2,049 results
Search Results
2. Older adults' preferences for, adherence to and experiences of two self-management falls prevention home exercise programmes: a comparison between a digital programme and a paper booklet.
- Author
-
Mansson L, Lundin-Olsson L, Skelton DA, Janols R, Lindgren H, Rosendahl E, and Sandlund M
- Subjects
- Aged, Aged, 80 and over, Exercise, Exercise Therapy, Female, Humans, Male, Pamphlets, Accidental Falls prevention & control, Self-Management
- Abstract
Background: Fall prevention exercise programmes are known to be effective, but access to these programmes is not always possible. The use of eHealth solutions might be a way forward to increase access and reach a wider population. In this feasibility study the aim was to explore the choice of programme, adherence, and self-reported experiences comparing two exercise programmes - a digital programme and a paper booklet., Methods: A participant preference trial of two self-managed fall prevention exercise interventions. Community-dwelling adults aged 70 years and older exercised independently for four months after one introduction meeting. Baseline information was collected at study start, including a short introduction of the exercise programme, a short physical assessment, and completion of questionnaires. During the four months intervention period, participants self-reported their performed exercises in an exercise diary. At a final meeting, questionnaires about their experiences, and post-assessments, were completed. For adherence analyses data from diaries were used and four subgroups for different levels of participation were compared. Exercise maintenance was followed up with a survey 12 months after study start., Results: Sixty-seven participants, with mean age 77 ± 4 years were included, 72% were women. Forty-three percent chose the digital programme. Attrition rate was 17% in the digital programme group and 37% in the paper booklet group (p = .078). In both groups 50-59% reported exercise at least 75% of the intervention period. The only significant difference for adherence was in the subgroup that completed ≥75% of exercise duration, the digital programme users exercised more minutes per week (p = .001). Participants in both groups were content with their programme but digital programme users reported a significantly higher (p = .026) degree of being content, and feeling supported by the programme (p = .044). At 12 months follow-up 67% of participants using the digital programme continued to exercise regularly compared with 35% for the paper booklet (p = .036)., Conclusions: Exercise interventions based on either a digital programme or a paper booklet can be used as a self-managed, independent fall prevention programme. There is a similar adherence in both programmes during a 4-month intervention, but the digital programme seems to facilitate long-term maintenance in regular exercise., Trial Registration: ClinTrial: NCT02916849.
- Published
- 2020
- Full Text
- View/download PDF
3. Critically appraised paper: Task-oriented gait training that focuses on the safe and correct use of a walking aid may reduce falls in people with multiple sclerosis [commentary].
- Author
-
Karpatkin H
- Subjects
- Exercise Therapy, Gait, Humans, Walking, Accidental Falls, Multiple Sclerosis
- Published
- 2020
- Full Text
- View/download PDF
4. Critically appraised paper: Task-oriented gait training that focuses on the safe and correct use of a walking aid may reduce falls in people with multiple sclerosis [synopsis].
- Author
-
Plummer P
- Subjects
- Exercise Therapy, Gait, Humans, Walking, Accidental Falls, Multiple Sclerosis
- Published
- 2020
- Full Text
- View/download PDF
5. Can a tailored exercise and home hazard reduction program reduce the rate of falls in community dwelling older people with cognitive impairment: protocol paper for the i-FOCIS randomised controlled trial.
- Author
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Close JC, Wesson J, Sherrington C, Hill KD, Kurrle S, Lord SR, Brodaty H, Howard K, Gitlin LN, O'Rourke SD, and Clemson L
- Subjects
- Aged, Aged, 80 and over, Cognition Disorders epidemiology, Cognition Disorders psychology, Female, Humans, Male, Pilot Projects, Accidental Falls prevention & control, Cognition Disorders therapy, Exercise Therapy methods, Residence Characteristics, Safety Management methods
- Abstract
Background: The rate of falls in community dwelling older people with cognitive impairment (CI) is twice that of a cognitively intact population, with almost two thirds of people with CI falling annually. Studies indicate that exercise involving balance and/or a home hazard reduction program are effective in preventing falls in cognitively intact older people. However the potential benefit of these interventions in reducing falls in people with CI has not been established.This randomised controlled trial will determine whether a tailored exercise and home hazard reduction program can reduce the rate of falls in community dwelling older people with CI. We will determine whether the intervention has beneficial effects on a range of physical and psychological outcome measures as well as quality of life of participants and their carers. A health economic analysis examining the cost and potential benefits of the program will also be undertaken., Methods and Design: Three hundred and sixty people aged 65 years or older living in the community with CI will be recruited to participate in the trial. Each will have an identifiable carer with a minimum of 3.5 hours of face to face contact each week.Participants will undergo an assessment at baseline with retests at 6 and 12 months. Participants allocated to the intervention group will participate in an exercise and home hazard reduction program tailored to their cognitive and physical abilities.The primary outcome measure will be the rate of falls which will be measured using monthly falls calendars. Secondary outcome measures will include the risk of falling, quality of life, measures of physical and cognitive function, fear of falling and planned and unplanned use of health services. Carers will be followed up to determine carer burden, coping strategies and quality of life., Discussion: The study will determine the impact of this tailored intervention in reducing the rate of falls in community dwelling older people with CI as well as the cost-effectiveness and adherence to the program. The results will have direct implications for the design and implementation of interventions for this high-risk group of older people., Trial Registration: The protocol for this study is registered with the Australian New Zealand Clinical Trials Registry - ACTRN12614000603617.
- Published
- 2014
- Full Text
- View/download PDF
6. Older adults’ preferences for, adherence to and experiences of two self-management falls prevention home exercise programmes: a comparison between a digital programme and a paper booklet
- Author
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Linda Mansson, Lillemor Lundin-Olsson, Dawn A. Skelton, Rebecka Janols, Helena Lindgren, Erik Rosendahl, and Marlene Sandlund
- Subjects
Accidental falls ,Aged ,Aged, 80 and over ,Digital health ,eHealth ,Exercise ,Geriatrics ,RC952-954.6 - Abstract
Abstract Background Fall prevention exercise programmes are known to be effective, but access to these programmes is not always possible. The use of eHealth solutions might be a way forward to increase access and reach a wider population. In this feasibility study the aim was to explore the choice of programme, adherence, and self-reported experiences comparing two exercise programmes – a digital programme and a paper booklet. Methods A participant preference trial of two self-managed fall prevention exercise interventions. Community-dwelling adults aged 70 years and older exercised independently for four months after one introduction meeting. Baseline information was collected at study start, including a short introduction of the exercise programme, a short physical assessment, and completion of questionnaires. During the four months intervention period, participants self-reported their performed exercises in an exercise diary. At a final meeting, questionnaires about their experiences, and post-assessments, were completed. For adherence analyses data from diaries were used and four subgroups for different levels of participation were compared. Exercise maintenance was followed up with a survey 12 months after study start. Results Sixty-seven participants, with mean age 77 ± 4 years were included, 72% were women. Forty-three percent chose the digital programme. Attrition rate was 17% in the digital programme group and 37% in the paper booklet group (p = .078). In both groups 50–59% reported exercise at least 75% of the intervention period. The only significant difference for adherence was in the subgroup that completed ≥75% of exercise duration, the digital programme users exercised more minutes per week (p = .001). Participants in both groups were content with their programme but digital programme users reported a significantly higher (p = .026) degree of being content, and feeling supported by the programme (p = .044). At 12 months follow-up 67% of participants using the digital programme continued to exercise regularly compared with 35% for the paper booklet (p = .036). Conclusions Exercise interventions based on either a digital programme or a paper booklet can be used as a self-managed, independent fall prevention programme. There is a similar adherence in both programmes during a 4-month intervention, but the digital programme seems to facilitate long-term maintenance in regular exercise. Trial registration ClinTrial: NCT02916849 .
- Published
- 2020
- Full Text
- View/download PDF
7. Critically appraised paper: Screening for fall risk and a targeted exercise or multifactorial intervention do not reduce fracture rate in older adults more than advice only [synopsis]
- Author
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Prudence Plummer
- Subjects
medicine.medical_specialty ,business.industry ,lcsh:RM1-950 ,MEDLINE ,Physical Therapy, Sports Therapy and Rehabilitation ,Fall risk ,Multifactorial intervention ,Fractures, Bone ,lcsh:Therapeutics. Pharmacology ,Physical therapy ,medicine ,Humans ,Accidental Falls ,business ,Exercise ,Aged - Published
- 2021
8. Critically appraised paper: Fall prevention program delivered electronically to community-dwelling older people can reduce fall rate over 24 months.
- Author
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Plummer, Prudence
- Subjects
EVALUATION of human services programs ,TIME ,INDEPENDENT living ,ACCIDENTAL falls ,TELEMEDICINE - Published
- 2022
- Full Text
- View/download PDF
9. Critically appraised paper: Fall prevention program delivered electronically to community-dwelling older people can reduce fall rate over 24 months [commentary].
- Author
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Soh, Sze-Ee
- Subjects
ACCIDENTAL falls ,INDEPENDENT living - Published
- 2022
- Full Text
- View/download PDF
10. Older adults preferences for, adherence to and experiences of two self-management falls prevention home exercise programmes: A comparison between a digital programme and a paper booklet
- Author
-
Linda Mansson, Lillemor Lundin-Olsson, Erik Rosendahl, Helena Lindgren, Dawn A. Skelton, Rebecka Janols, and Marlene Sandlund
- Subjects
Male ,medicine.medical_specialty ,Independent living ,Population ,Geriatrik ,lcsh:Geriatrics ,03 medical and health sciences ,0302 clinical medicine ,eHealth ,80 and over ,Self-management ,Medicine ,Humans ,030212 general & internal medicine ,Sjukgymnastik ,education ,mHealth ,Physiotherapy ,Exercise ,Accidental falls ,Aged ,Geriatrics ,Aged, 80 and over ,education.field_of_study ,business.industry ,Self-Management ,Falls prevention ,030229 sport sciences ,Digital health ,Exercise Therapy ,lcsh:RC952-954.6 ,Physical therapy ,Accidental Falls ,Female ,Pamphlets ,Geriatrics and Gerontology ,business ,Fall prevention ,Research Article - Abstract
Background Fall prevention exercise programmes are known to be effective, but access to these programmes is not always possible. The use of eHealth solutions might be a way forward to increase access and reach a wider population. In this feasibility study the aim was to explore the choice of programme, adherence, and self-reported experiences comparing two exercise programmes – a digital programme and a paper booklet. Methods A participant preference trial of two self-managed fall prevention exercise interventions. Community-dwelling adults aged 70 years and older exercised independently for four months after one introduction meeting. Baseline information was collected at study start, including a short introduction of the exercise programme, a short physical assessment, and completion of questionnaires. During the four months intervention period, participants self-reported their performed exercises in an exercise diary. At a final meeting, questionnaires about their experiences, and post-assessments, were completed. For adherence analyses data from diaries were used and four subgroups for different levels of participation were compared. Exercise maintenance was followed up with a survey 12 months after study start. Results Sixty-seven participants, with mean age 77 ± 4 years were included, 72% were women. Forty-three percent chose the digital programme. Attrition rate was 17% in the digital programme group and 37% in the paper booklet group (p = .078). In both groups 50–59% reported exercise at least 75% of the intervention period. The only significant difference for adherence was in the subgroup that completed ≥75% of exercise duration, the digital programme users exercised more minutes per week (p = .001). Participants in both groups were content with their programme but digital programme users reported a significantly higher (p = .026) degree of being content, and feeling supported by the programme (p = .044). At 12 months follow-up 67% of participants using the digital programme continued to exercise regularly compared with 35% for the paper booklet (p = .036). Conclusions Exercise interventions based on either a digital programme or a paper booklet can be used as a self-managed, independent fall prevention programme. There is a similar adherence in both programmes during a 4-month intervention, but the digital programme seems to facilitate long-term maintenance in regular exercise. Trial registration ClinTrial: NCT02916849.
