Effect of a multifactorial fall-and-fracture risk assessment and management program on gait and balance performances and disability in hospitalized older adults: a controlled study

Trombetti, Andrea; Hars, Mélany; Herrmann, Françoís; Rizzoli, René; Ferrari, Serge

doi:10.1007/s00198-012-2045-3

Cited by 27 publications

(56 citation statements)

References 49 publications

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“…Exercise programs have been reported to reduce falls, though few are sufficiently powered to confirm a reduction in fractures. [34][35][36][37][38][39][40][41] Use of tobacco or excessive alcohol consumption should be avoided.…”

Section: Lifestyle and Exercisementioning

confidence: 99%

Osteoporosis

Nanes

Kallen

2014

Seminars in Nuclear Medicine

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Osteoporotic fractures are common and result in extensive morbidity and mortality. It is possible to decrease the risk of fracture in postmenopausal, male, and glucocorticoid-induced osteoporosis with appropriate screening and treatment. The assessment of fracture risk, for which bone densitometry is only 1 component, should be the main focus of patient evaluation. Epidemiologically derived risk-assessment tools such as World Health Organization Fracture Risk Assessment Tool (FRAX) provide physicians with a way to determine the 10-year risk of osteoporotic fracture and effectively choose candidates for therapy. A number of potent skeletal antiresorptive and anabolic drugs have become available to treat osteoporosis and prevent up to 70% of fractures. Here, we provide a detailed update on clinical osteoporosis, the contribution of bone densitometry, and the approach to patients using risk assessment in the consideration of treatments. Progress in osteoporosis is an example of successful bench-to-bedside research benefitting populations worldwide.

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Section: Lifestyle and Exercisementioning

confidence: 99%

Osteoporosis

Nanes

Kallen

2014

Seminars in Nuclear Medicine

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“…Most of the trials were in an acute hospital setting (n = 22). Seven were conducted in sub-acute settings [36,38,52,[58][59][60]65] and six included both acute and sub-acute hospital wards [30,53,55,64,66,67]. Six studies reported including cognitively impaired patients [30,36,38,52,53,65].…”

Section: Study Characteristicsmentioning

confidence: 99%

“…The injury rates associated with falls were sometimes given [28,32,38,54,68,70,71,73]. Most of the trials showed an improvement in falls outcomes, with seven reporting otherwise [28,30,52,53,56,66,71]. Other outcomes included the impact of falls prevention interventions on staff knowledge and practice [31,58,71], patient adherence to the falls prevention interventions [32,61,69], changes in gait and balance [66], and economic outcomes [64,68,69].…”

Section: Fall-related Outcomesmentioning

confidence: 99%

Hospital falls prevention with patient education: a scoping review

et al. 2020

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Background: Hospital falls remain a frequent and debilitating problem worldwide. Most hospital falls prevention strategies have targeted clinician education, environmental modifications, assistive devices, hospital systems and medication reviews. The role that patients can play in preventing falls whilst in hospital has received less attention. This critical review scopes patient falls education interventions for hospitals. The quality of the educational designs under-pinning patient falls education programmes was also evaluated. The outcomes of patient-centred falls prevention programs were considered for a range of hospital settings and diagnoses. Methods: The Arksey and O'Malley (2005) framework for scoping reviews was adapted using Joanna Briggs Institute and PRISMA-ScR guidelines. Eight databases, including grey literature, were searched from January 2008 until February 2020. Two reviewers independently screened the articles and data were extracted and summarised thematically. The quality of falls prevention education programs for patients was also appraised using a modified quality metric tool. Results: Forty-three articles were included in the final analysis. The interventions included: (i) direct face-to-face patient education about falls risks and mitigation; (ii) educational tools; (iii) patient-focussed consumer materials such as pamphlets, brochures and handouts; and (iv) hospital systems, policies and procedures to assist patients to prevent falls. The included studies assessed falls or education related outcomes before and after patient falls prevention education. Few studies reported incorporating education design principles or educational theories. When reported, most educational programs were of low to moderate quality from an educational design perspective. Conclusions: There is emerging evidence that hospital falls prevention interventions that incorporate patient education can reduce falls and associated injuries such as bruising, lacerations or fractures. The design, mode of delivery and quality of educational design influence outcomes. Well-designed education programs can improve knowledge and self-perception of risk, empowering patients to reduce their risk of falling whilst in hospital.

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“…A mobilidade alterada também foi encontrada no estudo de Chen et al, 28 frequente em 83,8% dos 117 idosos de um hospital geral de Taiwan. Escores de desempenho no TUG similares ao presente estudo foram observados por Trombetti et al 29 e Said et al, 30 variando entre 26 e 31 segundos em média, dados que evidenciam um prejuízo funcional na mobilidade nos primeiros dias de hospitalização.…”

Section: Comounclassified

Funcionalidade global de idosos hospitalizados

Pereira

Souza

Carneiro

et al. 2014

Rev. bras. geriatr. gerontol.

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Objetivo: Identificar a funcionalidade global de idosos submetidos a internação, correlacionando o desempenho para as atividades de vida diária básicas (ABVD) e instrumentais (AIVD) com os principais sistemas funcionais (cognição, humor, mobilidade e comunicação). Métodos: Trata-se de estudo observacional transversal e analítico com a participação de 94 idosos internados em uma clínica médica. Os instrumentos utilizados foram: Escala de Katz, Escala de Lawton & Brody, Miniexame do Estado Mental (MEEM), Escala de Depressão Geriátrica 15 (GDS-15), Teste Timed Up and Go (TUG) e a Avaliação Funcional das Habilidades de Comunicação da Associação Americana de Fonoaudiologia (ASHA FACS). Resultados: Foram avaliados 94 idosos, cuja maioria apresentava algum grau de dependência para ABVD (61,71%) e para AIVD (52,13%). Nos sistemas funcionais, a autonomia mostrou-se preservada, com desempenho médio de 18,14 pontos no MEEM, e de 4,43 pontos na GDS-15; e a independência, alterada, por desempenho médio de 21,82 segundos no TUG, classificando-os com uma mobilidade regular, e de 5,27 pontos na ASHA FACS, considerando-os com a necessidade de auxílio moderado nessa função. Evidenciou-se moderada e significativa associação entre o desempenho para as ABVDs e AIVDs com quase todos os sistemas funcionais. Conclusão: A população estudada apresentou funcionalidade global alterada, devido a algum grau de dependência para as ABVDs e AIVDs, com autonomia preservada e independência prejudicada. As correlações evidenciaram que com o decréscimo dos principais sistemas funcionais, ocorreu declínio da funcionalidade global.

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Effect of a multifactorial fall-and-fracture risk assessment and management program on gait and balance performances and disability in hospitalized older adults: a controlled study

Abstract: A multifactorial fall-and-fracture risk-based intervention program, applied in a dedicated geriatric hospital unit, was effective and more beneficial than usual care in improving physical parameters related to the risk of fall and disability among high-risk oldest old patients.

Cited by 27 publications

References 49 publications

Osteoporosis

Osteoporosis

Hospital falls prevention with patient education: a scoping review

Funcionalidade global de idosos hospitalizados

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