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Objetivo: establecer el perfil de fragilidad de las personas mayores, residentes en la zona urbana de Bucaramanga, Medellín, Pereira, Popayán y Santa Marta en Colombia, en tanto que las personas de 60 o más años frágiles son cada vez más importantes en la atención primaria, debido al cambio demográfico. Métodos: estudio transversal de 2506 participantes, seleccionadas a través de muestreo bietápico y probabilístico, y clasificados según la escala FRAIL, para medir la fragilidad. Se construyó un modelo de correspondencias múltiples, para definir los perfiles de fragilidad-prefragilidad y no fragilidad. Resultados: la prevalencia de personas con fragilidad es del 9.6 %, y prefragilidad del 60,8 %. Estas condiciones se asociaron de manera independiente con el sexo femenino, la depresión, la dependencia para las actividades básicas cotidianas y las caídas. Igualmente, el perfil de los prefrágiles y frágiles está dado por la discapacidad, las caídas, el alto riesgo nutricional, la inactividad física, ser mujer y el estrato socioeconómico bajo. Conclusión: las personas mayores frágiles y prefrágiles tienen características modificables (discapacidad, caídas, riesgo nutricional, inactividad física y estrato socioeconómico), a fin de reducir la prevalencia de esta condición. Se recomienda que las personas mayores puedan ingresar a programas de atención en diferentes niveles, con el fin de contribuir a los procesos de envejecimiento saludable.

Objective: To establish the frailty profile of older people living in the urban areas of Bucaramanga, Medellín, Pereira, Popayán and Santa Marta in Colombia, as frail people aged 60 or over are increasingly important in primary care due to demographic change. Methods: Cross-sectional study of 2506 participants, selected through two-stage probabilistic sampling, and classified according to the FRAIL scale, to measure frailty. A multiple correspondence model was built to define the frailty-pre-frailty and non-frailty profiles. Results: The prevalence of people with frailty is 9.6%, and pre-frailty is 60.8%. These conditions were independently associated with female sex, depression, dependence for basic daily activities and falls. Similarly, the profile of pre-frail and frail elderly is determined by disability, falls, high nutritional risk, physical inactivity, being a woman and low socioeconomic status. Conclusion:Frail and pre-frail elderly people have modifiable characteristics (disability, falls, nutritional risk, physical inactivity and socioeconomic status), in order to reduce the prevalence of this condition. It is recommended that elderly people be able to enter care programs at different levels, in order to contribute to healthy aging processes.

Objetivo: estabelecer o perfil de fragilidade dos idosos residentes na área urbana de Bucaramanga, Medellín, Pereira, Popayán e Santa Marta na Colômbia, enquanto as pessoas frágeis com 60 anos ou mais são cada vez mais importantes na atenção primária, devido às mudanças demográficas. Métodos: estudo transversal com 2.506 participantes, selecionados por meio de amostragem probabilística e em dois estágios , e classificados segundo a escala FRAIL, para mensuração de fragilidade. Foi construído um modelo de correspondência múltipla para definir os perfis fragilidade- pré-fragilidade e não fragilidade.Resultados:a prevalência de pessoas com fragilidade é de 9.6% e a pré-fragilidade é de 60,8%. Essas condições foram independentemente associadas ao sexo feminino, à depressão, à dependência para atividades básicas da vida diária e às quedas. Da mesma forma, o perfil dos pré-frágeis e frágeis é dado por deficiência, quedas, alto risco nutricional, sedentarismo, ser mulher e baixo nível socioeconômico . Conclusão: idosos frágeis e pré-frágeis apresentam características modificáveis (incapacidade, quedas, risco nutricional, sedentarismo e nível socioeconômico), a fim de reduzir a prevalência desta condição. Recomenda-se que os idosos possam ingressar em programas de cuidados em diferentes níveis, a fim de contribuir para processos de envelhecimento saudável.

