Part 1 3000 word lit review part 2 2000 word research proposal - Essay Example

These falls have led to serious injuries in the elderly such as fractures of the hip and other skeletal parts (Daley & Spinks, 2000; Tinetti, et al., 1997). Falls have also led to lowered confidence and a fear of falling that has caused persons to remain sedentary, putting them at risk for other illnesses (Fortinsky et al., 2004). Studies have sought to ascertain the factors that contribute to falls in the elderly, and of these, most have been connected with strength and balance (Lord, Ward & Williams, 1999; Gardner, Robertson & Campbell, 2000).

Problems with strength and balance have been shown to be the major contributors to the instability of the elderly (Rubenstein, 2004; Gardner, Robertson & Campbell, 2000). Strength and power reduction are characteristics of ageing that lead to a loss of functional balance and confidence (Hunter et al., 2004). In fact, balance depends on an intricate interaction of several of the body's systems: musculo-skeletal, nervous, vestibular, and visual (Gauchard et al., 1999; Lemmer et al., 1999; Carter et al., 2002). Both strength and balance can be thought of as having a bearing on the body's the ability to maintain posture, and posture can be defined as the proper positioning of each body part in relation to another (Pajala et al.

, 2004; Lord, Ward, & Williams, 1996). The somatosensory system is responsible for providing the central nervous system with information about the body's position through proprioceptors contained inside the muscles (Anderson, 2002; Islam, 2004; Lord, et al., 1996). Yet the functioning of these balance components is shown to decline with age (Lord et al., 1994; Thelen et al., 1996; Judge, 2003). Exercise interventions of the form of proprioceptive and strength-training exercises have been cited as having the ability to reverse or slow many of these effects of ageing.

In fact, it has been strongly suggested by research that older persons who are physically active display better sensori-motor and balance skills than their inactive counterparts (Toulotte et al., 2003; Lemmer et al., 2000; Hunter et al., 2004). Though many researchers have studied the combined impact of these exercises on functional balance, much needs to be researched on the impact each has individually on functional ability. Further than that, what studies have had to say on confidence levels of the elderly following intervention is also of importance and has often been overlooked.

Veteran researchers such as Lord et al. (1996) and Brown et al. (2002) have demonstrated the benefit of these exercises, yet without separating them to isolate the effects of each. Other research done by Gauchard et al. (1999) has performed this separation, yet without the use of clinically tested interventions. Still others have employed good interventions and measures, but implemented exercises for far too short a period to achieve truly significant results (Carter et al., 2001). It is the purpose of this study to further critique the literature explored on both types of therapy for the prevention of falling in the elderly.

It will consider exercise interventions that employ both resistance and proprioceptive activities in an attempt to locate areas in which definite conclusions have been achieved, as well as to locate areas in which improvements can be made to achieve better results. It will then use the information gained to design, implement and evaluate the outcome of a specific lower limb proprioception exercise programme and