@article{ref1,
title="The effectiveness of e-interventions on fall, neuromuscular functions and quality of life in community-dwelling older adults: a systematic review and meta-analysis",
journal="International journal of nursing studies",
year="2020",
author="Chan, Janice Kuang Yeung and Klainin-Yobas, Piyanee and Chi, Yuchen and Gan, Javeil Ke En and Chow, Gigi and Wu, Xi Vivien",
volume="113",
number="",
pages="e103784-e103784",
abstract="BACKGROUND: Falls in older adults result in serious, life-limiting consequences. An increasing number of fall prevention interventions have used technology to reduce the number of falls in community-dwelling adults. Various types of e-interventions are being tested in clinical trials and in the community. These include telehealth, exergames, cognitive games, socialized training, smart home systems and non-conventional balance training. Currently, no systematic review and meta-analysis has assessed the overall effectiveness of e-interventions and compared the effectiveness of the different types.   OBJECTIVES: The aim of this review was to synthesize best available evidence concerning the effectiveness of e-interventions on fall, neuromuscular functions and quality of life in community-dwelling older adults.   METHODS: A rigorous three-step search was conducted in nine online databases for published and unpublished randomized controlled trials studying e-interventions. Studies were screened and assessed for individual and overall risk of bias by two independent reviewers. Six fall-related outcomes were evaluated in the meta-analysis: fall risk, balance, lower extremity strength, fall efficacy, cognitive function and health-related quality of life. Subgroup and sensitivity analysis were conducted during meta-analysis.   RESULTS: Thirty-one studies fit the eligibility criteria and had an overall 74.7% low risk of bias. A total of 4,877 older adults from 17 countries were included in narrative synthesis and meta-analysis. Telehealth combined with exercise programmes and smart home systems were able to reduce fall risk significantly (risk ratio=0.79, 95% CI [0.72, 0.86]). E-interventions also significantly improved balance and fall efficacy (standardized mean difference=0.28, 95% CI [0.04, 0.53]). However, lower extremity strength, cognitive function and health-related quality of life did not show significant improvements.   CONCLUSION: Telehealth combined with exercise and smart home systems demonstrated the best evidence of effectiveness in reduction of falls in community-dwelling older adults. Future research should focus on forecasting falls using smart home technology and Artificial Intelligence, and testing promising e-interventions on larger samples to improve the strength of evidence of fall prevention by e-interventions.<p /> <p>Language: en</p>",
language="en",
issn="0020-7489",
doi="10.1016/j.ijnurstu.2020.103784",
url="http://dx.doi.org/10.1016/j.ijnurstu.2020.103784"
}