- Published
- 2019
11. An intervention to improve outcomes of falls in dementia: the DIFRID mixed-methods feasibility study.
- Author
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Allan LM, Wheatley A, Smith A, Flynn E, Homer T, Robalino S, Beyer FR, Fox C, Howel D, Barber R, Connolly JA, Robinson L, Parry SW, Rochester L, Corner L, and Bamford C
- Subjects
- Aged, Aged, 80 and over, Feasibility Studies, Female, Humans, Male, Prospective Studies, Treatment Outcome, Accidental Falls, Dementia, Wounds and Injuries therapy
- Abstract
Background: Fall-related injuries are a significant cause of morbidity and mortality in people with dementia. There is presently little evidence to guide the management of such injuries, and yet there are potentially substantial benefits to be gained if the outcomes of these injuries could be improved. This study aimed to design an appropriate new health-care intervention for people with dementia following a fall and to assess the feasibility of its delivery in the UK NHS., Objectives: To determine whether or not it is possible to design an intervention to improve outcomes of falls in dementia, to investigate the feasibility and acceptability of the DIFRID (Developing an Intervention for Fall related Injuries in Dementia) intervention and to investigate the feasibility of a future randomised controlled trial and the data collection tools needed to evaluate both the effectiveness and the cost-effectiveness of the DIFRID intervention., Design: This was a mixed-methods feasibility study. A systematic review (using Cochrane methodology) and realist review [using Realist And Meta-narrative Evidence Syntheses: Evolving Standards (RAMESES) methodology] explored the existing evidence base and developed programme theories. Searches were carried out in November 2015 (updated in January 2018) for effectiveness studies and in August 2016 for economic studies. A prospective observational study identified service use via participant diary completion. Qualitative methods (semistructured interviews, focus groups and observation) were used to explore current practice, stakeholder perspectives of the health and social care needs of people with dementia following a fall, ideas for intervention and barriers to and facilitators of change. Each of the resulting data sets informed intervention development via Delphi consensus methods. Finally, a single-arm feasibility study with embedded process evaluation was conducted., Setting: This study was set in the community., Participants: The participants were (1) people with dementia presenting with falls necessitating health-care attention in each setting (primary care, the community and secondary care) at three sites and their carers, (2) professionals delivering the intervention, who were responsible for training and supervision and who were members of the intervention team, (3) professionals responsible for approaching and recruiting participants and (4) carers of participants with dementia., Interventions: This was a complex multidisciplinary therapy intervention. Physiotherapists, occupational therapists and support workers delivered up to 22 sessions of tailored activities in the home or local area of the person with dementia over a period of 12 weeks., Main Outcome Measures: (1) Assessment of feasibility of study procedures; (2) assessment of the acceptability, feasibility and fidelity of intervention components; and (3) assessment of the suitability and acceptability of outcome measures for people with dementia and their carers (number of falls, quality of life, fear of falling, activities of daily living, goal-setting, health-care utilisation and carer burden)., Results: A multidisciplinary intervention delivered in the homes of people with dementia was designed based on qualitative work, realist review and recommendations of the consensus panel. The intervention was delivered to 11 people with dementia. The study suggested that the intervention is both feasible and acceptable to stakeholders. A number of modifications were recommended to address some of the issues arising during feasibility testing. The measurement of outcome measures was successful., Conclusions: The study has highlighted the feasibility of delivering a creative, tailored, individual approach to intervention for people with dementia following a fall. Although the intervention required greater investment of time than usual practice, many staff valued the opportunity to work more closely with people with dementia and their carers. We conclude that further research is now needed to refine this intervention in the context of a pilot randomised controlled trial., Trial Registration: Current Controlled Trials ISRCTN41760734 and PROSPERO CRD42016029565., Funding: This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment ; Vol. 23, No. 59. See the NIHR Journals Library website for further project information., Competing Interests: Louise Robinson reports grants from the National Institute for Health Research (NIHR) Professor award and a NIHR Senior Investigator award outside the submitted work. Lynn Rochester reports grants from the Medical Research Council, the European Union, the Engineering and Physical Sciences Research Council, the Wellcome Trust (London, UK), Parkinson’s UK (London, UK), NIHR [Programme Development Grant, Physical Activity Interventions to Improve Outcomes for people with Rare Neurological Conditions (PARC), co-applicant (2018–20); and Health Technology Assessment, PDSAFE: a randomised controlled trial of the effectiveness of PDSAFE to prevent falls among people with Parkinson’s disease, co-applicant (2013–17)] and the Stroke Association (London, UK) outside the submitted work.
- Published
- 2019
- Full Text
- View/download PDF
12. PAPERS TO APPEAR IN ARCTIC
- Subjects
Arctic research ,Accidental falls ,Groundwater ,Earth sciences ,Regional focus/area studies - Abstract
Frigault, J.S., and Giles, A.R. Understanding Fall Risk Factors for Inuvialuit Elders in Inuvik, Northwest Territories, Canada. Gallagher, C.P., and Lea, E.V. Overwintering Habitat of American Dipper, Cinclus mexicanus, in [...]
- Published
- 2018
13. Critically appraised paper: Task-oriented gait training that focuses on the safe and correct use of a walking aid may reduce falls in people with multiple sclerosis [commentary]
- Author
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Herb Karpatkin
- Subjects
medicine.medical_specialty ,Multiple Sclerosis ,business.industry ,Multiple sclerosis ,Human factors and ergonomics ,Poison control ,Physical Therapy, Sports Therapy and Rehabilitation ,Walking ,medicine.disease ,Suicide prevention ,Article ,Occupational safety and health ,Exercise Therapy ,Gait (human) ,Physical medicine and rehabilitation ,Gait training ,Injury prevention ,medicine ,Physical therapy ,Humans ,Accidental Falls ,business ,Gait - Abstract
OBJECTIVE: To evaluate the effect of the Assistive Device Selection, Training and Education Program (ADSTEP) on falls and walking and sitting activity in people with multiple sclerosis (PwMS). DESIGN: Randomized controlled trial. SETTING: Veterans affairs medical center. PARTICIPANTS: PwMS (N=40) using a walking aid at baseline who had fallen in the previous year. INTERVENTIONS: Participants were randomly assigned to ADSTEP or control. ADSTEP had 6 weekly, 40-minute, 1-on-1 sessions with a physical therapist, starting with walking aid selection and fitting, followed by task-oriented progressive gait training. Control was usual medical care with the option of ADSTEP after the study. MAIN OUTCOME MEASURES: The following were assessed at baseline, intervention completion, and 3 months later: falls, timed Up and Go, timed 25-foot walk, 2-minute walk, Four Square Step Test, International Physical Activity Questionnaire, Quebec User Evaluation of Satisfaction with Assistive Technologies, Multiple Sclerosis Walking Scale-12, Activities-Specific Balance Confidence Scale, and Multiple Sclerosis Impact Scale-29. Effect on these outcomes was estimated by a 2-by-2 repeated measures general linear model. RESULTS: Fewer ADSTEP than control participants fell (χ(2)=3.96, P.05. ADSTEP 117.53±148.40min/d; control 46.43 ±58.55min/d; d=0.63). CONCLUSIONS: ADSTEP prevents falls, reduces sitting, and may increase walking in PwMS.
- Published
- 2020
14. Critically appraised paper: Screening for fall risk and a targeted exercise or multifactorial intervention do not reduce fracture rate in older adults more than advice only [commentary].
- Author
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Haines, Terry P
- Subjects
BONE fracture prevention ,MEDICAL screening ,RISK assessment ,ACCIDENTAL falls ,EXERCISE therapy ,OLD age - Published
- 2021
- Full Text
- View/download PDF
15. Accidental falls and associated factors among the elderly in Thailand: a national cross-sectional study in 2007, 2011, 2014 and 2017
- Author
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Khongboon, Pattaraporn and Kespichayawatt, Jiraporn
- Published
- 2022
- Full Text
- View/download PDF
16. Using multiple data sources to answer patient safety-related research questions in hospital inpatient settings: a discursive paper using inpatient falls as an example
- Author
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Huey-Ming Tzeng
- Subjects
Inpatients ,Safety Management ,Data collection ,Inpatient care ,business.industry ,Psychological intervention ,General Medicine ,medicine.disease ,Focus group ,United States ,Unit of analysis ,Hospitalization ,Patient safety ,Harm ,Nursing ,medicine ,Humans ,Accidental Falls ,Medical emergency ,business ,General Nursing ,Fall prevention - Abstract
Aim and objectives. This education-focused paper presents a discussion of possible data sources used in patient safety issues specific to fall reduction in hospital inpatient care settings. Background. Although hospitals and clinicians in the USA have been implored to improve care and reduce events that harm patients (falls), studies to date have failed to clearly address the facility system-level factors for falls. Making meaningful approaches to modify risk factors is clearly overdue. Design. Discursive paper. Method. Possible data sources for answering patient fall-related research questions in hospital settings are categorised as: (1) archived hospital data, (2) surveys of patients/families/clinicians, (3) interviews and focus groups of patients/families/clinicians, (4) publicly available data sets and (5) published legal cases. The complexities of research in fall prevention are illustrated using the conceptual models. Examples were included to illustrate the use of these data sources. Discussion. Data-related issues include: (1) unit of analysis, (2) computer data processing capabilities, (3) merging data sets from different sources and (4) data abstraction, aggregation and data analytic techniques. Conclusions. The trend to use multiple data sources to answer research questions is gradually emerging. To demonstrate effective fall prevention efforts across hospitals, publicly available data sets can be reliable sources for analyses to inform policymakers about meaningful fall prevention programmes that result in positive outcomes. Relevance to clinical practice. Challenges to develop and evaluate any interventions to eliminate risk factors for falls often relate to selecting feasible interventions and whether staff members accept the interventions and adhere to adopting the intervention. Using multiple data sources with time factors to cross-validate the sufficiency of nurses’ knowledge with their practice patterns may be more productive. This need further supports the importance of this paper about possible data sources used in the research on patient safety specific to fall reduction for adults in hospital inpatient care settings.
