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1.
Trials ; 22(1): 587, 2021 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-34479617

RESUMO

BACKGROUND: Falls are one of the most common accidents in older adults, often leading to injury, disability and quality-of-life declines. Foot core function contributes to postural stability in most static postures and dynamic activities. As efficient foot core training, the intrinsic-foot-muscle exercise has been proposed to improve postural control. However, the effects of the exercise on postural stability in the elderly remain unclear. Therefore, this study attempts to investigate the effect of 12-week intrinsic-foot-muscle exercise on postural stability in older adults with fall risk. METHODS: We will conduct a prospective, single-blind randomised controlled trail on 120 older adults with fall risk. Participants will be randomly assigned to an intrinsic-foot-muscle exercise combining the lower extremity resistance training group (IFM group), an extrinsic-foot-muscle exercise combining the lower extremity resistance training group (EFM group) and a control group. The control group will perform lower extremity resistance training. The IFM and EFM groups will be given additional short-foot exercise or towel-curl exercise training, respectively. After the intervention, participants will be followed up for another 12 weeks with no active intervention. The outcome measures will include the postural stability measurements, self-reported postural stability, number of falls, intrinsic-foot-muscle strength and foot arch function. Furthermore, adverse events will be recorded and analysed. If any participant withdraws from the trial, an intention-to-treat analysis will be performed. DISCUSSION: The trial is designed to investigate the efficacy of a 12-week intrinsic foot muscle training combined with the lower extremity resistance training on postural stability outcomes in elderly people with fall risk. The trial will also examine the comprehensive outcomes of postural stability during static standing and dynamic movements. The function of intrinsic foot muscle to support the arch will also be evaluated. Important features of this trial mainly include intervention setting, outcome measure selection and study duration. The results of this study will determine the effectiveness and provide scientific evidence to establish comprehensive fall prevention intervention. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR2000033623. Registered on 7 June 2020. http://www.chictr.org.cn/showproj.aspx?proj=54741.


Assuntos
Treinamento de Força , Acidentes por Quedas/prevenção & controle , Idoso , Exercício Físico , Terapia por Exercício , , Humanos , Músculo Esquelético , Equilíbrio Postural , Estudos Prospectivos , Ensaios Clínicos Controlados Aleatórios como Assunto , Método Simples-Cego
2.
Sensors (Basel) ; 21(17)2021 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-34502755

RESUMO

Sensor-based fall risk assessment (SFRA) utilizes wearable sensors for monitoring individuals' motions in fall risk assessment tasks. Previous SFRA reviews recommend methodological improvements to better support the use of SFRA in clinical practice. This systematic review aimed to investigate the existing evidence of SFRA (discriminative capability, classification performance) and methodological factors (study design, samples, sensor features, and model validation) contributing to the risk of bias. The review was conducted according to recommended guidelines and 33 of 389 screened records were eligible for inclusion. Evidence of SFRA was identified: several sensor features and three classification models differed significantly between groups with different fall risk (mostly fallers/non-fallers). Moreover, classification performance corresponding the AUCs of at least 0.74 and/or accuracies of at least 84% were obtained from sensor features in six studies and from classification models in seven studies. Specificity was at least as high as sensitivity among studies reporting both values. Insufficient use of prospective design, small sample size, low in-sample inclusion of participants with elevated fall risk, high amounts and low degree of consensus in used features, and limited use of recommended model validation methods were identified in the included studies. Hence, future SFRA research should further reduce risk of bias by continuously improving methodology.


