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Latest & greatest articles for falls
The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other forms of evidence. If you wanted the latest trusted evidence on falls or other clinical topics then use Trip today.
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Factors Predicting Falls and Mobility Outcomes in Patients With Stroke Returning Home After Rehabilitation Who Are at Risk of Falling To identify factors predicting falls and limited mobility in people with stroke at 12 months after returning home from rehabilitation.Observational cohort study with 12-month follow-up.Community.People with stroke (N=144) and increased falls risk discharged home from rehabilitation.Not applicable.Falls were measured using monthly calendars completed (...) by participants, and mobility was assessed using gait speed over 5m (high mobility: >0.8m/s vs low mobility: ≤0.8m/s). Both measures were assessed at 12 months postdischarge. Demographics and functional measures, including balance, strength, visual or spatial deficits, disability, physical activity level, executive function, functional independence, and falls risk, were analyzed to determine factors significantly predicting falls and mobility levels after 12 months.Those assessed as being at high falls risk
Falls Prevention in Community-Dwelling Older Adults: Interventions Recommendation | United States Preventive Services Taskforce Toggle navigation Main navigation Main navigation Recommendation Adults 65 years or older The USPSTF recommends exercise interventions to prevent falls in community-dwelling adults 65 years or older who are at increased risk for falls. B Adults 65 years or older The USPSTF recommends that clinicians selectively offer multifactorial interventions to prevent falls (...) to community-dwelling adults 65 years or older who are at increased risk for falls. Existing evidence indicates that the overall net benefit of routinely offering multifactorial interventions to prevent falls is small. When determining whether this service is appropriate for an individual, patients and clinicians should consider the balance of benefits and harms based on the circumstances of prior falls, presence of comorbid medical conditions, and the patient's values and preferences. See the Clinical
Improving Decisions About Transport to the Emergency Department for Assisted Living Residents Who Fall. Residents of assisted living facilities who fall may not be seriously ill or injured, but policies often require immediate transport to an emergency department regardless of the patient's condition.To determine whether unnecessary transport can be avoided.Prospective cohort study.One large county with a single system of emergency medical services.Convenience sample of residents in 22 assisted (...) living facilities served by 1 group of primary care physicians.Paramedics providing emergency medical services followed a protocol that included consulting with a physician by telephone.The number of transports after a fall and the number of time-sensitive conditions in nontransported patients.Of the 1473 eligible residents, 953 consented to participate in the study (mean age, 86 years; 76% female) and 359 had 840 falls in 43 months. The protocol recommended nontransport after 553 falls. Eleven
Does pride really come before a fall? Longitudinal analysis of older English adults. To test whether high levels of reported pride are associated with subsequent falls.Secondary analysis of the English Longitudinal Study of Ageing (ELSA) dataset.Multi-wave longitudinal sample of non-institutionalised older English adults.ELSA cohort of 6415 participants at wave 5 (baseline, 2010/11), of whom 4964 were available for follow-up at wave 7 (follow-up, 2014/15).Self reported pride at baseline (low (...) /moderate/high) and whether the participant had reported having fallen during the two years before follow-up.The findings did not support the contention that "pride comes before a fall." Unadjusted estimates indicate that the odds of reported falls were significantly lower for people with high pride levels compared with those who had low pride (odds ratio 0.69, 95% confidence interval 0.58 to 0.81, P<0.001). This association remained after adjustment for age, sex, household wealth, and history of falls
Effects of Antigravity Treadmill Training on Gait, Balance, and Fall Risk in Children With Diplegic Cerebral Palsy. The aim of this study was to investigate the effects of antigravity treadmill training on gait, balance, and fall risk in children with diplegic cerebral palsy.Thirty children with diplegic cerebral palsy were selected for this randomized controlled study. They were randomly assigned to (1) an experimental group that received antigravity treadmill training (20 mins/d, 3 d/wk (...) ) together with traditional physical therapy for 3 successive mos and (2) a control group that received only traditional physical therapy program for the same period. Outcomes included selected gait parameters, postural stability, and fall risk. Outcomes were measured at baseline and after 3 mos of intervention.Children in both groups showed significant improvements in the mean values of all measured variables (P < 0.05), with significantly greater improvements in the experimental group than the control
Falling upward with Parkinsonâ€™s disease Falls can injure, even kill. No one with Parkinson's disease (PD) wants to fall by accident. However, the potential nastiness of falls does not preclude a more nuanced understanding of the personal meaning that falls can have. Rather than view falls as a problem to fear and manage solely by preventing and repairing harm, people with PD and those who care for them may recast falls as a mixed blessing. Falls may be a resource, skill, and catalyst (...) for personal growth. We discuss how falls may give rise to opportunities in interrelated domains: capabilities, credo, character, creativity, chronemics, and connectedness. Clinicians could incorporate a positive focus across these domains to help people with PD to 'fall upward' in the sense of flourish.