- Published
- 2011
17. Latest Research Trends in Fall Detection and Prevention Using Machine Learning: A Systematic Review.
- Author
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Usmani S, Saboor A, Haris M, Khan MA, and Park H
- Subjects
- Aged, Algorithms, Humans, Machine Learning, Seasons, Accidental Falls prevention & control, Quality of Life
- Abstract
Falls are unusual actions that cause a significant health risk among older people. The growing percentage of people of old age requires urgent development of fall detection and prevention systems. The emerging technology focuses on developing such systems to improve quality of life, especially for the elderly. A fall prevention system tries to predict and reduce the risk of falls. In contrast, a fall detection system observes the fall and generates a help notification to minimize the consequences of falls. A plethora of technical and review papers exist in the literature with a primary focus on fall detection. Similarly, several studies are relatively old, with a focus on wearables only, and use statistical and threshold-based approaches with a high false alarm rate. Therefore, this paper presents the latest research trends in fall detection and prevention systems using Machine Learning (ML) algorithms. It uses recent studies and analyzes datasets, age groups, ML algorithms, sensors, and location. Additionally, it provides a detailed discussion of the current trends of fall detection and prevention systems with possible future directions. This overview can help researchers understand the current systems and propose new methodologies by improving the highlighted issues.
- Published
- 2021
- Full Text
- View/download PDF
18. Low Back Pain as a Risk Factor for Recurrent Falls in People With Knee Osteoarthritis.
- Author
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Iijima H, Shimoura K, Aoyama T, and Takahashi M
- Subjects
- Aged, Aged, 80 and over, Cross-Sectional Studies, Female, Humans, Japan epidemiology, Low Back Pain diagnosis, Male, Middle Aged, Osteoarthritis, Knee diagnosis, Prevalence, Recurrence, Risk Assessment, Risk Factors, Severity of Illness Index, Time Factors, Accidental Falls, Low Back Pain epidemiology, Osteoarthritis, Knee epidemiology
- Abstract
Objective: Knee osteoarthritis (OA) has been suggested to increase the risk of falls. Low back pain (LBP) is a potential risk factor for falls in people with knee OA, but this issue has not been addressed adequately in previous studies. The objective of this study was to investigate the relationship between LBP and falls in people with knee OA in a 12-month period., Methods: Participants with knee OA (Kellgren/Lawrence [K/L] grade ≥1) completed questionnaires for LBP and falls that occurred in the preceding 12 months. Binary and ordinal logistic regression analyses were performed to assess the relationship between LBP or moderate-to-severe LBP (numeric rating scale ≥4 points) and any fall (≥1 fall) or recurrent falls (≥2 falls) after adjustment for age, sex, K/L grade, knee pain severity, and quadriceps strength. Sensitivity analyses were performed excluding people with sciatica, nonchronic LBP, K/L grade 1, and those receiving pain medications., Results: We included 189 participants (ages 61-90 years, 78.3% women) in this study. Of these participants, 41 (21.6%) reported falls in the preceding 12 months. People with any LBP (n = 101) and those with moderate-to-severe LBP (n = 45) had 2.7- and 3.7-times higher odds of recurrent falls, respectively. Sensitivity analyses revealed a strong correlation between moderate-to-severe LBP and recurrent falls., Conclusion: Thorough investigation of LBP as a risk factor for recurrent falls in people with knee OA may provide a novel insight into the pathomechanics of recurrent falls in this population., (© 2020, American College of Rheumatology.)
- Published
- 2021
- Full Text
- View/download PDF
19. Critically appraised paper: Group-format dual-task training reduces dual-task interference in simple mobility tasks in people with chronic stroke [commentary].
- Author
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Kelly, Valerie E
- Subjects
CHRONIC diseases ,POSTURAL balance ,EXERCISE ,EXERCISE physiology ,ACCIDENTAL falls ,STROKE ,THERAPEUTICS ,WALKING ,PSYCHOSOCIAL factors ,BODY movement ,STROKE rehabilitation ,STROKE patients ,DISEASE complications - Abstract
The article presents a commentary on how group-format dual-task training reduces dual-task interference in mobility tasks in people with chronic stroke. Topics discussed include potential advantages in terms of increasing social interactions, improving adherence, and reducing costs; simultaneous performance practice of walking and concurrent tasks across numerous participants; and reductions in dual-task interference effects were observed only in the group receiving dual-task training.
- Published
- 2019
- Full Text
- View/download PDF
20. Critically appraised paper: Group-format dual-task training reduces dual-task interference in simple mobility tasks in people with chronic stroke [synopsis].
- Author
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Plummer, Prudence
- Subjects
COGNITION ,POSTURAL balance ,EXERCISE ,ACCIDENTAL falls ,EVALUATION of medical care ,STRETCH (Physiology) ,THERAPEUTICS ,WALKING ,GROUP process ,BODY movement ,INDEPENDENT living ,STROKE rehabilitation ,STROKE patients - Abstract
The article presents a synopsis on group-format dual-task training which reduces dual-task interference in mobility tasks in people with chronic stroke. Topics discussed include potential advantages in terms of increasing social interactions, improving adherence, and reducing costs; simultaneous performance practice of walking and concurrent tasks across numerous participants; and reductions in dual-task interference effects were observed only in the group receiving dual-task training.
- Published
- 2019
- Full Text
- View/download PDF
21. Can a tailored exercise and home hazard reduction program reduce the rate of falls in community dwelling older people with cognitive impairment: protocol paper for the i-FOCIS randomised controlled trial
- Author
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Keith D. Hill, Henry Brodaty, Susan Kurrle, Jacqueline Wesson, Laura N. Gitlin, Catherine Sherrington, Stephen R. Lord, Jacqueline C. T. Close, Lindy Clemson, Kirsten Howard, Sandra D. O'Rourke, Close, J, Wesson, J, Sherrington, C, Hill, Keith, Kurrle, Susan, Lord, S, Brodaty, H, Howard, Kirsten, Gitlin, Laura, O'Rourke, Sandra D, and Clemson, Lindy
- Subjects
Gerontology ,Male ,medicine.medical_specialty ,Safety Management ,Population ,Psychological intervention ,Poison control ,Pilot Projects ,Intervention ,Suicide prevention ,Fear of falling ,law.invention ,Study Protocol ,Quality of life (healthcare) ,Randomized controlled trial ,law ,Residence Characteristics ,Medicine ,Humans ,education ,Aged ,Aged, 80 and over ,education.field_of_study ,business.industry ,Prevention ,Tailored Intervention ,3. Good health ,Exercise Therapy ,Cognitive impairment ,Physical therapy ,Accidental Falls ,Female ,Dementia ,Geriatrics and Gerontology ,medicine.symptom ,business ,Cognition Disorders - Abstract
Background: The rate of falls in community dwelling older people with cognitive impairment (CI) is twice that of a cognitively intact population, with almost two thirds of people with CI falling annually. Studies indicate that exercise involving balance and/or a home hazard reduction program are effective in preventing falls in cognitively intact older people. However the potential benefit of these interventions in reducing falls in people with CI has not been established. This randomised controlled trial will determine whether a tailored exercise and home hazard reduction program can reduce the rate of falls in community dwelling older people with CI. We will determine whether the intervention has beneficial effects on a range of physical and psychological outcome measures as well as quality of life of participants and their carers. A health economic analysis examining the cost and potential benefits of the program will also be undertaken. Methods and design: Three hundred and sixty people aged 65 years or older living in the community with CI will be recruited to participate in the trial. Each will have an identifiable carer with a minimum of 3.5 hours of face to face contact each week. Participants will undergo an assessment at baseline with retests at 6 and 12 months. Participants allocated to the intervention group will participate in an exercise and home hazard reduction program tailored to their cognitive and physical abilities. The primary outcome measure will be the rate of falls which will be measured using monthly falls calendars. Secondary outcome measures will include the risk of falling, quality of life, measures of physical and cognitive function, fear of falling and planned and unplanned use of health services. Carers will be followed up to determine carer burden, coping strategies and quality of life. Discussion: The study will determine the impact of this tailored intervention in reducing the rate of falls in community dwelling older people with CI as well as the cost-effectiveness and adherence to the program. The results will have direct implications for the design and implementation of interventions for this high-risk group of older people. Trial registration: The protocol for this study is registered with the Australian New Zealand Clinical Trials Registry ACTRN12614000603617
- Published
- 2014
22. Practice Development Section Paper 1 Older People’s Perspectives on Fall Risk and Fall Prevention Programs: A Literature Review
- Author
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McMahon, Siobhan, Talley, Kristine M., and Wyman, Jean F.
- Subjects
Aging ,Geriatric Nursing ,Risk Factors ,Humans ,Accidental Falls ,Health Promotion ,Risk Reduction Behavior ,Article ,Aged - Abstract
Despite evidence supporting fall prevention methods, fall-related injury and death rates continue to rise. Understanding older people’s views on fall risk and prevention will help nurses and other health professionals in the design of fall prevention strategies that will broaden their scope, reach, and adoption. This literature review synthesized 19 qualitative and quantitative studies examining older people’s perspectives about fall risk and prevention using a social ecological framework. Three themes emerged about fall risk; fearing vulnerability, maintaining autonomy and independence, and interpreting risk. Four themes emerged about fall prevention programs; influence of participant and program characteristics, need for personal relevance and preference, maintaining autonomy and independence, and increased support for and access to programs. Implications for practice include individual, interpersonal, organizational and community level considerations for improving fall prevention efforts.
- Published
- 2011
23. Trends in Multicomponent Training Research in the Aged Population: A Bibliometric Analysis.
- Author
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Pereira-Payo, Damián, Denche-Zamorano, Ángel, Mendoza-Muñoz, María, Franco-García, Juan Manuel, Carlos-Vivas, Jorge, and Pérez-Gómez, Jorge
- Subjects
SERIAL publications ,HEALTH status indicators ,RESEARCH funding ,EXERCISE therapy ,CITATION analysis ,DESCRIPTIVE statistics ,RESISTANCE training ,MUSCLE strength ,THEMATIC analysis ,AGING ,MEDICAL research ,BIBLIOMETRICS ,PHYSICAL fitness ,QUALITY of life ,AEROBIC exercises ,DATA analysis software ,POSTURAL balance ,SARCOPENIA ,ACCIDENTAL falls - Abstract
The proportion of aged populations is increasing worldwide. Exercise has a palliating effect on some adverse implications of aging. Multicomponent training (MCT) is a recommended form of exercise for the aged population. The aims of this research were to (1) study the number of publications regarding MCT in the aged population following an exponential growth rate; (2) identify the journals, authors, and countries that stand out the most in this area; and (3) describe the most common themes and used keywords in this field. The analysis was performed through the traditional laws of bibliometrics, including, Price's, Lotka's, Bradford's, and Zipf's law. All documents published in journals indexed in the Web of Science (WoS) Core Collection from 2001 to November 2023 that met the inclusion criteria were included. The 485 documents included in this review revealed that the number of annual publications experienced an exponential growth phase, 15 journals with six or more publications formed the core journals on this topic, and the author Mikel Izquierdo and his collaborative network topped the lists of prominent and prolific co-authors. Spain was the leading country in number of publications. Various thematic lines and keywords regarding strength, sarcopenia, quality of life, falls, balance, dual-task exercise, and cognitive and physical functioning were identified. In conclusion, this work confirmed that research on this topic is going through an exponential growth phase and provided detailed information about the journals, authors, and countries involved in the subject, as well as the keywords most frequently used in the subject matter. [ABSTRACT FROM AUTHOR]
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- 2024
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24. Best Practices for Treating Blind and Visually Impaired Patients in the Emergency Department: A Scoping Review.