Assuntos
Acidentes por Quedas , Dispositivos Eletrônicos Vestíveis , Acidentes por Quedas/prevenção & controle , Idoso , Previsões , Humanos , Estudos Prospectivos
3.
Isr Med Assoc J ; 23(8): 479-483, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34392621

RESUMO

BACKGROUND: Little is known regarding the impact of the coronavirus disease-2019 (COVID-19) pandemic on the incidence of hip fractures among older adults. OBJECTIVES: To compare the characteristics of patients with a hip fracture following a fall during the COVID-19 pandemic year and during the preceding year. METHODS: We conducted a retrospective cohort study of older patients who had undergone surgery for hip fracture repair in a major 495-bed hospital located in northern central Israel following a fall. Characteristics of patients who had been hospitalized in 2020 (pandemic year, n=136) and in 2019 (non-pandemic year, n=151) were compared. RESULTS: During the pandemic year, patients were less likely to have fallen in a nursing facility, to have had muscle or balance problems, and to have had a history of falls and fractures following a fall. Moreover, the average length of stay (LOS) in the hospital was shorter; however, the average time from the injury to hospitalization was longer. Patients were less likely to have acquired a postoperative infection or to have died. During the pandemic year, postoperative infection was only associated with prolonged LOS. CONCLUSIONS: The COVID-19 pandemic may have had a positive impact on the behavior of older adults as well as on the management of hip fracture patients. However, healthcare providers should be aware of the possible reluctance to seek care during a pandemic. Moreover, further research on the impact of the change in management during COVID-19 on hip fracture survival is warranted.


Assuntos
Acidentes por Quedas , COVID-19 , Fixação de Fratura , Fraturas do Quadril , Controle de Infecções , Complicações Pós-Operatórias , Acidentes por Quedas/prevenção & controle , Acidentes por Quedas/estatística & dados numéricos , Idoso , COVID-19/epidemiologia , COVID-19/prevenção & controle , Feminino , Fixação de Fratura/métodos , Fixação de Fratura/reabilitação , Fixação de Fratura/estatística & dados numéricos , Fraturas do Quadril/epidemiologia , Fraturas do Quadril/etiologia , Fraturas do Quadril/cirurgia , Humanos , Controle de Infecções/métodos , Controle de Infecções/organização & administração , Israel/epidemiologia , Tempo de Internação/estatística & dados numéricos , Masculino , Avaliação de Processos e Resultados em Cuidados de Saúde , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos , SARS-CoV-2/isolamento & purificação
4.
BMJ Open ; 11(8): e039649, 2021 08 09.
Artigo em Inglês | MEDLINE | ID: mdl-34373286

RESUMO

OBJECTIVE: To determine the impact of the introduction of a falls risk assessment toolkit (FRAT) in a UK medical centre on the number and cost of non-elective admissions for falls and psychotropic medication utilisation. DESIGN: Interrupted time series analysis quantifying the number and cost of non-elective admissions for falls and primary care use data for Rushall Medical Centre before and after the implementation of FRAT at July 2017. SETTING: Data on the monthly number and cost of non-elective admissions for falls and number of referrals and assessment to the falls service were provided by Walsall Clinical Commissioning Group. Primary care prescribing cost and volume data for Rushall Medical Centre was derived from the Openprescribing.net website for prescriptions dispensed between April 2015 and November 2018. PRIMARY AND SECONDARY OUTCOME MEASURES: The number and cost of non-elective admissions for falls and number of referrals and assessment to the falls service, and the volume of utilisation of psychotropic medicines. RESULTS: Following the implementation of FRAT at Rushall Medical Centre in July 2017, the number of non-elective admissions for falls decreased at a rate of 0.414 admissions per month (p<0.033, 95% CI -0.796 to -0.032). The utilisation of psychotropic medications (alimemazine, citalopram, escitalopram, fluoxetine, mirtazapine, olanzapine and risperidone) decreased. The expenditure on psychotropic medications prescribed/used at Rushall Medical Centre decreased by at least £986 per month (p<0.001, 95% CI -2067 to -986). CONCLUSIONS: The implementation of FRAT at Rushall Medical Centre was associated with a reduction in the number of non-elective admissions for falls. Assessment of these patients together with deprescribing of psychotropic medications resulted in a reduction in the number of non-elective admissions for falls and associated costs.


