{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T03:52:20Z","timestamp":1785469940160,"version":"3.56.0"},"reference-count":13,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2020,1,20]],"date-time":"2020-01-20T00:00:00Z","timestamp":1579478400000},"content-version":"unspecified","delay-in-days":19,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,12,26]]},"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:p>Poor balance and falls pose substantial risks to health and well-being. Thalidomide survivors with arm defects have an additional risk being unable to protect themselves in a fall. Generic exercise information to improve strength and balance is increasingly available to the elderly. However, disability can carry a lifetime risk. Identifying and correcting underlying musculoskeletal issues, correction of gait abnormalities together with establishing an appropriate exercise routine that is affordable, convenient and fun should improve outcomes at any stage of adult life. This can be challenging, not least in those who have never previously exercised and who are now middle aged or older. The Thalidomide Trust piloted focused support for a middle-aged thalidomide survivor with bilateral radial club hands and increasing balance issues who had never previously exercised. This met with great success improving his strength, balance, gait and posture together with ensuring an established exercise routine to maintain the improvement.<\/jats:p>","DOI":"10.1136\/bcr-2019-231345","type":"journal-article","created":{"date-parts":[[2020,1,22]],"date-time":"2020-01-22T05:14:27Z","timestamp":1579670067000},"page":"e231345","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Poor balance, bilateral upper limb phocomelia, no previous exercise: a challenging combination for fall prevention in a middle-aged thalidomide survivor"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0967-1014","authenticated-orcid":false,"given":"Dee","family":"Morrison","sequence":"first","affiliation":[{"name":"The Thalidomide Trust, St Neots, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,1,21]]},"reference":[{"key":"2025082708075243000_13.1.e231345.1","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0210222","article-title":"The health and quality of life of Thalidomide survivors as they age - Evidence from a UK survey","volume":"14","author":"Newbronner","year":"2019","journal-title":"PLoS One"},{"key":"2025082708075243000_13.1.e231345.2","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0152902","article-title":"Peripheral nerve dysfunction in middle-aged subjects born with thalidomide embryopathy","volume":"11","author":"Nicotra","year":"2016","journal-title":"PLoS One"},{"key":"2025082708075243000_13.1.e231345.3","unstructured":"Newbronner E . Falls and balance problems Briefing paper, the thalidomide trust, 2017. Available: https:\/\/www.thalidomidetrust.org\/wp-content\/uploads\/2016\/10\/Falls-and-Balance-Problems-Briefing-Paper-FINAL.pdf [Accessed May 2019]."},{"key":"2025082708075243000_13.1.e231345.4","unstructured":"Morrison D . Falls and balance awareness. The thalidomide trust. Available: https:\/\/www.thalidomidetrust.org\/health-and-%20wellbeing\/health\/falls-and-balance-awareness\/ [Accessed May 2019]."},{"key":"2025082708075243000_13.1.e231345.5","unstructured":"Kent S . Get yourself active. The thalidomide trust. Available: https:\/\/www.thalidomidetrust.org\/get-yourself-active\/ [Accessed June 2019]."},{"key":"2025082708075243000_13.1.e231345.6","unstructured":"Illger S . Fit for the future. The thalidomide trust. Available: https:\/\/www.thalidomidetrust.org\/news\/events\/fit-for-the-future\/ [Accessed June 2019]."},{"key":"2025082708075243000_13.1.e231345.7","unstructured":"Simpson F . Physiotherapy video case study. The thalidomide trust. Available: https:\/\/www.thalidomidetrust.org\/physiotherapy-professionals\/physiotherapy-video-case-study\/ [Accessed August 2019]."},{"key":"2025082708075243000_13.1.e231345.8","unstructured":"NHS . Balance exercises. Available: https:\/\/www.nhs.uk\/live-well\/exercise\/balance-exercises\/ [Accessed May 2019]."},{"key":"2025082708075243000_13.1.e231345.9","unstructured":"NHS . Physical activity guidance for older adults (65+years). Available: www.nhs.uk\/Livewell\/fitness\/Documents\/older-adults-65-years.pdf [Accessed May 2019]."},{"key":"2025082708075243000_13.1.e231345.10","unstructured":"Saga . Get up and go, 6 exercises for staying healthy. Available: https:\/\/www.csp.org.uk\/system\/files\/web_friendly_english_0.pdf [Accessed May 2019]."},{"key":"2025082708075243000_13.1.e231345.11","unstructured":"Government . Health grant awarded to victims of thalidomide. Available: https:\/\/www.gov.uk\/government\/news\/health-grant-awarded-to-victims-of-thalidomide [Accessed May 2019]."},{"key":"2025082708075243000_13.1.e231345.12","unstructured":"NHS . Prevention falls, 2018. Available: https:\/\/www.nhs.uk\/conditions\/falls\/prevention\/ [Accessed May 2019]."},{"key":"2025082708075243000_13.1.e231345.13","unstructured":"National Institute for Health and Care Excellence . Quality statement 1: identifying people at risk of falling, 2017. Available: https:\/\/www.nice.org.uk\/guidance\/qs86\/chapter\/Quality-statement-1-Identifying-people-at-risk-of-falling [Accessed May 2019]."}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2019-231345","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T15:08:00Z","timestamp":1756307280000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2019-231345"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1]]},"references-count":13,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2020,1,21]]},"published-print":{"date-parts":[[2020,1]]}},"alternative-id":["10.1136\/bcr-2019-231345"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2019-231345","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,1]]}}}