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La presente investigación pretende evaluar el nivel de cumplimiento de las metas internacionales, que representan el foco principal para la mejora de calidad y seguridad de atención de los pacientes. La seguridad del paciente involucra a todos los estudios, prácticas y acciones promovidas por las instituciones sanitarias para disminuir y eliminar los riesgos de daños innecesarios relacionados con el cuidado de la salud. Metodología: Estudio descriptivo, observacional y transversal. De fuentes primaria y secundaria, Resultados: se abordaron las metas N° 1 la cual consiste en Identificar a los pacientes correctamente y la meta N° 6 la cual se refiere a Reducir el riesgo de lesiones en pacientes como resultado de caídas. En primer lugar, se destaca el cumplimiento en la identificación correcta del paciente y en segunda instancia la mejora del cumplimiento de medidas de prevención de caídas. Conclusión: Esta proximidad de los valores obtenidos genera un aspecto positivo para mejorar la seguridad de los pacientes y que, si bien el cumplimiento de las metas no es el deseado, es cercano al porcentaje planteado. Lo que en definitiva hace a este estudio un antecedente importante en la mejora continua con vista al futuro cercano[AU]

This research aims to evaluate the level of compliance with international goals, which represent the main focus for improving the quality and safety of patient care. Patient safety involves all studies, practices and actions promoted by health institutions to reduce and eliminate the risks of unnecessary harm related to health care. Methodology: Descriptive, observational and transversal study. From primary and secondary sources, Results: goals No. 1 were addressed, which consists of Identifying patients correctly and goal No. 6, which refers to Reducing the risk of injuries in patients as a result of falls. Firstly, compliance with correct patient identification stands out and secondly, improvement in compliance with fall prevention measures. Conclusion: This proximity of the values obtained generates a positive aspect to improve patient safety and that, although the fulfillment of the goals is not as desired, it is close to the proposed percentage. Which ultimately makes this study an important precedent in continuous improvement for the near future[AU]

Esta pesquisa tem como objetivo avaliar o nível de cumprimento das metas internacionais, que representam o foco principal para a melhoria da qualidade e segurança do atendimento ao paciente. A segurança do paciente envolve todos os estudos, e ações promovidas pelas instituições de saúde para reduzir e eliminar os riscos de danos desnecessários relacionados à assistência à saúde. Metodologia: Estudo descritivo, observacional e transversal. De fontes primárias e secundárias, dependendo do indicador e do objetivo para o qual a medição está sendo realizada. Resultados: Nesta pesquisa serão abordadas as metas nº1, que consiste em Identificar corretamente os pacientes e a meta nº 6, que es Reduzir o risco de lesões nos pacientes em decorrência de quedas. Foi realizado nos dois locais. Em primeiro lugar, destaca-se o cumprimento da correta identificação do paciente e, em segundo lugar, a melhoria no cumprimento das medidas de prevenção de quedas. Conclusão: Essa proximidade dos valores obtidos gera um aspecto positivo para melhorar a segurança do paciente e que, embora o cumprimento das metas não seja o desejado, está próximo do percentual proposto. O que acaba por tornar este estudo um precedente importante na melhoria contínua com vista ao futuro próximo.

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OBJECTIVE: This study aimed to evaluate kinesiophobia levels in patients with osteoporosis compared to healthy controls and investigate the associations with pain, depression, anxiety, fear of falling, and quality of life. METHODS: The study involved 60 postmenopausal osteoporosis patients and 60 healthy controls aged 50 years and above. Kinesiophobia was assessed using the Tampa Scale for Kinesiophobia, while quality of life, psychological symptoms, and fear of falling were evaluated using the Quality of Life Questionnaire of the European Foundation for Osteoporosis, Hospital Anxiety and Depression Scale, and Tinetti Falls Efficacy Scale. RESULTS: Kinesiophobia levels were significantly higher in the osteoporosis group compared to controls (p<0.05). Positive correlations were observed between kinesiophobia and Falls Efficacy Scale (r=0.278, p=0.002), as well as with Quality of Life Questionnaire of the European Foundation for Osteoporosis physical function scores (r=0.185, p=0.043). No significant relationship was found between kinesiophobia and depression or anxiety scores. CONCLUSION: Kinesiophobia is notably higher in osteoporosis patients compared to healthy individuals, correlating with an increased fear of falling and reduced physical function. Early identification and management of kinesiophobia are essential to prevent reduced physical activity and associated risks, such as decreased bone mineral density and higher fracture risk.