Assuntos
Acidentes por Quedas , Hospitalização , Acidentes por Quedas/prevenção & controle , Humanos , Análise de Séries Temporais Interrompida , Psicotrópicos/uso terapêutico , Medição de Risco
5.
Artigo em Inglês | MEDLINE | ID: mdl-34444514

RESUMO

Despite decades of research into patient falls, there is a dearth of evidence about how the design of patient rooms influences falls. Our multi-year study aims to better understand how patient room design can increase stability during ambulation, serving as a fall protection strategy for frail and/or elderly patients. The aim of this portion of the study was to ascertain the architect's perspective on designing a room to mitigate the risk of falls, as well as to evaluate the face validity of a predictive algorithm to assess risk in room design using the input of a design advisory council (AC). The purpose of this paper is to provide insight into the design process and decision-making for patient rooms; summarize the impressions of industry experts about the configurations and layout of the patient rooms tested in a preliminary augmented reality model; establish the face validity of modeled heat maps depicting risk; and report the results of a pre-meeting and post-meeting survey of expert opinions. Feedback was coded using human factors/ergonomic (HF/E) design principles, and the findings will be used to guide further development of an "optimal" prototype room for human subject testing. The results confirm the challenges that architects face as they balance competing priorities and reveal how a participatory process focusing on preventing falls can shift assumptions about design strategies, especially subtle changes (e.g., toilet orientation).


Assuntos
Acidentes por Quedas , Quartos de Pacientes , Acidentes por Quedas/prevenção & controle , Idoso , Atenção à Saúde , Ergonomia , Humanos , Inquéritos e Questionários
6.
S D Med ; 74(6): 250-254, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34449163

RESUMO

INTRODUCTION: Social adversities such as financial insecurity, poor access to healthcare, shortage of food, and housing concerns can significantly impact health, especially for pediatric patients. The American Academy of Pediatrics recommends that pediatricians address social risks and provide interventions. This is a study where a social needs assessment screening tool was implemented at a general pediatrics clinic in Sioux Falls, South Dakota, to determine the needs of patients in the community with secondary outcomes evaluating ethnic differences in social needs. METHODS: Caregivers of pediatric patients being seen for a well-child examination were asked to participate by completing a social needs assessment form. If social needs were indicated, the clinic's health coach or the integrative health therapist contacted families to address the social need with resources available in the community. RESULTS: Caregivers completed 240 forms. Sixty-eight (31 percent) of caregivers had at least one need, house utilities being the most common followed by childcare. Total number of needs was significantly affected by race and insurance status with more needs identified in American Indian and Black ethnicities and those with public insurance. CONCLUSIONS: This was a successful implementation of a social needs assessment tool at a General Pediatric clinic. Further development and implementation of screening tools is necessary to continue to determine social needs of patients.


Assuntos
Acidentes por Quedas , Pediatria , Acidentes por Quedas/prevenção & controle , Cuidadores , Criança , Cuidado da Criança , Humanos , Determinação de Necessidades de Cuidados de Saúde
7.
Lancet Public Health ; 6(9): e631-e640, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34371005

