An attendance of 377 delegates and speakers marks another step forward in this annual event which started as a local Nottingham initiative in 2000.

This year it moved from London to Manchester’s UMIST, with accommodation handy at the nearby University conference hotel. The venue worked well and will be repeated next year.

Exercise to prevent falls
The conference format, a mix of expert invited lectures, with platform presentations and posters of original research work or clinical practice examples has evolved over 4 years. The first session focused on assessment and treatment of postural instability. Prof Marion McMurdo opened with an overview on exercise and falls prevention. Her engaging, lucid yet scientifically ruthless approach is a delight. It is clear that “exercise” for falls prevention still needs closer definition. Devotees of Tai-Chi may reflect on the scant evidence for its widespread effectiveness. Her talk underlined the importance of careful targeting of well defined interventions.

Testing for propensity to fall
Prof Stephen Lord, a non-medical clinical scientist in Sydney, described the multi-dimensional Physiological Profile Assessment test battery covering vision, peripheral sensation, muscle strength, reaction time and balance. His work has reduced the assessment to 5 tests which produce a score accounting for 75% of the falls risk in studied populations. This enables individual targeting of multidimensional falls reduction programmes. He described several trials, some still unpublished, which have demonstrated effective falls reductions through tailored exercise-based interventions in defined populations.

Vision and falls
Dr Rowan Harwood reviewed vision and falls, including conflicting evidence on visual correction and falls reduction. He described their unpublished RCT of cataract removal, which demonstrated a reduction of recurrent but not total falls in the following year. Some answers but more questions!

National Initiatives - update
Then followed brief updates on various national falls initiatives. The National Osteoporosis Society’s Osteoporosis Nurse Initiative is currently addressing falls risk assessment (using modified Stratify) and osteoporosis treatment in care homes (www.nos.org.uk). ProFaNe (www.profane.eu.org) is a European falls researchers’ collaborative working towards consensus on the taxonomy, assessment and interventions for falls reductions in preparation for a major multi-centre trial.

Linda Henry reported on progress and lessons from the Health Communities and National Falls Collaboratives, both inspired by the NHS Plan 2000. Although they illustrate the range of views on the meaning of evidence, these have been influential in the field, particularly with PCTs. Successful service development locally may require squaring the circle. Finally, Prof Rose-Anne Kenny stunned the audience with preliminary news of the multi-centre SAFEPACE 2 study. In contrast to the single-centre SAFEPACE 1, this showed no falls reduction after pacemaker insertion for fallers with cardio-inhibitory CSS. Yet more questions!!

The afternoon session on fractures and osteoporosis heard from Aberdeen Professor of Orthopaedics, Jimmy Hutchinson on the Scottish Hip Fracture Audit, new and emerging concepts and treatments for osteoporosis from Manchester’s Peter Selby (the latest is strontium!) and Alastair McLennan’s account of the first 4 years of Glasgow’s Fracture Liaison Service (FLS).

In addition, there were six platform presentations, the prize winner being Pat Turner, an academic physiotherapist from Teesside reporting on physical activity and barriers to participation. The nineteen posters showed the strength and range of innovative work in falls and fracture prevention. Mrs Pat Turner also received a prize (£150) for her presentation: Types of activity and barriers to participation in physical activity in an older population with and without minimal trauma fractures.
 
Two joint winners for best poster prizes (£100 each) were awarded to Miss Julie Whitney for her poster: The effect of balance training on postural stability in Parkinson’s disease: a pilot study and to Dr Simon Mockett for his poster: The relationship between the four square step test and 3 other measures of balance: Berg Balance Scale, the Timed “Up & Go” Test, and postural sway in elderly subjects.

This year, as before, there was a buzz in the air and one could sense that people went home with re-energised enthusiasm. The conference amply demonstrated the SIG’s commitment to “act as a focus for multidisciplinary interest and expertise on falls prevention and bone health”. High points for me: the SAFEPACE2 enigma and the Glasgow FLS - it really might be possible to link orthopaedics, falls reduction interventions and optimal osteoporosis treatment. Evidence into practice!

Our thanks to the organisers – the outgoing SIG officers - Marion McMurdo, Jacqui Close and Jed Rowe, as well as to Tash Masud, Rob Morris and Hampton Medical for another good day.

See you in Manchester on Tuesday September 1st 2005.

Finbarr Martin
Chair : Falls Prevention and Bone Health SIG