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Community mobility, encompassing both active (e.g., walking) and passive (e.g., driving) transport, plays a crucial role in maintaining autonomy and social interaction among older adults. This study aimed to quantify community mobility in older adults and explore the relationship between GPS- and accelerometer-derived metrics and fall risk. METHODS: A total of 129 older adults, with and without a history of falls, were monitored over an 8 h period using GPS and accelerometer data. Three experimental conditions were evaluated: GPS data alone, accelerometer data alone, and a combination of both. Classification models, including Random Forest (RF), Support Vector Machines (SVMs), and K-Nearest Neighbors (KNN), were employed to classify participants based on their fall history. RESULTS: For GPS data alone, RF achieved 74% accuracy, while SVM and KNN reached 67% and 62%, respectively. Using accelerometer data, RF achieved 95% accuracy, and both SVM and KNN achieved 90%. Combining GPS and accelerometer data improved model performance, with RF reaching 97% accuracy, SVM achieving 95%, and KNN 87%. CONCLUSION: The integration of GPS and accelerometer data significantly enhances the accuracy of distinguishing older adults with and without a history of falls. These findings highlight the potential of sensor-based approaches for accurate fall risk assessment in community-dwelling older adults.

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This study estimated the association between hearing perception over time and the occurrence of falls among older adults during the COVID-19 pandemic. This is a longitudinal study, with data from the third wave of household interviews (2017/2019) and the fourth wave of telephone interviews from the EpiFloripa Idoso study (2021/2022), a population-based cohort with older adults aged 60 years or older, carried out since 2009 in the city of Florianópolis, state of Santa Catarina, Brazil. Fall event in the last year was the dependent variable in this study, while the perception of hearing over time was the independent variable. Logistic regression analysis was performed to identify the relation of the perception of hearing loss between the third and fourth waves of the study and the occurrence of falls. A total of 289 older adults participated in the study, mostly females (69.1%), aged 70 to 79 years (53.4%), and with 12 or more years of schooling (41%). Older adults who remained with impaired hearing were 181% more likely (OR = 2.81; 95%CI: 1.08-7.34) of falling, when compared to those without impaired hearing. In conclusion, this study results provide evidence of the association between hearing difficulty in older people and a higher chance of falls. Outcomes suggest the need for interventions aimed at auditory rehabilitation. Furthermore, an integrated and multifaceted approach is essential to mitigate the risks of falls in this age group, considering both hearing needs and fall prevention measures.

O objetivo deste estudo foi estimar a associação entre a percepção da audição ao longo do tempo e a ocorrência de quedas entre idosos durante a pandemia de COVID-19. Tratou-se de um estudo longitudinal, com dados da terceira onda de entrevistas domiciliares (2017/2019) e da quarta onda de entrevistas por telefone do estudo EpiFloripa Idoso (2021/2022), uma coorte de base populacional com idosos de 60 anos ou mais, realizada desde 2009 na cidade de Florianópolis, Santa Catarina, Brasil. A ocorrência de queda no último ano foi definida como a variável dependente neste estudo, enquanto a percepção da audição ao longo do tempo foi a variável independente. Foi realizada análise de regressão logística para identificar a relação entre a percepção da perda auditiva entre a terceira e a quarta onda do estudo com a ocorrência de quedas. Participaram do estudo 289 idosos, sendo a maioria do sexo feminino (69,1%), na faixa etária de 70 a 79 anos (53,4%) e com 12 anos ou mais de escolaridade (41%). Pessoas idosas que se mantiveram com dificuldade auditiva apresentaram 181% mais chance (OR = 2,81; IC95%: 1,08-7,34) de sofrer queda, quando comparado com as pessoas sem dificuldade auditiva. Em conclusão, os resultados deste estudo fornecem evidências da associação entre dificuldade auditiva em pessoas idosas e maior chance de quedas. Esses resultados sugerem a necessidade de intervenções que visem a reabilitação auditiva. Ainda, uma abordagem integrada e multifacetada é fundamental para mitigar os riscos de quedas nesse grupo etário, considerando tanto as necessidades auditivas quanto as medidas de prevenção de quedas.