RESUMO

BACKGROUND: As with many Indigenous populations internationally, Maori in New Zealand suffer health inequity. We aimed to assess the rate of fall injuries at home with and without home modifications in houses with Maori occupants. METHODS: We did a single-blind randomised controlled trial in the Wellington and Taranaki regions of New Zealand and enrolled owner-occupied households with at least one Maori occupant. Only households who stated they intended to live at that address for the subsequent 3 years were eligible for participation. We randomly assigned (1:1) households to either the intervention group, who received home modifications (handrails for outside steps and internal stairs, grab rails for bathrooms, outside lighting, repairs to window catches, high-visibility and slip-resistant edging for outside steps, fixing of lifted edges of carpets and mats, non-slip bath mats, and slip-resistant surfacing for outside areas such as decks) immediately, or the control group, who received the modifications 3 years later. Data on home injuries were obtained from the Accident Compensation Corporation and coded by study team members, who were masked to study group allocation. The primary outcome was the rate of medically treated fall injuries at home per household per year, analysed according to intention to treat. This Maori Home Injury Prevention Intervention (MHIPI) trial is now completed, and is registered with the Australian New Zealand Clinical Trials Registry, ACTRN12613000148774. FINDINGS: Between Sept 3, 2013, and Oct 1, 2014, 824 households were assessed for eligibility and 254 were enrolled, of which 126 (50%) were assigned to the intervention group and 128 (50%) were assigned to the control group. After adjustment for previous falls and geographical region, there was an estimated 31% reduction in the rate of fall injuries at home per year exposed to the intervention compared with households in the control group (adjusted relative rate 0·69 [95% CI 0·47-1·00]). INTERPRETATION: Low-cost home modifications and repairs can be an effective means to reduce injury disparities. The high prevalence of modifiable safety issues in Maori homes merits considerable policy and community effort. FUNDING: Health Research Council of New Zealand.


Assuntos
Acidentes por Quedas/prevenção & controle , Acidentes Domésticos/prevenção & controle , Habitação/normas , Grupo com Ancestrais Oceânicos/estatística & dados numéricos , Acidentes por Quedas/estatística & dados numéricos , Acidentes Domésticos/estatística & dados numéricos , Idoso , Disparidades nos Níveis de Saúde , Habitação/estatística & dados numéricos , Humanos , Nova Zelândia
8.
Psychogeriatrics ; 21(5): 826-831, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34363431

RESUMO

BACKGROUND: Understanding the physical and mental changes in community-dwelling elderly people is very important during the coronavirus disease 2019 (COVID-19) pandemic when considering preventive measures. The purpose of this study was to clarify the changes of physical function and anxiety for activities of daily living in community-dwelling older adults, focusing on locomotor function during the COVID-19 pandemic. METHODS: The study participants were 127 older people who participated in successive surveys, in the summers of 2019 and again in 2020, after the state of emergency. The Locomo 25 questionnaire, Geriatric Depression Scale-15 (GDS-15) questionnaire, medical history, and number of people living together were self-reported. The Locomo 25 covers six aspects of physical pain, movement-related difficulty, usual care, daily activity, social activities, and anxiety. RESULTS: The paired samples t-test revealed that Locomo 25 total scores in 2020 were significantly higher than those in 2019. The GDS-15 score showed no significant difference. The comparison of scores for each item of the Locomo 25 revealed significantly higher scores in 2020 on Q21 ('difficult to perform sports activity', P = 0.0021), Q22 ('restricted from meeting own friends', P < 0.001), Q23 ('restricted from joining social activities', P < 0.001), Q24 ('anxious about falling in own house', P = 0.0023), and Q25 ('anxious about being unable to walk in the future', P = 0.0016). CONCLUSIONS: About 2 months after declaration of the first state of emergency due to the COVID-19 pandemic in Japan, social activity was severely restricted. Older adults showed almost no changes in body pain and locomotive disabilities, but increases in their anxieties about walking ability and falling were remarkable.


Assuntos
Acidentes por Quedas , COVID-19 , Acidentes por Quedas/prevenção & controle , Atividades Cotidianas , Idoso , Ansiedade/epidemiologia , Medo , Humanos , Vida Independente , Japão/epidemiologia , Pandemias , SARS-CoV-2 , Caminhada
9.
Front Public Health ; 9: 614119, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34336750