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Hamadah, Kareem, Velagapudi, Mary, Navarro, Juliana J., Pirotte, Andrew, and Obersteadt, Chris
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HOLISTIC medicine ,PATIENT autonomy ,MEDICAL quality control ,VISION disorders ,PROFESSIONAL practice ,HOSPITAL care ,EMERGENCY medical services ,CONTINUUM of care ,SYSTEMATIC reviews ,MEDLINE ,LITERATURE reviews ,HEALTH equity ,BLINDNESS ,ONLINE information services ,MEDICAL needs assessment ,ACCIDENTAL falls ,MEDICAL care costs ,COMORBIDITY ,PROFESSIONAL competence ,DISEASE complications - Abstract
Introduction: Blind and visually impaired individuals, an under-represented population of the emergency department (ED), possess comorbidities and have a higher chance of in-hospital sequelae, including falls. This potentially vulnerable population, if not treated mindfully, can be subject to decreased quality of care, recurrent and/or longer hospitalizations, persistence of health issues, increased incidence of falls, and higher healthcare costs. For these reasons, it is crucial to implement holistic practices and train clinicians to treat blind and visually impaired patients in the ED setting. Methods: We identified and used a comprehensive article describing best practices for the care of blind and visually impaired patients to establish the ED-specific recommendations presented in this paper. A scoping review of the literature was then performed using PubMed to identify additional articles to support each recommendation. To ensure that recommendations could be implemented in a representative, scalable, and sustainable manner, we consulted an advocate for the blind to help refine and provide additional suggestions. Results: We identified 14 recommendations that focus on communication strategies, ED resource access, and continuity of care. The main recommendation is for the clinician to support the unique healthcare needs of the visually impaired individual and maintain the patient's autonomy. Another recommendation is the consistent use of assistive devices (eg, canes, guide dogs) to aid patients to safely ambulate in the ED. Also identified as best practices were discharge education with the use of a screen reader and timely follow-up with a primary care physician. Conclusion: While we summarize a variety of recommendations in this article, it is important to implement only the strategies that work best for the patients, personnel, and environment specific to your ED. After implementation, it is vital to refine (as frequently as needed) the interventions to optimize the strategies. This will enable the provision of exceptional and equal care to blind and visually impaired patients in the ED. [ABSTRACT FROM AUTHOR]
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- 2024
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25. Doppler Radar Sensor-Based Fall Detection Using a Convolutional Bidirectional Long Short-Term Memory Model.
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Li Z, Du J, Zhu B, Greenwald SE, Xu L, Yao Y, and Bao N
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- Humans, Aged, Deep Learning, Algorithms, Male, Neural Networks, Computer, Accidental Falls prevention & control, Radar
- Abstract
Falls among the elderly are a common and serious health risk that can lead to physical injuries and other complications. To promptly detect and respond to fall events, radar-based fall detection systems have gained widespread attention. In this paper, a deep learning model is proposed based on the frequency spectrum of radar signals, called the convolutional bidirectional long short-term memory (CB-LSTM) model. The introduction of the CB-LSTM model enables the fall detection system to capture both temporal sequential and spatial features simultaneously, thereby enhancing the accuracy and reliability of the detection. Extensive comparison experiments demonstrate that our model achieves an accuracy of 98.83% in detecting falls, surpassing other relevant methods currently available. In summary, this study provides effective technical support using the frequency spectrum and deep learning methods to monitor falls among the elderly through the design and experimental validation of a radar-based fall detection system, which has great potential for improving quality of life for the elderly and providing timely rescue measures.
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- 2024
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26. Acquisition of Data on Kinematic Responses to Unpredictable Gait Perturbations: Collection and Quality Assurance of Data for Use in Machine Learning Algorithms for (Near-)Fall Detection.
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Schneider M, Reich K, Hartmann U, Hermanns I, Kaufmann M, Kluge A, Fiedler A, Frese U, and Ellegast R
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- Humans, Biomechanical Phenomena physiology, Male, Adult, Female, Middle Aged, Accidents, Occupational, Young Adult, Databases, Factual, Machine Learning, Gait physiology, Algorithms, Accidental Falls prevention & control
- Abstract
Slip, trip, and fall (STF) accidents cause high rates of absence from work in many companies. During the 2022 reporting period, the German Social Accident Insurance recorded 165,420 STF accidents, of which 12 were fatal and 2485 led to disability pensions. Particularly in the traffic, transport and logistics sector, STF accidents are the most frequently reported occupational accidents. Therefore, an accurate detection of near-falls is critical to improve worker safety. Efficient detection algorithms are essential for this, but their performance heavily depends on large, well-curated datasets. However, there are drawbacks to current datasets, including small sample sizes, an emphasis on older demographics, and a reliance on simulated rather than real data. In this paper we report the collection of a standardised kinematic STF dataset from real-world STF events affecting parcel delivery workers and steelworkers. We further discuss the use of the data to evaluate dynamic stability control during locomotion for machine learning and build a standardised database. We present the data collection, discuss the classification of the data, present the totality of the data statistically, and compare it with existing databases. A significant research gap is the limited number of participants and focus on older populations in previous studies, as well as the reliance on simulated rather than real-world data. Our study addresses these gaps by providing a larger dataset of real-world STF events from a working population with physically demanding jobs. The population studied included 110 participants, consisting of 55 parcel delivery drivers and 55 steelworkers, both male and female, aged between 19 and 63 years. This diverse participant base allows for a more comprehensive understanding of STF incidents in different working environments.
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- 2024
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27. Human Fall Detection with Ultra-Wideband Radar and Adaptive Weighted Fusion.
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Huang L, Zhu A, Qian M, and An H
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- Humans, Algorithms, Neural Networks, Computer, Radar, Accidental Falls
- Abstract
To address the challenges in recognizing various types of falls, which often exhibit high similarity and are difficult to distinguish, this paper proposes a human fall classification system based on the SE-Residual Concatenate Network (SE-RCNet) with adaptive weighted fusion. First, we designed the innovative SE-RCNet network, incorporating SE modules after dense and residual connections to automatically recalibrate feature channel weights and suppress irrelevant features. Subsequently, this network was used to train and classify three types of radar images: time-distance images, time-distance images, and distance-distance images. By adaptively fusing the classification results of these three types of radar images, we achieved higher action recognition accuracy. Experimental results indicate that SE-RCNet achieved F1-scores of 94.0%, 94.3%, and 95.4% for the three radar image types on our self-built dataset. After applying the adaptive weighted fusion method, the F1-score further improved to 98.1%.
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- 2024
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28. Applicability of the Madymo Pedestrian Model for forensic fall analysis.
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de Vette V, Hutchinson K, Mugge W, Loeve A, and van Zandwijk JP
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- Humans, Biomechanical Phenomena, Male, Adult, Computer Simulation, Models, Biological, Female, Young Adult, Software, Accidental Falls, Forensic Sciences methods, Pedestrians
- Abstract
Forensic reconstruction and scenario evaluation are crucial in investigations of suspicious deaths related to falls from a height. In such cases, distinguishing between accidental falls, being pushed or jumping is an important but difficult task, since objective methods to do so are currently lacking. This paper explores the possibility of repurposing a passive rigid body model of a human from commercially available crash simulation software for forensic reconstruction and scenario evaluation of humans dropping from heights. To use this approach, a prerequisite is that the human body model can produce realistic movements compared to those of a real human, given similar environmental conditions. Therefore, this study assessed the validity of the commercially available Simcenter Madymo Pedestrian Model (MPM) for simulating human fall movements. Experimental kinematic and kinetic data was collected from nine participants, who dropped from a height in three different ways: passively tilting over, getting pushed, and jumping. Next, the performance of the MPM in reproducing the kinematics of the experimental falls was assessed by comparing the orientation of the body 0.3 s after platform release. The results show that the MPM currently does not consistently reproduce the experimentally recorded falling movements across multiple falling conditions and outcome measures. The MPM must therefore be adapted if to be used for forensic reconstruction and scenario evaluation, for example by implementing active movement., Competing Interests: Declaration of Competing Interest The authors declare no conflicts of interest., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)
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- 2024
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29. Fall Detection Method for Infrared Videos Based on Spatial-Temporal Graph Convolutional Network.
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Yang J, He Y, Zhu J, Lv Z, and Jin W
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- Humans, Accidental Falls, Algorithms, Neural Networks, Computer, Video Recording methods, Infrared Rays
- Abstract
The timely detection of falls and alerting medical aid is critical for health monitoring in elderly individuals living alone. This paper mainly focuses on issues such as poor adaptability, privacy infringement, and low recognition accuracy associated with traditional visual sensor-based fall detection. We propose an infrared video-based fall detection method utilizing spatial-temporal graph convolutional networks (ST-GCNs) to address these challenges. Our method used fine-tuned AlphaPose to extract 2D human skeleton sequences from infrared videos. Subsequently, the skeleton data was represented in Cartesian and polar coordinates and processed through a two-stream ST-GCN to recognize fall behaviors promptly. To enhance the network's recognition capability for fall actions, we improved the adjacency matrix of graph convolutional units and introduced multi-scale temporal graph convolution units. To facilitate practical deployment, we optimized time window and network depth of the ST-GCN, striking a balance between model accuracy and speed. The experimental results on a proprietary infrared human action recognition dataset demonstrated that our proposed algorithm accurately identifies fall behaviors with the highest accuracy of 96%. Moreover, our algorithm performed robustly, identifying falls in both near-infrared and thermal-infrared videos.
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- 2024
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30. Using machine learning models to predict falls in hospitalised adults.
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Jahandideh S, Hutchinson AF, Bucknall TK, Considine J, Driscoll A, Manias E, Phillips NM, Rasmussen B, Vos N, and Hutchinson AM
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- Humans, Retrospective Studies, Female, Male, Aged, Victoria, Risk Factors, Middle Aged, Risk Assessment methods, Aged, 80 and over, Electronic Health Records statistics & numerical data, Adult, Neural Networks, Computer, Accidental Falls prevention & control, Accidental Falls statistics & numerical data, Machine Learning, Hospitalization statistics & numerical data
- Abstract
Background: Identifying patients at high risk of falling is crucial in implementing effective fall prevention programs. While the integration of information systems is becoming more widespread in the healthcare industry, it poses a significant challenge in analysing vast amounts of data to identify factors that could enhance patient safety., Objective: To determine fall-associated factors and develop high-performance prediction tools for at-risk patients in acute and sub-acute care services in Australia., Methods: A retrospective study of 672,400 patients admitted to acute and sub-acute care services within a large metropolitan tertiary health service in Victoria, Australia, between January 1, 2019, and December 31, 2021. Data were obtained from four sources: the Department of Health Victorian Admitted Episodes Dataset, RiskMan
TM , electronic health records, and the health workforce dataset. Machine learning techniques, including Random Forest and Deep Neural Network models, were used to analyse the data, predict patient falls, and identify the most important risk factors for falls in this population. Model performance was evaluated using accuracy, F1-score, precision, recall, specificity, Matthew's correlation coefficient, and the area under the receiver operating characteristic curve (AUC)., Results: The deep neural network and random forest models were highly accurate in predicting hospital patient falls. The deep neural network model achieved an accuracy of 0.988 and a specificity of 0.999, while the RF achieved an accuracy of 0.989 and a specificity of 1.000. The top 20 variables impacting falls were compared across both models, and 12 common factors were identified. These factors can be broadly classified into three categories: patient-related factors, staffing-related factors, and admission-related factors. Although not all factors are modifiable, they must be considered when planning fall prevention interventions., Conclusion: The study demonstrated machine learning's potential to predict falls and identify key risk factors. Further validation across diverse populations and settings is essential for broader applicability., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)- Published
- 2024
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31. Second Reaction: Is Humpty Dumpty Gritty? Questioning a Paper Airplane Muse.
