Effects of a programme of multifactorial home visits on falls and mobility impairments in elderly people at risk: randomised controlled trial

Haastregt, Jolanda C. M. van; Diederiks, J.P.M.; Rossum, Erik van; Witte, Luc de; Voorhoeve, Peter M; Crebolder, H. F. J. M.

doi:10.1136/bmj.321.7267.994

Cited by 143 publications

(171 citation statements)

References 16 publications

Supporting

Mentioning

157

Contrasting

Unclassified

Order By: Relevance

“…Whereas these measures may decrease the risk of falling, the magnitude of the effect and their effect on hip fracture risk have been disappointing. 21,22 Another approach is to decrease the impact of falling with the use of hip protectors. Controlled trials suggest that hip protectors confer considerable protection against hip fracture risk, but compliance is a problem.…”

Section: Discussionmentioning

confidence: 99%

Acute and Long-Term Increase in Fracture Risk After Hospitalization for Stroke

Kanis

Odén

Johnell

2001

Stroke

239

196

View full text Add to dashboard Cite

Background and Purpose-The aims of this study were to determine the magnitude of the increase in fracture risk after hospitalization for stroke, and in particular to determine the time course of this risk. Methods-The records of the Swedish register of patients admitted during 1987-1996 were examined to identify all patients who were admitted to the hospital for stroke. Patients were followed for subsequent hospitalizations for hip and all fractures combined. We analyzed 16.3 million hospitalizations, from which 273 288 individuals with stroke were identified. A Poisson model was used to determine the absolute risk of subsequent fractures and the risk compared with that of the general population. Results-After hospitalization for stroke, there was a Ͼ7-fold increase in fracture risk, including that for hip fracture within the first year after hospitalization for stroke. Thereafter, fracture risk declined toward, but did not attain, the baseline risk except in men and women aged Ն80 years. Population studies suggest that the risk of fracture is increased approximately 2-to 4-fold. [1][2][3][4][5] Hip fracture occurs most commonly on the paretic side and is usually trochanteric, most likely due to a high risk of falling on the affected side. 3 Although less extensively studied, an increase in risk is seen in men as well as in women. 5,6 A gap in our epidemiological knowledge of relevance to treatment is whether the risk of fracture is highest in the months after stroke or remains consistently increased. Conclusions-TheWe have shown in a previous study that the risk of all fractures, including that of hip fracture, increases markedly after hospitalization for vertebral fracture. The increase in risk was particularly evident in the first year immediately after a vertebral fracture, and rates declined thereafter toward that of the general population. 7 The increase in risk was much greater than that likely on the basis of changes in bone density, suggesting that other factors associated with hospitalization were important for the transient increment in risk.The aims of the present study were to examine whether stroke might be associated with a transient increase in risk after the acute event. If a high but transient risk of fracture occurred, this might suggest that interventions could be offered to cover this acute period of risk rather than for the remaining lifetime of individuals. The aim of the present study was therefore to determine the time course of any increase in fracture risk after stroke. Subjects and MethodsWe studied 16.3 million admissions to Swedish hospitals during 1987-1996. Our source was the National Swedish Register (the patient register of the National Board of Health and Welfare), which documents each hospital admission. A unique personal identifier permitted the tracking of individuals for multiple admissions. All patient records were examined to identify individuals who were admitted to the hospital for a stroke during the 10-year interval. Patients with International Classification of Disea...

show abstract

Section: Discussionmentioning

confidence: 99%

Acute and Long-Term Increase in Fracture Risk After Hospitalization for Stroke

Kanis

Odén

Johnell

2001

Stroke

239

196

View full text Add to dashboard Cite

show abstract

“…The data are drawn from the baseline phase of a randomized controlled trial, which was conducted from September 1997 to June 1999 (Van Haastregt et al, 2000).…”

Section: Methodsmentioning

confidence: 99%

Falls and catastrophic thoughts about falls predict mobility restriction in community-dwelling older people: A structural equation modelling approach

Delbaere

Crombez

Haastregt

et al. 2009

Aging & Mental Health

View full text Add to dashboard Cite

“…(8) In the community, targeted or untargeted education about falls or fear of falling with no follow-up of recommendations has no evidence of effectiveness [61,80,89,91,92,95].…”

Section: Evidence From Risk Factor Studiesmentioning

confidence: 99%

“…Our extended search identified ten more studies [80][81][82][83][84][85][86][87][88][89]. Three additional studies [90][91][92] which met our criteria were identified by Feder et al [7] and six [90,91,[93][94][95][96] by the AGS panel [8].…”

Section: Evidence From Intervention Effectiveness Studiesmentioning

confidence: 99%

Evidence-Based Guidelines for the Secondary Prevention of Falls in Older Adults

Moreland

Richardson²,

Chan³

et al. 2003

Gerontology

207

151

View full text Add to dashboard Cite

Background: Falls are a significant problem for older adults. Individuals who have sustained a fall come to the attention of health care providers and are at risk of further falls. To promote the highest quality of care and reduce variation in care, a practice guideline is needed. Summarization of evidence regarding falls may be useful to researchers in this field. Objectives: To provide evidence-based guidelines of assessment and treatment to prevent falls in older adults and to provide researchers with tables of risk factor studies and randomized controlled trials of falls prevention. Methods: A template for the development of practice guidelines from the Agency for Health Care Policy and Research was used. Evidence for risk factors was accepted from prospective studies with more than 80% follow-up. Potentially modifiable risk factors were selected and a schema for evaluating the importance of each risk factor was used. Evidence for interventions was examined from randomized controlled trials and strength of the evidence was graded. Recommendations for aspects of care where judgment was required were made by panel consensus. Results: Information was drawn from 46 risk factor studies and 37 randomized controlled trials to develop a practice guideline consisting of assessment items and recommended interventions for community-dwelling and institution-dwelling older adults separately. For clinicians, a check list is provided. Summary tables of the results of studies are given to substantiate the recommendations. Conclusions: For community-dwelling older adults, there is strong evidence for multi-factorial specific risk assessment and targeted treatment. Balance exercises are recommended for all individuals who have had a fall and there is evidence for a program of home physiotherapy for women over 80 years of age regardless of risk factor status. For institutional settings, the establishment of a falls program for safety checks, ongoing staff education and monitoring is substantiated by research. Residents who have fallen need to be assessed for specific risk factors and clinical indicators to determine relevant management options.

show abstract

Effects of a programme of multifactorial home visits on falls and mobility impairments in elderly people at risk: randomised controlled trial

Cited by 143 publications

References 16 publications

Acute and Long-Term Increase in Fracture Risk After Hospitalization for Stroke

Acute and Long-Term Increase in Fracture Risk After Hospitalization for Stroke

Falls and catastrophic thoughts about falls predict mobility restriction in community-dwelling older people: A structural equation modelling approach

Evidence-Based Guidelines for the Secondary Prevention of Falls in Older Adults

Contact Info

Product

Resources

About