Balance function and fall-related efficacy in patients with newly operated hip fracture.

OBJECTIVE: To investigate the relation between fall-related efficacy in daily-life activities and functional as well as instrumental tests of balance in patients with hip fracture. DESIGN: Analysis of different aspects of balance using the Falls Efficacy Scale, Swedish version FES(S), questions on fear of falling, Functional Reach (FR) and tests on a balance platform (Chattanooga). SUBJECTS: Fifty-five elderly inpatients (mean age 82.3) with newly operated hip fracture who were assessed during the last week in hospital before discharge. RESULTS: The results showed a significant relationship between the subjective ability measured with the FES(S) and the objectively measured balance in the Functional Reach test and also between fall-related efficacy measured with FES(S) and fear of falling. Very few significant correlations were found between the results from balance tests on the force platform and those obtained with FES(S) and FR. CONCLUSIONS: Both the Falls Efficacy Scale, Swedish version, and the Functional Reach have been shown to be useful in analysing balance function in elderly patients newly operated on for hip fracture. The Falls Efficacy Scale also indicates which of the daily activities the patient perceives as troublesome and thus require further training.

Risk of long-term disability among patients with back pain.

The aim of this study was to find predictors of length of time on sick-leave and the change in sick-leave as a result of intervention. Many studies of back pain show that medical and psychosocial factors covary with length of sick-leave. The results are based on the questionnaire responses of 240 patients. A stepwise multiple regression showed that the significant predictors of number of sick-days the year after intervention were the number of sick-days before the intervention and also hypochondria. Significant predictors of sick-leave change were sleep disturbance and number of sick-days before intervention. A discriminant function analysis comparing a group that had decreased its sick-leave with one that had increased its sick-leave showed 7 predictors of increased sick-leave: high risk of somatisation; many children and family members living at home; a change in tasks at work owing to pain; brothers and sisters with longstanding pain problems; frequent pain, and sleep disturbance. It is important for physiotherapists to enquire about patients' earlier sick-leave patterns in order to identify risk factors for long-term disability among patients with back pain. Some of these factors have been identified in this study.

Diverticular disease and minor rectal bleeding.

The purpose of the study was to compare the history of rectal bleeding during the year before the study and the presence of faecal occult bleeding in patients with advanced diverticular disease of the large bowel and two sex- and age-matched reference groups, one consisting of patients with normal large-bowel barium enemas and the other of persons without any history of gastrointestinal disease. The number of persons with faecal occult bleeding or macroscopic anal bleeding during the year before the study was not increased in the group with diverticular disease as compared with the other two groups. The bleeding frequency and characteristics of the bleeding did not differ among the three groups. It is concluded that minor rectal bleeding is rather uncommon in persons with uncomplicated diverticular disease. Patients with a history of rectal bleeding in whom a barium study has only shown diverticular disease should be further investigated as though the diverticula were not present.