Do Canes or Walkers Make Any Difference? NonUse and Fall Injuries

Luz, Clare; Bush, Tamara Reid; Shen, Xipeng

doi:10.1093/geront/gnv096

Cited by 27 publications

(24 citation statements)

References 20 publications

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“…These findings identify that assistive device use might precipitate falling among home care clients with a neurological health condition, and these findings are relevant to the work of individuals tasked with coordinating home care and home health care practitioners to help prevent accidental falls among higher risk patient groups. The use of assistive devices for locomotion indoors, such as canes and walkers, by home care clients is typically a supportive measure to prevent falls, and previous studies have identified that falls occurred when clients were not using these assistive devices [39]. The use of canes and/or walkers may also be attributed to the fact that these users may be weaker than non-users, and so these users may be more susceptible to falls.…”

Section: Implications For Policies and Practices Pertaining To Home Carementioning

confidence: 99%

Associations with rates of falls among home care clients in Ontario, Canada: a population-based, cross-sectional study

2020

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Background: Accidental falls among older adults are a leading cause of injury-related hospitalizations. Reducing falls is an ongoing quality improvement priority for home care, given that many home care clients experience falls. In this study, we identify factors associated with the rate of falls among home care clients. Methods: We conducted a population-based, cross-sectional study using secondary data from the Hamilton, Niagara, Haldimand, and Brant health region of Ontario, Canada from January 1-March 31, 2018. We captured person-level characteristics with falls from the Resident Assessment Instrument-Home Care (RAI-HC). Negative binomial regression was used to model the rate of falls. Results: Functional characteristics of home care clients had strong, statistically significant associations with the rate of falls. Declines in activities of daily living, assistive device use for locomotion indoors, polypharmacy, and health conditions, such as dizziness or lightheadedness, and parkinsonism, were associated with a higher rate of falls. Males who used assistive devices had a higher rate of falls compared to females; however, males with neurological and cardiovascular health conditions had a decrease in the rate of falls compared to females. Home care clients with parkinsonism who used a cane and took eight or more drugs had stronger associations with an increased rate of falls compared to those who do not have parkinsonism. Conclusions: Functional characteristics, polypharmacy, and health conditions are associated with increased rates of falls among home care clients. Home care clients who are at a greater risk of falls may require environmental adjustments in their home to reduce or eliminate the possibility of falling.

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Section: Implications For Policies and Practices Pertaining To Home Carementioning

confidence: 99%

Associations with rates of falls among home care clients in Ontario, Canada: a population-based, cross-sectional study

2020

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“…In the current study, we noticed a high proportion of patients from either group that were not using any devices. In a study on community-dwelling older adults with fall history, the most frequent reasons for nonuse of canes and devices included believing it was not needed, forgetfulness, the device making them feel old, and inaccessibility [ 34 ]. The same study found that nonuse led to a significantly higher risk of falls resulting in surgery than among device users [ 34 ].…”

Section: Discussionmentioning

confidence: 99%

“…In a study on community-dwelling older adults with fall history, the most frequent reasons for nonuse of canes and devices included believing it was not needed, forgetfulness, the device making them feel old, and inaccessibility [ 34 ]. The same study found that nonuse led to a significantly higher risk of falls resulting in surgery than among device users [ 34 ]. The underlying reasons for underutilization of these devices in this population should be investigated in the future studies.…”

Section: Discussionmentioning

confidence: 99%

Falls in Older Patients with Cancer Undergoing Surgery: Prevalence and Association with Geriatric Syndromes and Levels of Disability Assessed in Preoperative Evaluation

Fahimnia

Roudsari

Doucette

et al. 2018

Current Gerontology and Geriatrics Research

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Falls are common among older adults. However, not much is known about the prevalence of falls among older patients with cancer. In 2015, older patients with cancer referred to Geriatrics service for preoperative evaluation were assessed for fall history, basic and instrumental activities of daily living (ADL and IADL), KPS, and use of assistive device. Of 806 patients, 215 (26.7%) patients reported fall. Incidence of last fall inside and outside home was 54.4% and 45.5%, respectively. Among patients with no falls, 33.6% had KPS ≤ 80 compared to 59.6% with one-time fall and 60.7% with multiple falls (p < 0.001). Among IADL, 8.5% of patients with no falls were unable to do shopping compared with 14.7% in one-time fall and 18.8% in multiple fallers (p < 0.001). In ADL items, the percentage of patients who were limited a lot in walking outside was 10.7% in no falls, 20.2% in one-time fall, and 27.1% in multiple fallers groups (p < 0.001). Only 17.8% of patients with no falls were using canes while 27.7% of patients with one-time fall and 38.8% with multiple falls were using canes (p < 0.001). Falls are prevalent among older patients with cancer. Fall history and number of falls are associated with functional status.

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“…For patients with Parkinson's disease, movement disorder can severely disrupt the performance of daily activities and increase the risk of falling. Despite various existing walkers are owned by seniors, reported statistics show that 33% of people over 60 years fell at least once (Luz et al, 2017). We argue that intelligence is essential for an elderly walker to detect abnormal user behaviors and provide timely safety support, since primitive assistance devices, such as rollators and walkers, are much likely to fail (Bertrand et al, 2017).…”

Section: Introductionmentioning

confidence: 91%

A Smart Robotic Walker With Intelligent Close-Proximity Interaction Capabilities for Elderly Mobility Safety

et al. 2020

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The elderly population has rapidly increased in past years, bringing huge demands for elderly serving devices, especially for those with mobility impairment. Present assistant walkers designed for elderly users are primitive with limited user interactivity and intelligence. We propose a novel smart robotic walker that targets a convenient-to-use indoor walking aid for the elderly. The walker supports multiple modes of interactions through voice, gait or haptic touch, and allows intelligent control via learning-based methods to achieve mobility safety. Our design enables a flexible, initiative and reliable walker due to the following: (1) we take a hybrid approach by combining the conventional mobile robotic platform with the existing rollator design, to achieve a novel robotic system that fulfills expected functionalities; (2) our walker tracks users in front by detecting lower limb gait, while providing close-proximity walking safety support; (3) our walker can detect human intentions and predict emergency events, e.g., falling, by monitoring force pressure on a specially designed soft-robotic interface on the handle; (4) our walker performs reinforcement learning-based sound source localization to locate and navigate to the user based on his/her voice signals. Experiment results demonstrate the sturdy mechanical structure, the reliability of multiple novel interactions, and the efficiency of the intelligent control algorithms implemented. The demonstration video is available at: https://sites.google.com/view/smart-walker-hku.

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Do Canes or Walkers Make Any Difference? NonUse and Fall Injuries

Abstract: Providers must place increased emphasis on the importance of cane/walker use for injury prevention through patient education to promote personal relevance, proper fitting, and training. New strategies are needed to improve device acceptability and accessibility.

Cited by 27 publications

References 20 publications

Associations with rates of falls among home care clients in Ontario, Canada: a population-based, cross-sectional study

Associations with rates of falls among home care clients in Ontario, Canada: a population-based, cross-sectional study

Falls in Older Patients with Cancer Undergoing Surgery: Prevalence and Association with Geriatric Syndromes and Levels of Disability Assessed in Preoperative Evaluation

A Smart Robotic Walker With Intelligent Close-Proximity Interaction Capabilities for Elderly Mobility Safety

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