RESUMO

Background: Falls affects one of three people after 65 years old, and it can lead to serious consequences. Scientific evidence point out that physical exercise is the most efficient way to prevent falls among older adults. Objective: The main objective of this study is to determine if a social marketing program can increase the attendance rate of people aged 60 and over at group balance workshops. Methods: This quasi-experimental multicenter study is being conducted in three French Regions (Loire, Haute-Loire and Rhône) over a period of 18 months. The Social Marketing Campaign will be done in three ways. Firstly, a Communication Campaign will take place in the two Test Areas but not in the Control Area. Secondly, flyers have been designed to be distributed by local partners. Finally, conferences for older people will be organized in the areas of intervention in order to reach the target audience for the program. The study will include people aged 60 and older who want to participate in the Balance Program. Results: The Crédit Agricole Loire/Haute-Loire Foundation funded the study and the Jean Monnet University of Saint-Etienne reviewed it. The Ethics Committee of the University Teaching Hospital of Saint-Etienne approved and peer-reviewed it on September 6, 2019, under Reference Number IRBN622019/CHUSTE. Conclusion: The results of this first study will demonstrate whether or not social marketing for promoting group balance workshops in the elderly will increase their attendanceship in adapted physical activity sessions, especially those that prevent falls. Clinical Trial Registration: https://clinicaltrials.gov/ct2/show/NCT04136938, identifier NCT04136938.


Assuntos
Acidentes por Quedas , Marketing Social , Acidentes por Quedas/prevenção & controle , Idoso , Exercício Físico , Terapia por Exercício , Humanos , Pessoa de Meia-Idade , Estudos Multicêntricos como Assunto
10.
Sensors (Basel) ; 21(15)2021 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-34372371

RESUMO

Falls are unusual actions that cause a significant health risk among older people. The growing percentage of people of old age requires urgent development of fall detection and prevention systems. The emerging technology focuses on developing such systems to improve quality of life, especially for the elderly. A fall prevention system tries to predict and reduce the risk of falls. In contrast, a fall detection system observes the fall and generates a help notification to minimize the consequences of falls. A plethora of technical and review papers exist in the literature with a primary focus on fall detection. Similarly, several studies are relatively old, with a focus on wearables only, and use statistical and threshold-based approaches with a high false alarm rate. Therefore, this paper presents the latest research trends in fall detection and prevention systems using Machine Learning (ML) algorithms. It uses recent studies and analyzes datasets, age groups, ML algorithms, sensors, and location. Additionally, it provides a detailed discussion of the current trends of fall detection and prevention systems with possible future directions. This overview can help researchers understand the current systems and propose new methodologies by improving the highlighted issues.


Assuntos
Acidentes por Quedas , Qualidade de Vida , Acidentes por Quedas/prevenção & controle , Idoso , Algoritmos , Humanos , Aprendizado de Máquina , Estações do Ano
11.
Sensors (Basel) ; 21(15)2021 Aug 03.
Artigo em Inglês | MEDLINE | ID: mdl-34372477

RESUMO

Human falls pose a serious threat to the person's health, especially for the elderly and disease-impacted people. Early detection of involuntary human gait change can indicate a forthcoming fall. Therefore, human body fall warning can help avoid falls and their caused injuries for the skeleton and joints. A simple and easy-to-use fall detection system based on gait analysis can be very helpful, especially if sensors of this system are implemented inside the shoes without causing a sensible discomfort for the user. We created a methodology for the fall prediction using three specially designed Velostat®-based wearable feet sensors installed in the shoe lining. Measured pressure distribution of the feet allows the analysis of the gait by evaluating the main parameters: stepping rhythm, size of the step, weight distribution between heel and foot, and timing of the gait phases. The proposed method was evaluated by recording normal gait and simulated abnormal gait of subjects. The obtained results show the efficiency of the proposed method: the accuracy of abnormal gait detection reached up to 94%. In this way, it becomes possible to predict the fall in the early stage or avoid gait discoordination and warn the subject or helping companion person.


