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21.
《Gait & posture》2017
BackgroundWhile the relevance of falls in raising the risk of fractures, hospitalization and disability in older age is well recognized, the factors influencing the onset of fractures and the need for ward admission after a fall have yet to be fully elucidated. We investigated which factors and fall dynamics were mainly associated with fall-related injuries and hospitalization among elderly persons accessing the Emergency Department (ED) following a fall.MethodsThe study involved 2144 older subjects who accessed the ED after a fall. Data on the fall´s nature and related injuries, ward admissions, history of falls, dementia, and medical therapies were examined for all patients. Considering dynamics, we distinguished accidental falls (due to interaction with environmental hazards while in motion) and falls from standing (secondary to syncope, lipothymia, drop attack, or vertigo).ResultsThe overall prevalence of fractures in our population did not differ significantly with advancing age, though hip fractures were more common in the oldest, and upper limb fractures in the youngest patients. Falls from standing were associated with polypharmacy and with higher ward admission rate despite a lower fractures´ prevalence than accidental falls. The chances of fall-related fractures were more than fourfold as high for accidental dynamics (OR = 4.05, 95%CI:3.10–5.29, p < 0.0001). Ward admission was associated with polypharmacy, dementia, anticoagulants´ use and fall-related fractures (OR = 6.84, 95%CI:5.45–8.58, p < 0.0001), while it correlated inversely with accidental fall dynamics.ConclusionsOutcomes of falls in older age depend not only on any fall-related injuries, but also on factors such as polypharmacy, cognitive status and fall dynamics. 相似文献
22.
Hongwei HSIAO 《Industrial health》2014,52(5):381-392
Slips, trips, and falls (STF) represent a serious hazard to workers and
occupants in many industries, homes, and communities. Often, the cause of a STF incident
is multifactorial, encompassing human, environmental, and task risk factors. A STF-related
disability can greatly diminish the occupational capability and quality of life of
individuals in both the workplace and the home. Countering STF hazards and risks both on
and off the job and on all aspects of control measures is a “total worker safety” matter,
a challenging yet tangible undertaking. As the federal organization responsible for
conducting research for the prevention of work-related injuries in the United States, the
National Institute for Occupational Safety and Health (NIOSH) has been conducting research
on STF controls for some decades. Many NIOSH research outcomes have been utilized for STF
prevention in workplaces, with potential for prevention in homes as well. This paper
summarizes the concept of total worker safety for STF control, NIOSH priority research
goals, major activities, and accomplishments, and some emerging issues on STF. The
strategic planning process for the NIOSH research goals and some identified research
focuses are applicable to the development and implementation of global STF research
goals. 相似文献
23.
24.
《Current medical research and opinion》2013,29(10):2373-2387
ABSTRACTBackground: Osteoporosis is predominantly a condition of the elderly, and the median age for hip fracture in women is approximately 83 years. Osteoporotic fracture risk is multifactorial, and often involves the balance between bone strength and propensity for falling.Objective: To present an overview of the available evidence, located primarily by Medline searches up to April, 2009, for the different management strategies aimed at reducing the risk of falls and osteoporotic fractures in the elderly.Results: Frailty is an independent predictor of falls, hip fractures, hospitalisation, disability and death in the elderly that is receiving increasing attention. Non-pharmacological strategies to reduce fall risk can prevent osteoporotic fractures. Exercise programmes, especially those involving high doses of exercise and incorporating balance training, have been shown to be effective. Many older people, especially the very elderly and those living in care institutions, have vitamin D inadequacy. In appropriate patients and given in sufficient doses, vitamin D and calcium supplementation is effective in reducing both falls and osteoporotic fractures, including hip fractures. Specific anti-osteoporosis drugs are underused, even in those most at risk of osteoporotic fracture. The evidence base for the efficacy of most such drugs in the elderly is incomplete, particularly with regard to nonvertebral and hip fractures. The evidence base is perhaps most complete for the relatively recently introduced drug, strontium ranelate. Non-adherence to treatment is a substantial problem, and may be exacerbated by the requirements for safe oral administration of bisphosphonates.Conclusion: Evidence-based strategies are available for reducing osteoporotic fracture risk in the elderly, and include exercise training, vitamin D and calcium supplementation, and use of evidence-based anti-osteoporotic drugs. A positive and determined approach to optimising the use of such strategies could reduce the burden of osteoporotic fractures in this high-risk group. 相似文献
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26.