Comparison of ISS, NISS, and RTS score as predictor of mortality in pediatric fall Studies to identify an ideal trauma score tool representing prediction of outcomes of the pediatric fall patient remains elusive. Our study was undertaken to identify better predictor of mortality in the pediatric fall patients.Data was retrieved from prospectively maintained trauma registry project at level 1 trauma center developed as part of Multicentric Project-Towards Improving Trauma Care Outcomes (TITCO (...) having 50, 50, and 86% of area under the curve on ROCs, and RTS was statistically significant among them.Physiologically based trauma score systems (RTS) are much better predictors of inhospital mortality in comparison to anatomical based scoring systems (ISS and NISS) for unintentional pediatric falls.
Identifying characteristics and outcomes that are associated with fall-related fatalities: multi-year retrospective summary of fall deaths in older adults from 2005â€“2012 Fall-related deaths continue to be the leading cause of accidental deaths in the older adult (65+ year) population. However, many fall-related fatalities are unspecified and little is known about the fall characteristics and personal demographics at the time of the fall. Therefore, this report describes the characteristics (...) , circumstances and injuries of falls that resulted in older adult deaths in one U.S. County and explores the variables associated with fatal injuries from falls.This is a continued retrospective analysis of 841older adults whose underlying cause of death was due to a fall over an 8-year period (2005-2012). Demographics and logistic regression of fall characteristics and injuries were analyzed.Falls that led to death most often occurred when walking in one's own home. Most of the residents in this study were
Examining the Impact of Interprofessional Training and Patient Engagement on Falls Prevention Rapid Synthesis Examining the Impact of Interprofessional Training and Patient Engagement on Falls Prevention 30 April 2017 McMaster Health Forum 1 Evidence >> Insight >> Action Rapid Synthesis: Examining the Impact of Interprofessional Training and Patient Engagement on Falls Prevention 30 April 2017 Examining the Impact of Interprofessional Training and Patient Engagement on Falls Prevention 2 (...) relevance. Acknowledgments The authors wish to thank Shane Natalwalla for help with data extraction. We would also like to thank Bonny Jung and Maureen Markle-Reid for their insightful comments and suggestions. Citation Waddell K, Wilson MG. Rapid synthesis: Examining the impact of interprofessional training and patient engagement on falls prevention. Hamilton: McMaster Health Forum, 30 April 2017. Product registration numbers ISSN 2292-7999 (online) Examining the Impact of Interprofessional Training
Older adult falls prevention behaviors 60 days post-discharge from an urban emergency department after treatment for a fallFalls are a common and debilitating health problem for older adults. Older adults are often treated and discharged home by emergency department (ED)-based providers with the hope they will receive falls prevention resources and referrals from their primary care provider. This descriptive study investigated falls prevention activities, including interactions with primary (...) care providers, among community-dwelling older adults who were discharged home after presenting to an ED with a fall-related injury.We enrolled English speaking patients, aged ≥ 65 years, who presented to the ED of an urban level one trauma center with a fall or fall related injury and discharged home. During subjects' initial visits to the ED, we screened and enrolled patients, gathered patient demographics and provided them with a flyer for a Matter of Balance course. Sixty-days post enrollment
A home program of strength training, movement strategy training and education did not prevent falls in people with Parkinson`s disease: a randomised trial For people with idiopathic Parkinson's disease, does a 6-week, comprehensive, home exercise program reduce falls and disability and improve health-related quality of life? Is the program cost-effective?Randomised, controlled trial with concealed allocation and assessor blinding.One hundred and thirty-three community-dwelling adults (...) with Parkinson's disease.The experimental group completed a 6-week home program comprising progressive resistance strength training, movement strategy training and falls education. The control group completed 6 weeks of non-specific life skills training. Participants in both groups received weekly therapist-guided sessions for 6 consecutive weeks and a weekly self-directed home program.The primary outcome was the rate of falls, documented for the 12-month period immediately after therapy. Secondary outcomes