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Hansen, Allison Segarra
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ACCIDENTAL falls - Published
- 2018
32. Enhancing fall risk assessment: instrumenting vision with deep learning during walks.
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Moore J, Catena R, Fournier L, Jamali P, McMeekin P, Stuart S, Walker R, Salisbury T, and Godfrey A
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- Humans, Risk Assessment methods, Male, Female, Adult, Eye-Tracking Technology, Eye Movements physiology, Gait physiology, Video Recording, Young Adult, Deep Learning, Accidental Falls prevention & control, Walking physiology
- Abstract
Background: Falls are common in a range of clinical cohorts, where routine risk assessment often comprises subjective visual observation only. Typically, observational assessment involves evaluation of an individual's gait during scripted walking protocols within a lab to identify deficits that potentially increase fall risk, but subtle deficits may not be (readily) observable. Therefore, objective approaches (e.g., inertial measurement units, IMUs) are useful for quantifying high resolution gait characteristics, enabling more informed fall risk assessment by capturing subtle deficits. However, IMU-based gait instrumentation alone is limited, failing to consider participant behaviour and details within the environment (e.g., obstacles). Video-based eye-tracking glasses may provide additional insight to fall risk, clarifying how people traverse environments based on head and eye movements. Recording head and eye movements can provide insights into how the allocation of visual attention to environmental stimuli influences successful navigation around obstacles. Yet, manual review of video data to evaluate head and eye movements is time-consuming and subjective. An automated approach is needed but none currently exists. This paper proposes a deep learning-based object detection algorithm (VARFA) to instrument vision and video data during walks, complementing instrumented gait., Method: The approach automatically labels video data captured in a gait lab to assess visual attention and details of the environment. The proposed algorithm uses a YoloV8 model trained on with a novel lab-based dataset., Results: VARFA achieved excellent evaluation metrics (0.93 mAP50), identifying, and localizing static objects (e.g., obstacles in the walking path) with an average accuracy of 93%. Similarly, a U-NET based track/path segmentation model achieved good metrics (IoU 0.82), suggesting that the predicted tracks (i.e., walking paths) align closely with the actual track, with an overlap of 82%. Notably, both models achieved these metrics while processing at real-time speeds, demonstrating efficiency and effectiveness for pragmatic applications., Conclusion: The instrumented approach improves the efficiency and accuracy of fall risk assessment by evaluating the visual allocation of attention (i.e., information about when and where a person is attending) during navigation, improving the breadth of instrumentation in this area. Use of VARFA to instrument vision could be used to better inform fall risk assessment by providing behaviour and context data to complement instrumented e.g., IMU data during gait tasks. That may have notable (e.g., personalized) rehabilitation implications across a wide range of clinical cohorts where poor gait and increased fall risk are common., (© 2024. The Author(s).)
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- 2024
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33. Exploring Factors Associated with Falls in Multiple Sclerosis: Insights from a Scoping Review.
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Kaddoura R, Faraji H, Othman M, Abu Hijleh A, Loney T, Goswami N, and Benamer HTS
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- Humans, Risk Factors, Fear, Fatigue epidemiology, Disease Progression, Cognitive Dysfunction epidemiology, Severity of Illness Index, Accidental Falls statistics & numerical data, Accidental Falls prevention & control, Multiple Sclerosis complications, Postural Balance
- Abstract
Multiple sclerosis (MS) is a chronic inflammatory condition that causes demyelination of the central nervous system accompanied by a wide range of symptoms. The high prevalence of falls among patients diagnosed with MS within the initial six months highlights the importance of this issue. The objective of this study is to identify factors associated with falls in MS patients in order to increase awareness and reduce the risk of falls. This scoping review used specific Mesh terms to formulate the literature search around falls and MS using Medline, Google Scholar, Scopus, and Embase search engines. English papers published between 2012 and 2022, studies with a clear definition of falls, McDonald's diagnostic criteria for MS, and those with Expanded Disability Status Scale (EDSS) or Patient Determined Disease Steps (PDDS) scores were included. Critical data from the selected articles were extracted and classified according to the different factors associated with falls in MS patients. Eighteen articles were included in this review. The most important factors associated with falls in MS patients identified were the severity and progression of the disease, mobility and balance problems, bladder dysfunction, fear of falling, fatigue, and cognitive dysfunction. In conclusion, this scoping review yielded the most common factors associated with falls in patients with MS. Study findings can be used to develop future interventions focusing on improving mobility, proprioception, and balance to decrease fall risk and injury amongst MS patients., Competing Interests: The authors report no conflicts of interest in this work., (© 2024 Kaddoura et al.)
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- 2024
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34. Fallspeed measurement and high-resolution multi-angle photography of hydrometeors in freefall.
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Garrett, T. J., Fallgatter, C., Shkurko, K., and Howlett, D.
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CAMERAS ,ACCIDENTAL falls ,IMAGE analysis ,SCATTERING (Physics) - Abstract
The article discusses a study which describes the Multi-Angle Snowflake Camera (MASC) instrument for capturing hydrometeors in freefall. The study involves stereoscopic photographs captures by continous measurements from high altitude location in Wasatch Front in Utah for two months. It also illustrates the importance of MASC in refining microwave scattering calculations.
- Published
- 2012
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35. Educational paper
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Sieswerda-Hoogendoorn, Tessa, Boos, Stephen, Spivack, Betty, Bilo, Rob A. C., and van Rijn, Rick R.
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Haematoma ,Closed ,Review ,Subdural ,Diagnosis, Differential ,Craniocerebral Trauma ,Humans ,Child Abuse ,Pediatrics, Perinatology, and Child Health ,Head injury, closed ,Child ,Ultrasonography ,Patient Care Team ,Abusive head trauma ,Incidence ,Skull ,Infant, Newborn ,Infant ,Shaken Baby Syndrome ,Subarachnoid Hemorrhage ,Magnetic Resonance Imaging ,Head injury ,Haematoma, subdural ,Accidental Falls ,Radiology ,Tomography, X-Ray Computed - Abstract
Abusive Head Trauma (AHT) refers to the combination of findings formerly described as shaken baby syndrome. Although these findings can be caused by shaking, it has become clear that in many cases there may have been impact trauma as well. Therefore a less specific term has been adopted by the American Academy of Pediatrics. AHT is a relatively common cause of childhood neurotrauma with an estimated incidence of 14–40 cases per 100,000 children under the age of 1 year. About 15–23% of these children die within hours or days after the incident. Studies among AHT survivors demonstrate that approximately one-third of the children are severely disabled, one-third of them are moderately disabled and one-third have no or only mild symptoms. Other publications suggest that neurological problems can occur after a symptom-free interval and that half of these children have IQs below the 10th percentile. Clinical findings are depending on the definitions used, but AHT should be considered in all children with neurological signs and symptoms especially if no or only mild trauma is described. Subdural haematomas are the most reported finding. The only feature that has been identified discriminating AHT from accidental injury is apnoea. Conclusion: AHT should be approached with a structured approach, as in any other (potentially lethal) disease. The clinician can only establish this diagnosis if he/she has knowledge of the signs and symptoms of AHT, risk factors, the differential diagnosis and which additional investigations to perform, the more so since parents seldom will describe the true state of affairs spontaneously.
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36. Meta‐analysis and GRADE profiles of exercise interventions for falls prevention in long‐term care facilities
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Helga E. Breimaier and Daniela Schoberer
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medicine.medical_specialty ,CINAHL ,Care setting ,03 medical and health sciences ,0302 clinical medicine ,nursing ,systematic review ,Humans ,Medicine ,030212 general & internal medicine ,GRADE approach ,Review Papers ,General Nursing ,Balance (ability) ,Review Paper ,exercise ,030504 nursing ,Exercise intervention ,business.industry ,Evidence Synthesis ,Long-Term Care ,long‐term care ,Nursing Homes ,aged ,Long-term care ,Systematic review ,Increased risk ,meta‐analysis ,Meta-analysis ,Physical therapy ,Accidental Falls ,0305 other medical science ,business - Abstract
To provide a comprehensive collection of evidence on the effectiveness of exercise interventions to prevent falls and support clinical decision-making.A systematic literature review and meta-analysis of randomized controlled trails were performed by combining trials from published systematic reviews and more recent ones from a separate literature search.The literature search was performed using PubMed, CINAHL, Cochrane Databases, and Google Scholar dating January 2007 - March 2018.Comparable studies were pooled using the random-effects model. The GRADE approach was used to judge the evidence.Exercises with a balance component or with technical devices reduced falls significantly, however, with low confidence in the evidence. The evidence indicated that exercises conducted longer than 6 months were beneficial. In frail residents, exercise interventions seemed to have substantially negative effects on falls.Exercise interventions with technical devices, those with a balance component, and those performed longer than 6 months are recommended in long-term care settings. Frail residents need special attention when performing exercises due to their increased risk of falling.Exercises with a balance component and exercises carried out with technical devices have beneficial effects, whereas exercises performed longer than 6 months are more effective than short-term performances. No significant reduction or decrease in the number of falls was found for exercise in cognitively impaired residents. In frail residents, however, the number of fall events increased substantially as a result of exercise interventions. The results of this review are useful for clinical decision-makers in long-term care facilities with regard to the planning and performance of exercise interventions for residents.目的: 在于为预防跌倒和促进临床决策的运动干预有效性提供全面的证据收集。 设计: 通过结合已发表系统综述的试验和独立文献检索的近期试验,对随机对照试验进行系统文献综述和荟萃分析。 资料来源: 在PubMed、CINAHL、Cochrane Databases和Google Scholar上搜索了2007年1月至2018年3月的相关文献。 综述方法: 使用了随机效应模型来汇总了可比研究。采用了GRADE方法来判断证据。 结果: 减少使用平衡部件或技术设备的运动明显下降,但是对证据缺乏信心。有证据表明,锻炼时间超过6个月大有裨益。对于虚弱的居民,运动干预似乎对跌倒有很大的负面影响。 结论: 建议在长期护理环境中使用技术设备进行锻炼干预,使用平衡部件进行锻炼干预,以及采用时间超过6个月的锻炼干预。需要特别注意在进行锻炼时的虚弱居民,鉴于他们摔倒的风险与日俱增。 影响: 使用平衡部件的锻炼和使用技术设备进的锻炼同样大有裨益,而超过6个月的锻炼比短期锻炼更为有效。对于认知障碍类居民,没有发现因运动而导致跌倒次数显著减少或降低。然而,对于虚弱的居民,由于运动干预,跌倒事件的数量有所显著上升。本篇综述的结果能有助于长期护理机构的临床决策者规划和实施居民运动干预。.
