日期:2019-03-07 00:00:00
abstract:OBJECTIVES:Syphilis is a global health concern with an estimated 12 million infections occurring annually. Due to the increasing rates of new syphilis infections being reported in patients infected with HIV, and their higher risk for atypical and severe presentations, periodic screening has been recommended as a routin...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-021544
更新日期:2018-07-10 00:00:00
abstract:OBJECTIVES:Assessment of the relations between recorded gonorrhoea rates and clinical testing activity and disposable diagnostic tests. METHODS:In Denmark, two sources of information on the epidemiology of gonorrhoea are available: (1) a mandatory clinical notification system (since 1867) comprising summary informatio...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2015-008013
更新日期:2015-11-30 00:00:00
abstract:OBJECTIVES:There is limited published research studying the effect of antibiotic prophylaxis on surgical site infection (SSI) in dermatological surgery, and there is no consensus for its use in higher-risk cases. The objective of this study was to determine the effectiveness of a single oral preoperative 2 g dose of ce...
journal_title:BMJ open
pub_type: 杂志文章,随机对照试验
doi:10.1136/bmjopen-2017-020213
更新日期:2018-04-19 00:00:00
abstract:INTRODUCTION:People living with and beyond cancer are vulnerable to a number of physical, functional and psychological issues. Undertaking a holistic needs assessment (HNA) is one way to support a structured discussion of patients' needs within a clinical consultation. However, there is little evidence on how HNA impac...
journal_title:BMJ open
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmjopen-2014-006840
更新日期:2015-05-11 00:00:00
abstract:OBJECTIVES:The aim of this systematic review was to examine the epidemiology of malpractice claims in primary care. DESIGN:A computerised systematic literature search was conducted. Studies were included if they reported original data (≥10 cases) pertinent to malpractice claims, were based in primary care and were pub...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2013-002929
更新日期:2013-07-18 00:00:00
abstract:INTRODUCTION:Thrombocytopaenia is one of the most common haemostatic abnormalities among neonates. It affects approximately one-quarter of neonates admitted into neonatal intensive care units and may lead to a high risk of bleeding and mortality, which are substantial causes for concern by neonatologists. Platelet tran...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2020-039132
更新日期:2020-10-16 00:00:00
abstract:OBJECTIVES:We compared the effectiveness of the Gold Standard Programme (a comprehensive smoking cessation intervention commonly used in Denmark) with other face-to-face smoking cessation programmes in Denmark after implementation in real life, and we identified factors associated with successful quitting. DESIGN:Pros...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2016-013553
更新日期:2017-02-27 00:00:00
abstract:OBJECTIVES:The aim of the study was to assess whether gastrostomy placement before 18 months of age results in a greater increase in z-score for weight and to assess whether admission rates were reduced postgastrostomy in this age group. DESIGN:Retrospective cross-sectional study. SETTING:Single-centre secondary care...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2012-001793
更新日期:2012-11-21 00:00:00
abstract:OBJECTIVE:To assess the representativeness of the Heart Protection Study (HPS) and the Collaborative Atorvastatin Diabetes Study (CARDS) for incident statin users. DESIGN:A population-based analysis with linked register data. SETTING:Finland. POPULATION:56 963 patients with diabetes initiating statin use from 2005 t...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2014-005402
更新日期:2014-06-19 00:00:00
abstract:OBJECTIVE:Leave-on emollients form the mainstay of eczema treatment, but adherence is poor. We aimed to explore parents'/carers' views on effectiveness and acceptability of leave-on emollients for childhood eczema through secondary analysis of data from 2 qualitative data sets. SETTING:Study 1 recruited through mail-o...
journal_title:BMJ open
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmjopen-2016-011887
更新日期:2016-08-19 00:00:00
abstract:OBJECTIVE:To examine the relationship between socioeconomic status (SES) and type 2 diabetes using the Korea National Health and Nutrition Examination Survey (KNHANES) 2010-2012. DESIGN:A pooled sample cross-sectional study. SETTING:A nationally representative population survey data. PARTICIPANTS:A total of 14,330 i...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2014-005710
更新日期:2014-08-19 00:00:00
abstract:BACKGROUND:According to new Norwegian laws, mental healthcare for adults are obligated to assess all patients who are parents and to act on their children's needs. This article describes the study protocol of implementing the interventions Family Assessment and Child Talks for children of patients in the adult psychiat...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2011-000709
更新日期:2012-05-03 00:00:00
abstract:OBJECTIVES:To characterise the pattern of colonisation and serotypes of Streptococcus pneumoniae among patients with chronic obstructive pulmonary disease (COPD) who currently receive the 23-valent pneumococcal polysaccharide vaccine (PPV-23) according to vaccination status, use of antibiotics and steroids. To investig...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2016-013944
更新日期:2017-07-09 00:00:00
abstract:OBJECTIVES:Atrial fibrillation (AF) is the most common cardiac rhythm disorder with a significant health burden. The aim of this study was to characterise patients with recently diagnosed AF and to estimate the rates of comorbidities and outcome events requiring hospitalisation in routine clinical practice. DESIGN:Pha...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2013-003839
更新日期:2014-01-27 00:00:00
abstract:INTRODUCTION:Adolescence is a critical period for youths with chronic conditions, when they are supposed to take over the responsibility for their health. Type 1 diabetes (T1D) is one of the most common chronic conditions in childhood and inadequate self-management increases the risk of short-term and long-term complic...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-036496
更新日期:2020-04-14 00:00:00
abstract:OBJECTIVE:To compare maternal and neonatal birth outcomes and morbidities associated with the intention to give birth in two freestanding midwifery units and two tertiary-level maternity units in New South Wales, Australia. DESIGN:Prospective cohort study. PARTICIPANTS:494 women who intended to give birth at freestan...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2014-006252
更新日期:2014-10-31 00:00:00
abstract:OBJECTIVE:This study was designed to evaluate the severity of subclinical atherosclerosis in patients with asymptomatic impaired fasting glucose (IFG) compared to those with diabetes mellitus (DM) and normal fasting glucose (NFG), as measured by coronary computed tomographic angiography (CCTA). DESIGN:Subjects were di...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2014-005148
更新日期:2016-08-16 00:00:00
abstract:INTRODUCTION:Tobacco causes kidney damage that can progress to chronic kidney disease. However, the diagnostic parameters used in clinics are not effective in identifying smokers at risk. Our first objective is to more effectively detect subclinical renal damage in smokers. In addition, we hypothesise that tobacco cons...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-032918
更新日期:2020-03-08 00:00:00
abstract:OBJECTIVE:Provision of a discharge care plan and prevention therapies is often suboptimal. Our objective was to design and pilot test an interdisciplinary, organisational intervention to improve discharge care using stroke as the case study using a mixed-methods, controlled before-after observational study design. SET...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2017-016010
更新日期:2017-08-04 00:00:00
abstract:OBJECTIVES:The health benefits of professional sport dissipate after retirement unless an active lifestyle is adopted, yet reasons for adopting an active or inactive lifestyle after retirement from sport are poorly understood. Elite cricket is all-encompassing, requiring a high volume of activity and unique physical de...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2017-017785
更新日期:2017-11-17 00:00:00
abstract:BACKGROUND:The unmet burden of surgical care is high in low-income and middle-income countries. The Lancet Commission on Global Surgery (LCoGS) proposed six indicators to guide the development of national plans for improving and monitoring access to essential surgical care. This study aimed to characterise the Somalila...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2020-042968
更新日期:2020-12-29 00:00:00