El objetivo de este estudio fue estimar la asociación entre la percepción auditiva a lo largo del tiempo y la incidencia de caídas entre ancianos durante la pandemia de COVID-19. Se trata de un estudio longitudinal, con datos de la tercera ola de entrevistas en hogares (2017/2019) y de la cuarta ola de entrevistas telefónicas del estudio EpiFloripa Anciano (2021/2022), una cohorte de base poblacional con personas de 60 años o más, realizado desde el 2009 en la ciudad de Florianópolis, Santa Catarina, Brasil. La incidencia de caídas en el último año se definió como la variable dependiente en este estudio, mientras que la percepción auditiva a lo largo del tiempo fue la variable independiente. Se realizó un análisis de regresión logística para identificar la relación entre la percepción de la pérdida auditiva entre la tercera y la cuarta ola del estudio y la incidencia de caídas. Participaron en el estudio 289 ancianos, la mayoría del sexo femenino (69,1%), con edades entre 70 y 79 años (53,4%) y con 12 años o más de escolaridad (41%). Los ancianos que permanecieron con dificultades auditivas tuvieron 181% más probabilidades (OR = 2,81; IC95%: 1,08-7,34) de sufrir una caída, en comparación con las personas que permanecieron sin dificultades auditivas. En conclusión, los resultados de este estudio aportan evidencias de la asociación entre la dificultad auditiva en ancianos y una mayor probabilidad de sufrir una caída. Estos resultados sugieren la necesidad de intervenciones dirigidas a la rehabilitación auditiva. Además, es esencial un enfoque integrado y multifacético para mitigar los riesgos de caídas en este rango de edad, teniendo en cuenta tanto las necesidades auditivas como las medidas para prevenir las caídas.

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BACKGROUND: Falls are known to cause injuries ranging from minor to severe, resulting in local or systemic lesions. Addressing prognostic factors associated with falls is crucial for preventing this adverse event through the implementation of patient care protocols. This study aimed to explore the epidemiological, clinical, and pharmacological prognostic factors influencing falls in adult and elderly patients, assessing the timing and impact of these factors using survival curve analysis. METHODS: A retrospective observational cohort study included 176 hospitalized patients experiencing falls, categorized into adults (<60 years) and elderly (≥60 years). Binomial tests and logistic regression assessed variable associations, while Kaplan-Meier curves and Cox proportional hazards models analyzed survival. RESULTS: Overall, 25.9 % of adults and 33.3 % of the elderly experienced some form of injury (minor or moderate). Patients were alone during the fall in 77.6 % of cases for those under 60, compared to 50 % for those 60 and older (p < 0.001). Falls from own height were the most common, occurring in 46.6 % of patients under 60 years and 66.7 % of elderly patients (p = 0.011). Among adults under 60, factors such as past alcohol history (p = 0.0276), falling alone (p = 0.0002), benzodiazepine use (p = 0.0001), antiarrhythmic/antihypertensive medication (p = 0.0005), and antipsychotics (p = 0.0001) were significantly associated with falls. In the elderly, significant factors included falling from one's own height (p = 0.0112), muscle weakness (p = 0.0183), gait disorders (p = 0.0443), vasodilators (p = 0.0107), antihistamines (p = 0.0003), and hypoglycemic agents (p = 0.0041). Survival curve analysis indicated women under 60 had a worse prognosis for falls compared to elderly women (p = 0.038). For the elderly, opioid use (p = 0.045) and muscle weakness (p = 0.037) represented poor prognostic factors compared to adults under 60. In Cox regression, only female sex in patients under 60 showed a higher risk (HR=1.47) compared to women over 60 (p = 0.0014). Although not significant in multivariate analysis, muscle weakness (p = 0.066) and opioid use (p = 0.0545) had proportional hazards of 1.37 and 1.12, respectively. CONCLUSION: Female sex indicated poorer prognosis in <60 s, while opioids and muscle weakness were concerning for the elderly. These findings emphasize the need for tailored care protocols to stratify patient fall risk and prognosis during hospitalization and develop effective preventive strategies in healthcare.

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BACKGROUND: A core component of older adult health care assessment includes identifying fall risk, which also includes identifying those with subtle balance deficits. OBJECTIVE: To compare body displacement of the Center of Pressure (CoP) and time held during the balance test. Also, to examine whether balance tests at baseline can predict falls after 6 months. METHODS: A longitudinal study with 153 community-dwelling older adults, between 60-89 years old. Anteroposterior (AP) and mediolateral (ML) amplitude and velocity CoP displacements were assessed in four upright positions using a force platform: double-leg, semi-tandem, tandem, and single-leg stances, with a maximum duration of 30 s each. Adjusted repeated measures ANOVA were used to compare the differences among the balance positions. Comparisons between males and females were also conducted. Logistic regression adjusted for confounders was performed to verify whether upright balance tests can predict future falls. RESULTS: As the base of support narrows, body sway increases. A decrease in stance time was observed across the balance stages, i.e., double-leg/semi-tandem versus tandem versus single-leg stances. The mean duration held in the single-leg stance was 14.8 s and for tandem was 22.2 s. Similar stance durations were observed for double-leg and semi-tandem stances. Males were able to maintain balance positions longer than females even with greater CoP displacement. ML amplitude of CoP displacement and the time held during tandem and single-leg positions were able to predict falls after 6 months (p < 0.05). CONCLUSION: In clinical practice in which only stance time is recorded, it is possible to interchangeably use the double-leg or semi-tandem stance. To identify early signs of imbalance, we suggest setting a time limit for the balance test equal to or greater than 23 s, as 10 s appear to be insufficient to detect subtle balance deficits. The time maintenance on tandem and single-leg positions was able to predict future falls.