- Published
- 2019
37. Associations of falls and severe falls with blood pressure and frailty among Chinese community-dwelling oldest olds: The Chinese Longitudinal Health and Longevity Study
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Jianhua Li, Yujiao Deng, Haiyan Shi, Jianqiao Chen, Weihao Xu, Yulun Cai, Benchuan Hao, and Yujian Song
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Male ,Aging ,Multivariate statistics ,Systole ,media_common.quotation_subject ,Longevity ,Logistic regression ,Odds ,Asian People ,Diastole ,falls ,Odds Ratio ,Humans ,Medicine ,Longitudinal Studies ,Cause of death ,media_common ,Aged, 80 and over ,Chinese ,oldest old ,Frailty ,business.industry ,blood pressure ,Cell Biology ,Odds ratio ,Confidence interval ,Blood pressure ,Accidental Falls ,Female ,Independent Living ,business ,Research Paper ,Demography - Abstract
Introduction: Falls are a leading cause of death among Chinese oldest olds. However, studies on Chinese community-dwelling older adults are lacking. We aimed to identify the associations of falls and severe falls with blood pressure and frailty among Chinese community-dwelling oldest olds. Methods: Cross-sectional analyses were conducted with 6,595 community-dwelling oldest olds (aged ≥80 years) from 22 Chinese provinces from the Chinese Longitudinal Health and Longevity Study (CLHLS). Systolic BP (SBP) and diastolic BP (DBP) were measured twice at participants’ homes, and a 38-item frailty index was used to assess the frailty status of participants. Falls and severe falls were confirmed through face-to-face interviews. Multivariate logistic regression was used to investigate the associations of BP and frailty with falls and severe falls. Results: The mean participant age was 91.0 years, and 56.1% were female. In total, 24.2% participants had a history of fall and 8.3% had a history of severe falls. The multivariate-adjusted odds ratio (OR) for falls among the oldest old with SBP ≥140 mm Hg compared to those with an SBP of 120–129 mm Hg was 1.20 (95% confidence interval [CI], 1.01–1.44). The adjusted OR for falls among frail participants compared to robust participants was 1.39 (95% CI, 1.02–1.89). DBP and pre-frailty were not associated with falls after multivariate adjustment. SBP, DBP, and frailty status were not associated with severe falls after multivariate adjustment. Conclusions: SBP and frailty but not DBP and pre-frailty are associated with increased odds of falls among Chinese community-dwelling oldest olds.
- Published
- 2021
38. Impact of adiposity on muscle function and clinical events among elders with dynapenia, presarcopenia and sarcopenia: a community-based cross-sectional study
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Chi-Ling Chen, Tao-Chun Peng, Wei-Liang Chen, Wei-Shiung Yang, Tung-Wei Kao, and Der-Sheng Han
- Subjects
Male ,obesity ,Sarcopenia ,Aging ,medicine.medical_specialty ,Waist ,fall ,fat to muscle ratio ,Body fat percentage ,Risk Factors ,Internal medicine ,medicine ,Humans ,Muscle, Skeletal ,Adiposity ,Aged ,Metabolic Syndrome ,Muscle Weakness ,Hand Strength ,business.industry ,dynapenia ,Cell Biology ,Odds ratio ,medicine.disease ,Obesity ,Confidence interval ,Preferred walking speed ,Cross-Sectional Studies ,Accidental Falls ,Female ,Metabolic syndrome ,business ,Research Paper - Abstract
Introduction: Low muscle function determined unfavorable clinical outcome than low muscle mass; nevertheless, comparison of detrimental parameters among dynapenia, presarcopenia and sarcopenia was sparse. We hypothesized that adiposity is implicated in low muscle function related adverse events. Methods: We recruited community elders to measure handgrip strength and walking speed. Using bioelectronics impedance analyzer to examine body compositions. The faller is indicated of having a fall event in the past one year. Associations of different obesity parameters, metabolic syndrome (MetS) and fall among the groups were analyzed. Results: Among 765 participants, the dynapenia group had higher metabolic profiles, body fat percentage (BFP), waist circumference, and fat to muscle ratio (FMR) than the other groups, whereas the presarcopenia subjects had the lowest obesity parameters. The fallers tended to have poorer muscle function than non-fallers (p
- Published
- 2021
39. Atypical symptoms, SARS-CoV-2 test results and immunisation rates in 456 residents from eight nursing homes facing a COVID-19 outbreak
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Stéphanie Miot, Yves Rolland, Mylène Albrand, Marie Christine Picot, Edouard Tuaillon, Nadia Giacosa, Lucie Gamon, Amandine Pisoni, Jean Bousquet, Hubert Blain, Boutin, Marion, Département de Gériatrie, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Département d'Information Médicale [CHRU Montpellier], Pathogenesis and Control of Chronic and Emerging Infections (PCCEI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Université des Antilles (UA)-Etablissement français du don du sang [Montpellier], Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, INSERM, U1027, Toulouse, France., Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc-Roussillon (MACVIA-LR), Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-European Innovation Partnership on Active and Healthy Ageing Reference Site (EIP on AHA), Commission Européenne-Commission Européenne-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), Humboldt University Of Berlin, Pathogénèse et contrôle des infections chroniques (PCCI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre Hospitalier Universitaire de Montpellier (CHU Montpellier ), and Humboldt University of Berlin
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Male ,Aging ,Longitudinal study ,Multivariate analysis ,[SDV]Life Sciences [q-bio] ,rRT-PCR ,nursing homes ,urologic and male genital diseases ,Antibodies, Viral ,Polymerase Chain Reaction ,Disease Outbreaks ,older people ,AcademicSubjects/MED00280 ,0302 clinical medicine ,[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,antibodies ,Infection control ,Longitudinal Studies ,030212 general & internal medicine ,False Negative Reactions ,Aged, 80 and over ,testing for SARS-CoV-2 ,[SDV.MHEP.GEG] Life Sciences [q-bio]/Human health and pathology/Geriatry and gerontology ,[SDV.MHEP.GEG]Life Sciences [q-bio]/Human health and pathology/Geriatry and gerontology ,immunisation ,General Medicine ,female genital diseases and pregnancy complications ,Anorexia ,3. Good health ,[SDV] Life Sciences [q-bio] ,COVID-19 Nucleic Acid Testing ,[SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,Female ,medicine.symptom ,Research Paper ,medicine.medical_specialty ,immunization ,Sensitivity and Specificity ,Asymptomatic ,Malaise ,03 medical and health sciences ,Internal medicine ,medicine ,Humans ,False Positive Reactions ,Serologic Tests ,Pandemics ,Aged ,Retrospective Studies ,SARS-CoV-2 ,business.industry ,COVID-19 ,Retrospective cohort study ,Immunoglobulin G ,symptoms ,Accidental Falls ,Geriatrics and Gerontology ,business ,030217 neurology & neurosurgery - Abstract
Background Frail older persons may have an atypical presentation of coronavirus disease 2019 (COVID-19). The value of real-time reverse-transcriptase polymerase chain reaction (rRT-PCR) testing for identifying severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nursing homes (NHs) residents is not known. Objective To determine whether (i) atypical symptoms may predict rRT-PCR results and (ii) rRT-PCR results may predict immunisation against SARS-CoV-2 in NH residents. Design A retrospective longitudinal study. Setting Eight NHs with at least 10 rRT-PCR-positive residents. Subjects A total of 456 residents. Methods Typical and atypical symptoms recorded in residents’ files during the 14 days before and after rRT-PCR testing were analysed. Residents underwent blood testing for IgG-SARS-CoV-2 nucleocapsid protein 6 to 8 weeks after testing. Univariate and multivariate analyses compared symptoms and immunisation rates in rRT-PCR-positive and negative residents. Results A total of 161 residents had a positive rRT-PCR (35.3%), 17.4% of whom were asymptomatic before testing. Temperature >37.8°C, oxygen saturation Conclusion This study supports a strategy based on (i) testing residents with typical or unexplained atypical symptoms for an early identification of the first SARS-CoV-2 cases, (ii) rT-PCR testing for identifying COVID-19 residents, (iii) repeated wide-facility testing (including asymptomatic cases) as soon as a resident is tested positive for SARS-CoV-2 and (iv) implementing SARS-CoV-2 infection control measures in rRT-PCR-negative residents when they have unexplained typical or atypical symptoms.
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- 2021
40. Challenges for Joint Commission International accreditation: performance of orthopedic surgeons based on International Patient Safety Goals
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Kobayashi, Kazuyoshi, Ando, Kei, Nakashima, Hiroaki, Machino, Masaaki, Kanbara, Shunsuke, Ito, Sadayuki, Inoue, Taro, Yamaguchi, Hidetoshi, Ishiguro, Naoki, and Imagama, Shiro
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Medical safety ,Original Paper ,International Patient Safety Goals (IPSGs) ,Cross Infection ,Patient Identification Systems ,Physician-Patient Relations ,Internationality ,Medical care quality ,education ,Orthopedic Surgeons ,United States ,National University Hospital ,Accreditation ,Hospitals, University ,Japan ,International standard ,Humans ,Accidental Falls ,Orthopedic Procedures ,Joint Commission on Accreditation of Healthcare Organizations ,Patient Safety ,Goals ,health care economics and organizations ,Joint Commission International (JCI) ,Quality Indicators, Health Care - Abstract
The Joint Commission International (JCI) is a US-based organization that accredits and certifies hospitals worldwide. Among the requirements for accreditation, the JCI emphasizes continuous quality improvement (CQI) with regard to international patient safety goals (IPSGs). Our university hospital treats about 26,000 hospitalized patients and 600,000 outpatients annually, and our goal is patient safety in compliance with IPSGs. The purpose of this study is to examine the activities of orthopedic surgeons in preparation for JCI accreditation, including clear identification of patients, preoperative timeout and marking to ensure correct surgery, timely approval of CT/MRI reports, care with pain management, prevention of infection, setting of quality indicators and daily monitoring, and teamwork. Examiners from the JCI visited our hospital to review medical records and documents, and to interview patients, nurses and doctors. There were 1270 evaluation items covering 16 fields, including reviews of IPSGs, patient evaluation and care, infection prevention and control, and governance and leadership. Most importantly, the efforts of all the medical staff in our hospital in obtaining the first JCI accreditation among national university hospitals in Japan have promoted the safety and quality of medical care from the perspective of the patient.
