Interventions to reduce falls in community‐dwelling adults with intellectual disability: a systematic review

Author:

Lalor A.12,Callaway L.12,Koritsas S.3ORCID,Curran‐Bennett A.3,Wong R.34,Zannier R.3,Hill K.1ORCID

Affiliation:

1. Rehabilitation Ageing and Independent Living (RAIL) Research Centre Monash University Melbourne Victoria Australia

2. Department of Occupational Therapy Monash University Melbourne Victoria Australia

3. Department of Strategy and Transformation Scope Melbourne Australia Australia

4. IDEAS Therapy Services Victoria Australia

Abstract

AbstractBackgroundPeople with intellectual disability have a high risk of falls and falls‐related injuries. Although people with intellectual disability are at increased risk of falls, there is a need to better understand the efficacy of interventions that can help reduce falls and address risk factors in this population. This systematic review aimed to evaluate the type, nature and effectiveness of interventions undertaken to reduce falls with community‐dwelling adults with intellectual disability and the quality of this evidence.MethodFour electronic databases were searched: Ovid MEDLINE, PsycINFO, CINAHL Plus and the Cochrane Library. Studies were included if they involved people aged 18 years or over, at least 50% of study participants had intellectual disability, participants were community‐dwelling, and the study evaluated any interventions aiming to reduce falls. Study quality was assessed using the National Institutes of Health study quality assessment tools. Reporting of the review followed Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines.ResultsSeven studies were eligible for review, with a total of 286 participants and mean age of 50.4 years. As only one randomised trial was identified, a narrative synthesis of results was undertaken. Five studies evaluated exercise interventions, one evaluated a falls clinic programme, and one evaluated stretch fabric splinting garments. Methodological quality varied (two studies rated as good, four as fair, and one as poor). Exercise interventions varied in terms of exercise type and dosage, frequency and intensity, and most did not align with recommendations for successful falls prevention exercise interventions reported for older people. While the majority of studies reported reduced falls, they differed in methods of reporting falls, and most did not utilise statistical analyses to evaluate outcomes.ConclusionThis review identified a small number of falls prevention intervention studies for people with intellectual disability. Although several studies reported improvements in fall outcomes, ability to draw conclusions about intervention effectiveness is limited by small sample sizes and few studies. Further large‐scale research is required to implement and evaluate falls prevention interventions specifically for adults with intellectual disability.

Funder

Scope Australia

Publisher

Wiley

Subject

Psychiatry and Mental health,Neurology (clinical),Neurology,Arts and Humanities (miscellaneous),Rehabilitation

Reference64 articles.

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3. Australian Commission on Safety and Quality in Health Care(2009b)Preventing falls and harm from falls in older people ‐ best practice guidelines for Australian Residential Care Facilities. Available at:https://www.safetyandquality.gov.au/publications‐and‐resources/resource‐library/preventing‐falls‐and‐harm‐falls‐older‐people‐best‐practice‐guidelines‐residential‐aged‐care‐facilities

4. Australian Institute of Health and Welfare (AIHW)(2020)Australia's health 2020: in brief. Australia's health series no. 17 Cat. no. AUS 232. Canberra: AIHW.

5. Falls resulting in health care among older people with intellectual disability in comparison with the general population

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