PurposeExperiencing a fall can be a detrimental experience for older adults and may affect an individual’s beliefs about participating in future physical activity (PA) behavior. The purpose of this study was to identify if determinants of PA differ between older adults who have a history of a fall (HF) and those with no history of a fall (NHF) within the Health Belief Model (HBM), expanded through the constructs of intention and habit.Materials and MethodsParticipants (N = 667) were community-dwelling older adults who completed online measures of original HBM determinants (beliefs, barriers, self-efficacy, cues, and perceived threat variables) related to participating in PA in addition to past PA behavior and intention.ResultsNovel findings include perceived barriers significantly predicted intention to participate in PA among those with a HF but not among those with NHF, and past PA behavior predicted decreased perceived threat of falling among both groups. The model also supported cues to predict physical activity habit.ConclusionsPerceived barriers (time constraints and bodily pain) deterred PA intentions among those with a HF, suggesting the importance of intervention planning to reduce/resolve these barriers for this group. Past PA was negatively associated with perceived threat of falling, which signposts the importance of providing a safe environment for older adults to engage in PA. The study also provides formative notes for interpreting and further investigating perceived threat and its antecedents (susceptibility and seriousness) in addition to cues, which generally have been omitted in previous studies that employ the HBM. 相似文献
27.
Manckoundia P Buatois S Gueguen R Perret-Guillaume C Laurain MC Pfitzenmeyer P Benetos A 《Archives of gerontology and geriatrics》2008,47(2):217-228
We assessed the role of clinical and biological parameters on performance in four balance tests in elderly subjects. An observational study was conducted in the Center for Preventive Medicine of Nancy (France) in 2368 community-living elderly subjects aged 60 and older. Body mass index (BMI), Mini-Mental State Examination (MMSE), clock test, “Health score” and use of psychotropic drugs (UPD) were assessed. Participants performed four balance tests: “one-leg-stand” (OLS), “timed-up-and-go” (TUG), “rise-from-the-floor” (RFF) and “sit-to-stand” (STS). The statistical analysis showed that women were almost twice as likely to fail balance tests as men. In both women and men, the following determinant factors of the performance in balance tests were found: for OLS: age, BMI and health score; for TUG: age, BMI, clock test and health score; for RFF: BMI and health score. In addition, in women other determinant factors were: MMSE for OLS, UPD for TUG, age and clock test for RFF. In men, the clock test and the UPD were also significant determinant factors for OLS. Similar results were found for STS. In conclusion, female sex, overweight, low cognitive status, low self-perception of health and UPD were associated with a higher risk of failure in balance tests. 相似文献
28.
29.
Henrique de Alencar Gomes Bruno de Souza Moreira Rosana Ferreira Sampaio Sheyla Rossana Cavalcanti Furtado Sebastião Cronemberger Roberto de Alencar Gomes Renata Noce Kirkwood 《Revista brasileira de fisioterapia (S?o Carlos (S?o Paulo, Brazil))》2018,22(5):376-382
Objective
This study investigated the influence of early to moderate primary open angle glaucoma on gait, functional mobility and fall risk.Methods
Thirty-three participants in the early and moderate stages of primary open angle glaucoma and 34 asymptomatic controls participated in the study. Spatiotemporal gait data were obtained with the GAITRite system and included: velocity, cadence, step length, base of support, swing, stance and double support times. Functional measures included the Timed Up and Go test, the Five-Repetition Sit-To-Stand test and the Dynamic Gait Index. Fall risk was measured using the Physiological Profile Assessment.Results
The variables contrast sensitivity, proprioception and the Timed Up and Go and Dynamic Gait Index tests were significantly different between groups. In addition, the glaucoma group presented significantly higher risk of falling compared to the control group. Individuals in the early and moderate stages of primary open glaucoma presented mobility and sensory deficits that increase the risk of falling.Conclusions
The results of this study suggest that adding the Timed Up and Go and Dynamic Gait Index tests to routine physical therapy assessment of individuals with early glaucoma could be useful. Rehabilitation programs should focus on maintaining and/or improving mobility and balance, and prevention of falls in this population. 相似文献30.