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- 2021
41. The effect of simulated gestational weight gain on balance, gait, and fear of falling
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Inoue-Hirakawa, Tomoe, Ito, Arisa, Iguchi, Saki, Watanabe, Hikari, Kato, Chikako, Sugiura, Hideshi, and Suzuki, Shigeyuki
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Psychiatric Status Rating Scales ,Original Paper ,Pregnancy Trimester, Third ,Fear ,walking speed ,gait ,Gestational Weight Gain ,Patient Simulation ,Young Adult ,Pregnancy ,Exercise Test ,Humans ,Accidental Falls ,Female ,Prospective Studies ,Gait Analysis ,Postural Balance ,pregnant women - Abstract
The effects of pregnancy on balance with the eyes closed and maximum walking speed remain unclarified. The present study aimed to examine the effect of simulated gestational weight gain on balance, gait, and fear of falling in nulligravid women to enhance understanding of the impact of gestational weight gain. We prospectively evaluated the following outcomes in 24 healthy nulligravid women with and without a maternity-simulation jacket that simulated third-trimester pregnancy. To measure balance, we used the single-leg-stance test with eyes open and closed, and the functional reach test. We evaluated gait function by measuring walking speed, step length, and cadence at self-selected and maximum speeds. We used the timed-up-and-go test as a comprehensive measure of gait and balance, and the modified falls efficacy scale to evaluate fear of falling. Differences in these parameters between a simulated gestational weight gain condition and a “nonpregnant” condition were assessed. Simulated gestational weight gain caused significantly worse performances in the single-leg-stance test with eyes open and closed, functional reach test, walking speed, step length at self-selected and maximum speeds, and timed-up-and-go test. The effect size was larger for the single-leg-stance test with eyes closed than with eyes open. The average score for each modified falls efficacy scale item ranged from 4.7–8.5. In conclusion, balance decreased with simulated gestational weight gain, and balance may be more affected without visual feedback. Simulated gestational weight gain resulted in worse gait function at both self-selected and maximum speeds.
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- 2021
42. The development of anti-fall functional clothing for elderly.
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Chuan Tang, Zakaria, Norsaadah, and Ruznan, Wan Syazehan
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AESTHETICS ,TEXTILES ,SYSTEMATIC reviews ,PROTECTIVE clothing ,WEARABLE technology ,PHYSICAL fitness ,PRODUCT design ,ACCIDENTAL falls ,PILLOWS ,DESCRIPTIVE statistics ,NEW product development ,ALGORITHMS ,OLD age - Abstract
Objective: The consequences of falls in the elderly are severe, ranging from skin abrasion to hip fracture, which is very easy to cause death. Using advanced technology to develop anti-fall clothing that meets the needs of the elderly can play a significant role in protecting the elderly. By reviewing and analyzing the existing literature on the importance of fall protection clothing in reducing falls and protecting the body of the elderly, it is hoped to explore further research that needs improvement. Methods: Guided by the preferred reporting items for systematic reviews and meta-analyses, eight related studies were identified through Web of Science, Scopus and Chinese National Knowledge Infrastructure. The research objects, approaches, material and equipment, protection principle, and survey results are extracted. Results: Two articles verified the fall detection algorithm adopted in the research through experiments, which significantly improved fall detection accuracy. Six papers found that selecting appropriate cushioning materials can effectively reduce the consequences of falls of the elderly through experimental comparative analysis. Finally, three attributes for significant design value are drawn: (1) size and fit; (2) cushioning materials; (3) wearable sensing elements. Conclusions: Anti-fall clothing can effectively protect the elderly when they fall. Further design experiments are needed to select appropriate cushioning materials and wearable sensing elements based on anthropometry and aesthetics to design the style and structure of the garment to achieve the purpose of protecting the elderly. [ABSTRACT FROM AUTHOR]
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- 2023
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43. A paramedic's role in reducing number of falls and fall-related emergency service use by over 65s: a systematic review.
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Bonner, Mhairi, Capsey, Matt, and Batey, Jo
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EMERGENCY medical technicians ,EMERGENCY medical services ,ADULTS ,OLDER patients ,QUALITY of life ,AMBULANCE service - Abstract
Background: Around 10–25% of emergency calls for adults aged over 65 are attributed to falls. Regardless of whether injuries are caused, quality of life is often affected by fear of falling, leading to reduced confidence and activity, negatively impacting mobility and risking depression and isolation. Ambulance service staff are well placed to identify falls risk factors so patients can be directed to falls prevention services. This article aims to determine how the referral by paramedics of uninjured falls patients to community falls services may reduce future falls and emergency services use. Methods: The CINAHL, MEDLINE and AMED electronic databases, grey literature sources and reference lists of relevant papers were systematically searched to identify primary research of an experimental design. Studies were eligible if they included elderly patients, aged over 65, who had received a paramedic response following a fall, were found to be uninjured and who were referred to local falls services rather than being transported to hospital. The study outcomes were required to include the rate of subsequent falls and emergency service use. Results: Four papers from three studies were included in the review following quality assessment. Results were not always statistically significant but showed a reduction in subsequent falls, particularly in the high-risk population, and in emergency service call-outs. A consistent positive effect was seen on the patients' well-being and independence related to activities of daily living across the studies. Conclusions: The relationship between paramedics and local falls services has changed the pre-hospital management of these patients. Generally, access to a falls-specific care package has proved beneficial in supporting independence and reducing unnecessary transport to hospital. Further research into the uptake of this care pathway by paramedics now it is more established may be useful, as would research into barriers to adherence of the elderly to such an intervention. [ABSTRACT FROM AUTHOR]
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- 2021
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44. Potentially inappropriate medications and their effect on falls during hospital admission
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Ameen Abu-Hanna, Nathalie van der Velde, Birgit A. Damoiseaux-Volman, Johannes A. Romijn, Kimmy Raven, Stephanie Medlock, Danielle Sent, Graduate School, APH - Aging & Later Life, APH - Methodology, Medical Informatics, APH - Health Behaviors & Chronic Diseases, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, Endocrinology, Geriatrics, and AMS - Ageing & Vitality
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Aging ,medicine.medical_specialty ,Inappropriate Prescribing ,older people ,AcademicSubjects/MED00280 ,hemic and lymphatic diseases ,medicine ,Humans ,hospital ,Potentially Inappropriate Medication List ,Aged ,Retrospective Studies ,Proportional hazards model ,business.industry ,Confounding ,Hazard ratio ,General Medicine ,Odds ratio ,Inappropriate Prescriptions ,inappropriate prescriptions ,Hospitals ,Confidence interval ,ageing/17 ,Emergency medicine ,ageing/10 ,Observational study ,accidental falls ,Geriatrics and Gerontology ,business ,Research Paper ,Fall prevention - Abstract
Objective to investigate the effect of potentially inappropriate medications (PIMs) on inpatient falls and to identify whether PIMs as defined by STOPPFall or the designated section K for falls of STOPP v2 have a stronger association with inpatient falls when compared to the general tool STOPP v2. Methods a retrospective observational matching study using an electronic health records dataset of patients (≥70 years) admitted to an academic hospital (2015–19), including free text to identify inpatient falls. PIMs were identified using the STOPP v2, section K of STOPP v2 and STOPPFall. We first matched admissions with PIMs to those without PIMs on confounding factors. We then applied multinomial logistic regression analysis and Cox proportional hazards analysis on the matched datasets to identify effects of PIMs on inpatient falls. Results the dataset included 16,678 hospital admissions, with a mean age of 77.2 years. Inpatient falls occurred during 446 (2.7%) admissions. Adjusted odds ratio (OR) (95% confidence interval (CI)) for the association between PIM exposure and falls were 7.9 (6.1–10.3) for STOPP section K, 2.2 (2.0–2.5) for STOPP and 1.4 (1.3–1.5) for STOPPFall. Adjusted hazard ratio (HR) (95% CI) for the effect on time to first fall were 2.8 (2.3–3.5) for STOPP section K, 1.5 (1.3–1.6) for STOPP and 1.3 (1.2–1.5) for STOPPFall. Conclusions we identified an independent association of PIMs on inpatient falls for all applied (de)prescribing tools. The strongest effect was identified for STOPP section K, which is restricted to high-risk medication for falls. Our results suggest that decreasing PIM exposure during hospital stay might benefit fall prevention, but intervention studies are warranted.
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- 2022
45. Postural control of Parkinson’s disease: A visualized analysis based on Citespace knowledge graph.
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Yan Li, Jie-Jiao Zheng, Xie Wu, Wen Gao, and Chan-Jing Liu
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POSTURAL balance ,SYSTEMATIC reviews ,RISK assessment ,PARKINSON'S disease ,POSTURE ,ACCIDENTAL falls ,RESEARCH funding ,DATA analysis software - Abstract
Postural control impairment is one of the primary motor symptoms in patients with Parkinson’s disease, leading to an increased risk of falling. Several studies have been conducted on postural control disorders in Parkinson’s disease patients, but no relevant bibliometric analysis has been found. In this paper, the Web of Science Core Collection database was searched for 1,295 relevant papers on postural control in Parkinson’s disease patients from December 2011 to December 2021. Based on the Citespace knowledge graph, these relevant papers over the last decade were analyzed from the perspectives of annual publication volume, countries and institutes cooperation, authors cooperation, dual-map overlay of journals, co-citation literature, and keywords. The purpose of this study was to explore the current research status, research hotspots, and frontiers in this field, and to provide a reference for further promoting the research on postural control in Parkinson’s disease patients. [ABSTRACT FROM AUTHOR]
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- 2023
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46. Polypharmacy, benzodiazepines, and antidepressants, but not antipsychotics, are associated with increased falls risk in UK care home residents: a prospective multi-centre study
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Madeline A. D. Izza, Eleanor Lunt, Pip Logan, Adam L. Gordon, John R.F. Gladman, and Sarah Armstrong
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Male ,medicine.medical_specialty ,Psychological intervention ,Poison control ,Residential facilities ,Benzodiazepines ,03 medical and health sciences ,0302 clinical medicine ,Injury prevention ,Homes for the Aged ,Humans ,Medicine ,Prospective Studies ,030212 general & internal medicine ,Aged ,Aged, 80 and over ,Polypharmacy ,030214 geriatrics ,business.industry ,Infant ,Odds ratio ,Antidepressive Agents ,United Kingdom ,Family medicine ,Psychotropic medications ,Cohort ,Accidental Falls ,Female ,Deprescribing ,business ,Antipsychotic Agents ,Research Paper ,Cohort study - Abstract
Key summary points Aim To explore the link between polypharmacy, psychotropic medications, and falls risk in a cohort of UK care home residents. Findings Polypharmacy and psychotropic drugs are predictive of falls in UK care home residents. Message Deprescribing interventions relating to psychotropic drugs should continue to be encouraged., Purpose Falls and polypharmacy are both common in care home residents. Deprescribing of medications in residents with increased falls risk is encouraged. Psychotropic medications are known to increase falls risk in older adults. These drugs are often used in care home residents for depression, anxiety, and behavioural and psychological symptoms of dementia. However, a few studies have explored the link between polypharmacy, psychotropic medications, and falls risk in care home residents. Methods This was a prospective cohort study of residents from 84 UK care homes. Data were collected from residents’ care records and medication administration records. Age, diagnoses, gender, number of medications, and number of psychotropic medications were collected at baseline and residents were monitored over three months for occurrence of falls. Logistic regression models were used to assess the effect of multiple medications and psychotropic medication on falls whilst adjusting for confounders. Results Of the 1655 participants, mean age 85 (SD 8.9) years, 67.9% female, 519 (31%) fell in 3 months. Both the total number of regular drugs prescribed and taking ≥ 1 regular psychotropic medication were independent risk factors for falling (adjusted odds ratio (OR) 1.06 (95% CI 1.03–1.09, p 0.05). Conclusion In UK care homes, number of medications and psychotropic medications (particularly antidepressants and benzodiazepines) predicted falls. This information can be used to inform prescribing and deprescribing decisions.