Assuntos
Acidentes por Quedas , Dispositivos Eletrônicos Vestíveis , Acidentes por Quedas/prevenção & controle , Idoso , , Marcha , Humanos , Sapatos
12.
BMC Health Serv Res ; 21(1): 803, 2021 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-34384404

RESUMO

BACKGROUND: Quality improvement (QI) is used in nursing homes (NH) to implement and sustain improvements in patient outcomes. Little is known about how QI strategies are used in NHs. This lack of information is a barrier to replicating successful strategies. Guided by the Framework for Implementation Research, the purpose of this study was to map-out the use, evaluation, and reporting of QI strategies in NHs. METHODS: This scoping review was completed to identify reports published between July 2003 through February 2019. Two reviewers screened articles and included those with (1) the term "quality improvement" to describe their methods, or reported use of a QI model (e.g., Six Sigma) or strategy (e.g., process mapping) (2), findings related to impact on service and/or resident outcomes, and (3) two or more NHs included. Reviewers extracted data on study design, setting, population, problem, solution to address problem, QI strategies, and outcomes (implementation, service, and resident). Vote counting and narrative synthesis were used to describe the use of QI strategies, implementation outcomes, and service and/or resident outcomes. RESULTS: Of 2302 articles identified, the full text of 77 articles reporting on 59 studies were included. Studies focused on 23 clinical problems, most commonly pressure ulcers, falls, and pain. Studies used an average of 6 to 7 QI strategies. The rate that strategies were used varied substantially, e.g., the rate of in-person training (55%) was more than twice the rate of plan-do-study-act cycles (20%). On average, studies assessed two implementation outcomes; the rate these outcomes were used varied widely, with 37% reporting on staff perceptions (e.g., feasibility) of solutions or QI strategies vs. 8% reporting on fidelity and sustainment. Most studies (n = 49) reported service outcomes and over half (n = 34) reported resident outcomes. In studies with statistical tests of improvement, service outcomes improved more often than resident outcomes. CONCLUSIONS: This study maps-out the scope of published, peer-reviewed studies of QI in NHs. The findings suggest preliminary guidance for future studies designed to promote the replication and synthesis of promising solutions. The findings also suggest strategies to refine procedures for more effective improvement work in NHs.


Assuntos
Lesão por Pressão , Melhoria de Qualidade , Acidentes por Quedas/prevenção & controle , Humanos , Casas de Saúde , Gestão da Qualidade Total
13.
Appl Ergon ; 97: 103525, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34256320

RESUMO

Falls during stair descent are dangerous and costly. Contrasting tread edge highlighters improve measures of stair safety, however the necessary contrast level of these interventions has not been investigated. Thirteen older adults (67.7 ± 5.5 years) completed stair descent trials under normal (300lx) and low (30lx) lighting conditions, blurred and normal vision, and four different contrast levels (0%, 30%, 50%, 70%) between the tread edge highlighter and the neighbouring tread surface. Cadence and heel clearance decreased for 0% contrast compared to 50% and 70% contrast conditions, but contrast had no effect on foot overhang. Blurred vision was observed to be a greater factor influencing biomechanical measures of fall risk than low ambient lighting. Results suggest higher contrast highlighters improve measures of safety, even more so during simulated vision impairment, and that at least 50% contrast difference provides adequate visual information for safer stair ambulation.


Assuntos
Marcha , Caminhada , Acidentes por Quedas/prevenção & controle , Idoso , Fenômenos Biomecânicos , Humanos , Transtornos da Visão
14.
Geriatr Gerontol Int ; 21(9): 842-848, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34233381

