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      Falls in Korean Polio Survivors: Incidence, Consequences, and Risk Factors

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          Abstract

          Falls and fall-related injuries are important issue among polio survivors. The purpose of this study was to determine the incidence of, and consequences and factors associated with falls among Korean polio survivors. A total of 317 polio survivors participated in this study. All participants completed a questionnaire including fall history, symptoms related to post-polio syndrome and other information through a telephone interview. Among them, 80 participants visited our clinic for additional physical measurements and tests. Of the 317 respondents, 68.5% reported at least one fall in the past year. Of the fallers, 42.5% experienced at least one fall during one month. Most falls occurred during ambulation (76.6%), outside (75.2%) and by slipping down (29.7%). Of fallers, 45% reported any injuries caused by falls, and 23.3% reported fractures specifically. Female sex, old age, low bone mineral density, the presence of symptoms related to post-polio syndrome (PPS), poor balance confidence, short physical performance battery and weak muscle strength of knee extensor were not significantly associated with falls. Only leg-length discrepancy using spine-malleolar distance (SMD) was a significant factor associated with falls among Korean polio survivors. Our findings suggest that malalignment between the paralytic and non-paralytic limb length should be addressed in polio survivors for preventing falls.

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          Interventions for preventing falls in older people living in the community

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            Falls in individuals with stroke.

            Stroke survivors are at high risk for falls in all poststroke stages. Falls may have severe consequences, both physically and psychosocially. Individuals with stroke have an increased risk for hip fractures, and after such a fracture, they less often regain independent mobility. In addition, fear of falling is a common consequence of falls, which may lead to decreased physical activity, social deprivation and, eventually, loss of independence. Important risk factors for falls are balance and gait deficits. Stroke-related balance deficits comprise reduced postural stability during quiet standing and delayed and less coordinated responses to both self-induced and external balance perturbations. Gait deficits include reduced propulsion at push-off, decreased hip and knee flexion during the swing phase, and reduced stability during the stance phase. Interventions addressing these deficits can be expected to prevent falls more successfully. Preliminary evidence shows that task-specific exercise programs targeting balance and gait deficits can indeed reduce the number of falls in individuals with stroke. Technological advances in assistive devices are another promising area. More research is needed, however, to provide conclusive evidence of the efficacy of these interventions regarding the prevention of falls in individuals with stroke.
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              Leg length discrepancy.

              The role of leg length discrepancy (LLD) both as a biomechanical impediment and a predisposing factor for associated musculoskeletal disorders has been a source of controversy for some time. LLD has been implicated in affecting gait and running mechanics and economy, standing posture, postural sway, as well as increased incidence of scoliosis, low back pain, osteoarthritis of the hip and spine, aseptic loosening of hip prosthesis, and lower extremity stress fractures. Authors disagree on the extent (if any) to which LLD causes these problems, and what magnitude of LLD is necessary to generate these problems. This paper represents an overview of the classification and etiology of LLD, the controversy of several measurement and treatment protocols, and a consolidation of research addressing the role of LLD on standing posture, standing balance, gait, running, and various pathological conditions. Finally, this paper will attempt to generalize findings regarding indications of treatment for specific populations.
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                Author and article information

                Journal
                J Korean Med Sci
                J. Korean Med. Sci
                JKMS
                Journal of Korean Medical Science
                The Korean Academy of Medical Sciences
                1011-8934
                1598-6357
                February 2016
                13 January 2016
                : 31
                : 2
                : 301-309
                Affiliations
                [1 ]Department of Rehabilitation Medicine, Dongguk University Ilsan Hospital, Goyang, Korea.
                [2 ]Department of Physical Medicine and Rehabilitation, Soonchunhyang University Bucheon Hospital, Bucheon, Korea.
                [3 ]Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
                [4 ]Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, Korea.
                [5 ]Department of Rehabilitation Medicine, Seoul National University Boramae Medical Center, Seoul, Korea.
                [6 ]Red Cross College of Nursing, Chung-Ang University, Seoul, Korea.
                [7 ]Department of Rehabilitation Medicine, Ewha Womans University Medical Center, Seoul, Korea.
                [8 ]Department of Rehabilitation Medicine, National Rehabilitation Center, Seoul, Korea.
                Author notes
                Address for Correspondence: Jae-Young Lim, MD. Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, 82, Gumi-ro 173-beon-gil, Bundang-gu, Seongnam 13620, Korea. Tel: +82.31-787-7732, Fax: +82.31-787-4056, drlim1@ 123456snu.ac.kr
                Author information
                http://orcid.org/0000-0001-6932-6541
                http://orcid.org/0000-0002-9454-0344
                Article
                10.3346/jkms.2016.31.2.301
                4729513
                26839487
                962b0f5c-ff0c-45ef-b4ad-adff4f3e2a08
                © 2016 The Korean Academy of Medical Sciences.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 04 May 2015
                : 02 October 2015
                Categories
                Original Article
                Rehabilitation & Sports Medicine

                Medicine
                poliomyelitis,postpoliomyelitis syndrome,survivors,accidental falls,risk factors
                Medicine
                poliomyelitis, postpoliomyelitis syndrome, survivors, accidental falls, risk factors

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