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- 2020
47. Factors associated with institutionalization among home-dwelling patients of Urgent Geriatric Outpatient Clinic: a 3-year follow-up study
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Laura Viikari, Maarit Wuorela, Paula Viikari, Tero Vahlberg, Jonna Laine, Matti Viitanen, and Marika Salminen
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Gerontology ,Male ,Institutionalisation ,Home dwelling ,Ambulatory Care Facilities ,03 medical and health sciences ,0302 clinical medicine ,Medicine ,Dementia ,Outpatient clinic ,Humans ,030212 general & internal medicine ,Aged ,Aged, 80 and over ,business.industry ,Proportional hazards model ,030503 health policy & services ,Hazard ratio ,Follow up studies ,Institutionalization ,medicine.disease ,Home Care Services ,Confidence interval ,Accidental Falls ,Female ,Older people ,0305 other medical science ,business ,Research Paper ,Predictor ,Follow-Up Studies - Abstract
Key summary points Aim To examine the effect of predictive factors on institutionalization among home-dwelling patients of Urgent Geriatric Outpatient Clinic during a 3-year follow-up. Findings The rates of institutionalization and mortality were 29.9% and 46.1%, respectively. The use of home care, dementia, higher age and falls during the previous 12 months significantly predicted institutionalization during the follow-up. Message Cognitive and/or functional impairment mainly predicted institutionalization among older patients of UrGeriC having health problems and acute difficulties in managing at home., Purpose To examine the effect of predictive factors on institutionalization among older patients. Methods The participants were older (aged 75 years or older) home-dwelling citizens evaluated at Urgent Geriatric Outpatient Clinic (UrGeriC) for the first time between the 1st of September 2013 and the 1st of September 2014 (n = 1300). They were followed up for institutionalization for 3 years. Death was used as a competing risk in Cox regression analyses. Results The mean age of the participants was 85.1 years (standard deviation [SD] 5.5, range 75–103 years), and 74% were female. The rates of institutionalization and mortality were 29.9% and 46.1%, respectively. The mean age for institutionalization was 86.1 (SD 5.6) years. According to multivariate Cox regression analyses, the use of home care (hazard ratio 2.43, 95% confidence interval 1.80–3.27, p
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- 2020
48. A Guiding Nightlight Decreases Fear of Falling and Increases Sleep Quality of Community-Dwelling Older People: A Quantitative and Qualitative Evaluation
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Eef C T Lamers, Marcel G. M. Olde Rikkert, and Thessa W Thölking
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Male ,Aging ,medicine.medical_specialty ,Alzheimer`s disease Donders Center for Medical Neuroscience [Radboudumc 1] ,Psychological intervention ,Poison control ,Fear of falling ,Suicide prevention ,050105 experimental psychology ,Occupational safety and health ,03 medical and health sciences ,All institutes and research themes of the Radboud University Medical Center ,030502 gerontology ,Risk Factors ,Injury prevention ,medicine ,Humans ,Technological Section / Original Paper ,0501 psychology and cognitive sciences ,Risk factor ,Geriatric Assessment ,Lighting ,Aged ,Aged, 80 and over ,business.industry ,05 social sciences ,Fear ,Middle Aged ,Physical therapy ,Accidental Falls ,Environment Design ,Female ,Independent Living ,Geriatrics and Gerontology ,medicine.symptom ,0305 other medical science ,business ,Sleep ,Fall prevention - Abstract
Background: Even though poor lighting at nighttime is an important risk factor for falls (and most falls occur during the night), lighting interventions to improve nightly lighting from bed to bathroom are rarely evaluated for fall prevention. Objective: We tested the hypothesis that an automated guiding light would reduce nightly fear of falling (FOF) and increase sleep quality of community-dwelling older people. Methods: This study had a pragmatic uncontrolled before-after design, including participants during a period of 8 months if they (i) were aged at least 65 years, (ii) ambulated independently at night, and (iii) had no cognitive or audiovisual impairments obstructing outcome measurement. Automated LED strips (GightTM) were installed in the participants’ homes. The primary outcome measure was overnight FOF on a scale of 0–10. Secondary outcome measures included sleep quality on a scale of 0–10 and fall rate. Additionally, a sample of participants was interviewed about their experiences with Gight. Results: Sixty-four participants were included (mean age: 80.8 ± 8.1 years; 89% living independently). Mean study length was 118 days (range: 30–231). In the intention-to-treat analysis, overnight FOF declined from 5.5 ± 3.0 to 3.8 ± 3.2 (p = 0.001), and sleep quality increased from 6.7 ± 2.4 to 7.4 ± 1.7 (p = 0.012). The fall rate during the study was too low to detect changes. Participants appreciated Gight (8.4 ± 0.8 on a scale of 10), and the majority (57%) reported a subjective decrease in FOF. Conclusion: Gight shows promising results for overnight FOF and sleep quality, but the effect of lighting interventions on fall rate should be evaluated further before widespread implementation.
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- 2020
49. Učestalost padova, njihova etiologija i čimbenici rizika kod neuroloških bolesnika primljenih u bolnicu u sjevernoj Turskoj
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Ayşegül Memiş, Zeliha Koç, and Zeynep Sağlam
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Adult ,Male ,Risk ,Balance ,030213 general clinical medicine ,0209 industrial biotechnology ,medicine.medical_specialty ,Pediatrics ,Neurology ,Turkey ,Etiology ,lcsh:Medicine ,02 engineering and technology ,03 medical and health sciences ,020901 industrial engineering & automation ,0302 clinical medicine ,Risk Factors ,Fall ,Prevalence ,Medicine ,Humans ,Original Scientific Papers ,Postural Balance ,Balance (ability) ,Aged ,Prevention ,Aged, 80 and over ,Inpatients ,Impaired Balance ,business.industry ,lcsh:R ,General Medicine ,Fall risk ,Fear ,Middle Aged ,Hospitals ,Chronic disease ,Falling (accident) ,Cross-Sectional Studies ,Berg Balance Scale ,Ravnoteža ,Etiologija ,Pad ,Neurologija ,Učestalost ,Prevencija ,Rizik ,Accidental Falls ,Female ,medicine.symptom ,Nervous System Diseases ,business - Abstract
This study was carried out to determine the prevalence of falls, their etiology and risk factors in neurological patients admitted to the hospital in northern Turkey. A cross-sectional, descriptive design was used. Data were collected by survey that identified socio-demographic and clinical features of the subjects, Hendrich II fall risk model and Berg Balance Scale (BBS). Study results revealed approximately one-third of the study patients (33.1%) to have sustained falls before. Concerning the timing of falls, 24.9% of these incidents had occurred within the last year. The most common reason for falling was dizziness (14.3%). The mean score on the Hendrich II fall risk model was 2.7±0.1 for those who had fallen and 2.3±0.1 for those who had not fallen. The respective mean BBS score was 20.7±1.9 and 18.4±1.3. It was found that approximately one-third of neurological patients had fallen before and had restricted their activities due to fear of falls; the great majority of them had a chronic disease and permanently used medicines; and the most important risk factors for falls were advanced age, fear of falls and impaired balance., Proveli smo presječno deskriptivno istraživanje kako bismo utvrdili učestalost padova, njihovu etiologiju i rizične čimbenike kod neuroloških bolesnika primljenih u bolnicu u sjevernoj Turskoj. Prikupljeni su podaci kojima su utvrđene sociodemografske i kliničke karakteristike ispitanika, model rizika za pad Hendrich II. i Berg balance scale (BBS). Rezultati su pokazali da je otprilike jedna trećina bolesnika uključenih u istraživanje (33,1%) već prije doživjela pad, pri čemu se 24,9% takvih incidenata dogodilo tijekom protekle godine. Omaglica je bila najčešći razlog za pad (14,3%). Srednji zbir u modelu rizika za pad Hendrich II. bio je 2,7±0,1 za bolesnike koji su doživjeli pad i 2,3±0,1 za bolesnike koji nisu doživjeli pad. Srednji zbir BBS bio je 20,7±1,9 odnosno 18,4±1,3 za bolesnike koji su doživjeli odnosno nisu doživjeli pad. Otprilike jedna trećina neuroloških bolesnika već je prije doživjela pad pa su ograničili svoje aktivnosti zbog straha od pada. Velika većina bolesnika imala je kronične bolesti i trajno su uzimali lijekove. Najvažniji čimbenici rizika za pad bili su poodmakla dob, strah od pada i poremećaj ravnoteže.
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- 2020
50. The Effect of the COVID-19 Pandemic on the Workload of an Adult Major Trauma Centre in Northern Ireland
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Owen, Jefferies, David, Kealey, Susan, Yoong, Ruth, Houston, and Caoimhe, Tennyson
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Adult ,Male ,SARS-CoV-2 ,Accidents, Traffic ,COVID-19 ,Northern Ireland ,Workload ,Middle Aged ,Patient Admission ,Trauma Centers ,Clinical Paper ,Humans ,Accidental Falls ,Female ,Pandemics ,Aged - Abstract
Introduction: Based in Belfast, the Royal Victoria Hospital is the only Major Trauma Centre in Northern Ireland. Due to the COVID-19 pandemic, on 23rd March 2020, Northern Ireland was placed into ‘lockdown' with the majority of the population advised to “stay at home”. The objective of this paper is to identify what effect the lockdown restrictions had on the workload of the Major Trauma Service at the Royal Victoria Hospital. Method: Patients were identified at the orthopaedic trauma meetings and from direct referral to the Major Trauma Service (MTS). Patients admitted and seen by the MTS from 23/03/20, the day lockdown was announced, to 29/05/20, when restrictions were partially lifted, were included in the analysis. Admissions data from this time period was then compared to admissions data from the same period in 2019 (23/03/19 - 29/05/19). Results: When comparing pre-lockdown and lockdown groups there was an overall decrease of 26% in admissions to the MTS (n=57 vs n=42). Road Traffic Accidents were reduced by 53% (n=31 vs n=15) and falls from >2m were reduced by 29% (n=21 vs n=15). Conclusion: Overall the number of admissions to the major trauma service was reduced during the lockdown period. A significant proportion of the reduction may be a result of social restrictions that reduced volume of traffic on Northern Irelands roads. Further study of future lockdowns and including admissions data of other MTCs in the UK would allow us to draw more robust conclusions.
- Published
- 2021
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