RESUMO

AIM: Undesirable events, such as falls, aspiration, and pressure ulcers, are associated with functional decline and lower quality of life among older adults. This study describes the frequency of such events among residents of geriatric care facilities and assesses the effect of training care managers in a multidisciplinary plan-do-check-adjust cycle on preventing such events. METHODS: This was a Japan-based, non-randomized cluster intervention study. The intervention group comprised geriatric care facilities from which care managers had attended a training course, while the control group comprised facilities with care managers who did not receive this training. Six-month pre-admission and 3-month post-admission incidences of undesirable events were collected from both groups, and the two groups were compared. RESULTS: Valid data were collected from 862 residents (416 and 446 from the intervention and control groups, respectively) from 130 facilities (60 and 70, respectively). Three-month post-admission incidences were 27.8%, 20.0%, and 11.3% for falls, fever, and pressure ulcers, respectively. There was no difference between the groups regarding post-admission incidence for any event type. Training care managers reduced the post-admission incidence of pressure ulcers among residents with a history of such ulcers. CONCLUSIONS: The training of care managers in a multidisciplinary risk-management cycle was not effective for preventing falls, fever, or pressure ulcers. Results underscore the difficulty of preventing risk events in geriatric care facility residents even with organizational training efforts. The authors believe it is important to share such risks with residents and their families. Geriatr Gerontol Int 2021; 21: 842-848.


Assuntos
Lesão por Pressão , Qualidade de Vida , Acidentes por Quedas/prevenção & controle , Idoso , Humanos , Incidência , Japão/epidemiologia , Lesão por Pressão/epidemiologia , Lesão por Pressão/prevenção & controle
15.
Sensors (Basel) ; 21(14)2021 Jul 07.
Artigo em Inglês | MEDLINE | ID: mdl-34300399

RESUMO

Loss-of-balance (LOB) events, such as trips and slips, are frequent among community-dwelling older adults and are an indicator of increased fall risk. In a preliminary study, eight community-dwelling older adults with a history of falls were asked to perform everyday tasks in the real world while donning a set of three inertial measurement sensors (IMUs) and report LOB events via a voice-recording device. Over 290 h of real-world kinematic data were collected and used to build and evaluate classification models to detect the occurrence of LOB events. Spatiotemporal gait metrics were calculated, and time stamps for when LOB events occurred were identified. Using these data and machine learning approaches, we built classifiers to detect LOB events. Through a leave-one-participant-out validation scheme, performance was assessed in terms of the area under the receiver operating characteristic curve (AUROC) and the area under the precision recall curve (AUPR). The best model achieved an AUROC ≥0.87 for every held-out participant and an AUPR 4-20 times the incidence rate of LOB events. Such models could be used to filter large datasets prior to manual classification by a trained healthcare provider. In this context, the models filtered out at least 65.7% of the data, while detecting ≥87.0% of events on average. Based on the demonstrated discriminative ability to separate LOBs and normal walking segments, such models could be applied retrospectively to track the occurrence of LOBs over an extended period of time.


Assuntos
Acidentes por Quedas , Dispositivos Eletrônicos Vestíveis , Acidentes por Quedas/prevenção & controle , Idoso , Marcha , Humanos , Estudos Retrospectivos , Caminhada
16.
Artigo em Inglês | MEDLINE | ID: mdl-34281139

RESUMO

Falls are common among persons with late effects of polio (LEoP), which may lead to fear of falling and activity avoidance in everyday life. Here, we assessed the occurrence of fall-related activity avoidance among persons with LEoP and explored how these experiences influenced daily life. Fourteen ambulatory persons (seven women; mean age 70 years) with LEoP participated. They responded to the modified Survey of Activities and Fear of Falling in the Elderly (mSAFFE) and participated in individual interviews, which were analysed by systematic text condensation. Each quotation was deductively analysed from its representation with regard to mSAFFE. We found that many persons often avoided activities related to standing and walking, for example, taking a bath, performing household chores, walking outdoors, attending social events if there were stairs in the building and travelling by public transport, due to fear of falling, increased pain and fatigability. To facilitate the performance of daily activities participants expressed that strategic thinking and aids were important to use. In conclusion, fall-related activity avoidance is common in persons with LEoP, which negatively influence daily life and social participation. To increase daily functioning in this population, fall-related activity avoidance should be included in a multifaceted fall management program.