Paramedic Assessment of Older Adults After Falls, Including Community Care Referral Pathway: Cluster Randomized Trial We aim to determine clinical and cost-effectiveness of a paramedic protocol for the care of older people who fall.We undertook a cluster randomized trial in 3 UK ambulance services between March 2011 and June 2012. We included patients aged 65 years or older after an emergency call for a fall, attended by paramedics based at trial stations. Intervention paramedics could refer (...) the patient to a community-based falls service instead of transporting the patient to the emergency department. Control paramedics provided care as usual. The primary outcome was subsequent emergency contacts or death.One hundred five paramedics based at 14 intervention stations attended 3,073 eligible patients; 110 paramedics based at 11 control stations attended 2,841 eligible patients. We analyzed primary outcomes for 2,391 intervention and 2,264 control patients. One third of patients made further
Fall Risk Score at the Time of Discharge Predicts Readmission Following Total Joint Arthroplasty Readmission among Medicare recipients is a leading driver of healthcare expenditure. To date, most predictive tools are too coarse for direct clinical application. Our objective in this study is to determine if a pre-existing tool to identify patients at increased risk for inpatient falls, the Hendrich Fall Risk Score, could be used to accurately identify Medicare patients at increased risk (...) for readmission following arthroplasty, regardless of whether the readmission was due to a fall.This study is a retrospective cohort study. We identified 2437 Medicare patients who underwent a primary elective total joint arthroplasty (TJA) of the hip or knee for osteoarthritis between 2011 and 2014. The Hendrich Fall Risk score was recorded for each patient preoperatively and postoperatively. Our main outcome measure was hospital readmission within 30 days of discharge.Of 2437 eligible TJA recipients
Evaluation of an inpatient fall risk screening tool to identify the most critical fall risk factors in inpatients To evaluate the accuracy of the inpatient fall risk screening tool and to identify the most critical fall risk factors in inpatients.Variations exist in several screening tools applied in acute care hospitals for examining risk factors for falls and identifying high-risk inpatients.Secondary data analysis.A subset of inpatient data for the period from June 2011-June 2014 (...) was extracted from the nursing information system and adverse event reporting system of an 818-bed teaching medical centre in Taipei. Data were analysed using descriptive statistics, receiver operating characteristic curve analysis and logistic regression analysis.During the study period, 205 fallers and 37,232 nonfallers were identified. The results revealed that the inpatient fall risk screening tool (cut-off point of ≥3) had a low sensitivity level (60%), satisfactory specificity (87%), a positive
Historical Perspective on the Rise and Fall and Rise of Antibiotics and Human Weight Gain. In recent medical and popular literature, audiences have been asked to consider whether antibiotics have contributed to the rising obesity epidemic. Prominent magazines have stated that weight may be adversely affected by antibiotics that destroy existing microbiomes and replace them with less helpful ones. However, there is a long history of efforts to investigate the relationship between antibiotics
Reducing falls in residential care Reducing falls in residential care 1 Reducing falls in residential care Citation Garrubba M, Melder A, Joseph C. 2017. Reducing falls in residential care: Systematic Review. Centre for Clinical Effectiveness, Monash Innovation and Quality, Monash Health, Melbourne, Australia. Background The Deputy Director of Nursing / Operations – Residential Services, Kingston Centre and Satellites on behalf of a falls prevention task force have requested a review (...) of the literature focusing on the investigation of any falls prevention management strategies that could be implemented to assist Monash Health in reducing the rate of falls and falls with injury across the older aged population. Question 1. What is the effectiveness of interventions designed to reduce falls by older people in residential care settings? 2. What is the effectiveness of strategies to implement falls prevention programs/initiatives/interventions? Methods A systematic search of papers in English
Accuracy of validated falls risk assessment tools and clinical judgement Accuracy of validated falls risk assessment tools and clinical judgement Page 1 Accuracy of validated falls risk assessment tools and clinical judgement Citation Yap G. and Melder A. Accuracy of validated falls risk assessment tools and clinical judgement: Rapid Review. Centre for Clinical Effectiveness, Monash Innovation and Quality, Monash Health, Melbourne, Australia. Abstract Background The Executive Director (...) judgement. 2) To identify the best validated risk assessment tools (or alternative) that accurately assesses and predict falls in hospital inpatients. Methodology A search for synthesised evidence published in English from 2012 to present was conducted in Ovid MEDLINE® and CINAHL Plus (Table 5 and Table 6) and documents were screened according to inclusion criteria and exclusion criteria listed in Table 2. A brief assessment was made on the quality of the evidence included in the report based