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OP0314-HPR A home-based fall prevention programme reduces fear of falling in seniors
  1. B Zindel1,
  2. A Meichtry2,
  3. V Krafft1,
  4. K Niedermann2
  1. 1Swiss League against Rheumatisme, Zurich
  2. 2Zurich University of Applied Sciences, Winterthur, Switzerland

Abstract

Background Every year, over 80,000 elderly persons in Switzerland have accidents caused by tripping and falling, and half of these falls happen at home or in the direct vicinity (1). Falls, due to its often severe medical consequences and persistent mobility impairments, together with the demographic development, are one of the most important musculo-sceletal problems and public health issue. Falls are often due to a combination of internal risk factors (such as vertigo, osteoporosis, cognitive impairments, decreased ability for dual tasking) and external risk factors (such as medication and environmental risk factors) (2).

The Swiss League Against Rheumatism (SLAR) has developed a multidimensional home-based fall prevention programme, which is supported by health insurances. Trained physiotherapists (PTs) and occupational therapists (OTs) visit the seniors at home in order to perform a detailed assessment of the senior's individual risk of falling. Subsequently the PT or OT eliminates identified environmental risk factors and provide tailored exercises. After 4 weeks, a telephone call was made by the PT/OT to discuss unclear instructions and after 16 weeks, follow up data were collected by telephone.

Objectives The objective was to evaluate the effects of the fall prevention programme.

Methods A retrospective analysis was carried out on the data of 671 participants in 2015. Available data were participant's characteristics, fall risk factors, determined by the Timed “Up&Go” with additional motor and cognitive task) (4). Fall Efficacy Scale (5), the recommendations made by the PTs/OTs and satisfaction of the seniors.

Results The participants were mainly female (62.6%) and had a mean age of 81.7 years (SD=5.5, range 66.1–100 years). Several risk factors were present: 64.1% fell at least once in the last year and 45% were not able to perform a dual task (TUG + additional cognitive task).

Main recommendations made by PTs/OTs were “fixing down of carpets” (56.6%) and instruction of an exercise programme (strength, balance and multi-task capability) (82.6%). After four months, fear of falling had decreased (change in FES-I: -1.24 points 95% CI: (-1.44, -1.04), p-value<0.001). 92% of the participants self-reported to follow the recommendations and 98.4% were satisfied with the programme and would recommend it to others.

Conclusions The low-threshold, multidimensional home-based fall prevention developed by the SLAR was feasible and effective. Participants implemented the recommendations and the fear of falling' decreased. Reduced fear of falling is considered a strong predictor of falling, however a prospective study is needed to determine if the reduced fear of falling leads to a decreased number of falls.

References

  1. Bfu, Schweiz 2014.

  2. Gschwind, Y.J., Bridenbaugh St. A. & Kressig, R. W. (2013). Sturz im Alter. In Pinter, G. Likar et al. Geriatrische Notfallversorgung Strategien und Konzepte.

  3. Shumway-Cook, A., Brauer, S. & Woollacott, M. (2000). Predicting the probability for falls in community-dwelling older adults using the Timed Up & Go Test. Physical Therapy, 80(9).

  4. Kempen, G. I. J. M., Yardley, L., van Haastregt, J. C. M., Zijlstra, G. A. R., Beyer, N., Hauer, K. & Todd, Chris (2008). The Short FES-I: a shortened version of the falls efficacy scale-international to assess fear of falling. Age and Ageing, 37(1).

References

Disclosure of Interest None declared

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