Assuntos
Acidentes por Quedas , Poliomielite , Acidentes por Quedas/prevenção & controle , Atividades Cotidianas , Idoso , Medo , Feminino , Humanos , Caminhada
17.
Rev Bras Enferm ; 74Suppl 2(Suppl 2): e20200904, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34231780

RESUMO

OBJECTIVE: to identify scientific productions on nursing care related to fall risk prevention among hospitalized elderly people. METHODS: an integrative literature review from 2015 to 2019 in the PubMed/MEDLINE, Scopus, Web of Science, LILACS, BDENF, SciELO and CINAHL databases, in Portuguese, English and Spanish. The keywords were elderly, hospitalization, accidents due to falls, nursing care. RESULTS: thirty-three publications were analyzed. The synthesis of the studies resulted in the categories: Clinical nursing assessments to prevent falls among hospitalized elderly people; Fall risk factors for elderly people; Fall risk prevention strategies for elderly people. FINAL CONSIDERATIONS: it was found that the scientific knowledge produced on nursing care related to fall risk prevention for hospitalized elderly people evidences the clinical assessment, risk factors and strategies such as nursing care, contributing to foster self-care behavior and promotion security for elderly people.


Assuntos
Acidentes por Quedas , Cuidados de Enfermagem , Acidentes por Quedas/prevenção & controle , Idoso , Hospitalização , Humanos , Fatores de Risco
18.
Adv Gerontol ; 34(2): 300-305, 2021.
Artigo em Russo | MEDLINE | ID: mdl-34245515

RESUMO

The article presents characteristics of the dynamic component of postural balance and its features in elderly women with postural deficit. The assessment of the dynamic component of postural balance was performed on a computer stabilometric complex «Balance Manager¼ in women aged 60-74 with and without a history of falls. The most significant changes are manifested by an increase in the time of implementation and a decrease in the effectiveness of performing complex motor acts. In the factor structure of indicators of the dynamic component of postural balance in postural deficit, the leading factor is the factor that characterizes speed and power indicators in the implementation of complex motor acts. The study of the dynamic component of postural balance is recommended to be included in the comprehensive diagnosis of walking disorders in the elderly and in evaluating the effectiveness of treatment and rehabilitation measures.


Assuntos
Acidentes por Quedas , Equilíbrio Postural , Acidentes por Quedas/prevenção & controle , Idoso , Feminino , Humanos , Caminhada
19.
Sr Care Pharm ; 36(8): 363-364, 2021 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-34311813

RESUMO

The July issue of The Senior Care Pharmacist featured two excellent articles about the essential role of pharmacists in reducing falls and falls-risk factors among older people. It is up to senior care pharmacists to contribute to a rational and balanced discussion of pharmacotherapy options, which are best achieved through a multidisciplinary approach where the pharmacist?s unique and important input can be integrated into the treatment plan.


Assuntos
Acidentes por Quedas , Farmacêuticos , Acidentes por Quedas/prevenção & controle , Idoso , Humanos , Fatores de Risco
20.
J Gerontol Nurs ; 47(8): 29-35, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34309452

RESUMO

Fear of falling is common among older adults with spinal diseases. The purpose of the current study was to examine fear of falling and related factors in this population. A total of 138 participants were recruited and completed survey questionnaires along with the Timed Up & Go Test. Participants were 73.7 years old on average, 52% had fall experience, and 56% were taking more than four medications. Multivariate regression analyses revealed that the use of sleeping pills, residence type, pain, activities of daily living, gait ability, and gait efficacy were significant predictors of fear of falling. Findings suggest that a fall prevention intervention for older adults with spinal diseases should include pain management, functional improvement, and gait rehabilitation with a focus on gait performance and gait efficacy. In addition, it is important to improve living environment and sleep hygiene, which are conducive to falls. [Journal of Gerontological Nursing, 47(8), 29-35.].


Assuntos
Acidentes por Quedas , Doenças da Coluna Vertebral , Acidentes por Quedas/prevenção & controle , Atividades Cotidianas , Idoso , Medo , Marcha , Humanos
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