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This cross-sectional study examines treatment received for falls from a section of the US-Mexico border wall with a focus on emergency medical services activation and type of treatment.

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OBJECTIVE: To analyze the effect of an improvement project on the implementation of Basic Patient Safety Protocols in Brazilian public hospitals. METHOD: This is an intervention study aimed at comparing measurements before-and-after the implementation of an improvement project in 35 public hospitals across three Brazilian regions, between July 2021 and September 2023. The intervention consisted of a set of activities to support the implementation of six Basic Patient Safety Protocols, with semimonthly collection of indicators. The data were analyzed using descriptive statistics, with the use of trend charts to demonstrate improvements, considering the first seven collection points as the baseline for comparisons. RESULTS: After the intervention period, all Patient Safety Protocols showed improvements in their indicators. The prevention of falls and safe surgery stood out, with a 73% reduction in prevalence and a 675% increase in adherence to the safe surgery checklist, respectively, compared to the group of hospitals. CONCLUSION: The improvement project had a positive effect on patient safety in the institutions, evidenced by the improvement in indicators of all analyzed protocols.

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INTRODUCTION: In-hospital falls represent significant health and economic concerns, but previous studies regarding the economic cost of falls do not account for other cofounders (comorbidities and clinical aspects) in this cost evaluation. AIM: The aim of this study is to analyse the cost of in-hospital falls comparing those who had falls to nonfalls patients while accounting for several risk factors associated with falls. METHODS: Data were collected from January 2020 to December 2022, in a private hospital in Brazil. The sample was divided into two groups: one with patients who fell and the other with nonfallers on a 1:2 ratio, and these groups were matched to avoid confounding variables. RESULTS: The median cost for patients who experienced falls was US$7520.26 compared to US$6144.24 for those without falls (p < 0.01). This trend was especially marked in men aged 20-40 who suffered falls and showed a significantly elevated median cost of US$29 722.02 distinguishing them from those without falls with a median cost of US$1179.48 (p < 0.01). CONCLUSION: Hospital falls significantly increase financial costs compared to nonfall cases, irrespective of comorbidities, length of stay or case-mix variations. The findings recommend a universal precautions approach to fall prevention in hospitals, targeting all hospitalised patients to effectively minimise the economic burden associated with in-hospital falls.

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OBJECTIVE: To describe the occurrence of domestic accidents due to children's falls. METHOD: This is a descriptive, cross-sectional study carried out with 181 parents and/or other caregivers of children aged between 2 and 5 years. Data were collected in March and April 2024, through a questionnaire containing 23 items, which were subjected to descriptive analysis. RESULTS: The sample was composed mostly of mothers (93.9%), with a predominance of female children (52.2%), and 86.2% of infants suffered some type of fall at home. Falls from bed (56.4%), hitting the head/face (52.6%), mainly causing cuts/lacerations (16%), were predominant. CONCLUSION: The results show that it is essential to raise awareness among families about the imminent responsibility of protecting children from domestic accidents, protecting them from injuries that can be avoided through changes in behavior and adopting a proactive stance by intervening in anticipation of risk factors.

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OBJECTIVE: This study aimed to investigate the locomotor behavior of older adults with and without a history of falls as they avoided obstacles with different physical characteristics. METHODS: Twenty-one older adults participated in this study. The group was divided into higher risk of falling (n = 10) and lower risk of falling (n = 11). The following conditions were carried out: (1) walking and avoiding a solid obstacle and (2) walking and avoiding a fragile obstacle. RESULTS: Older adults at higher risk of falling had worse performance during the obstacle approach phase. Both groups performed worse when avoiding the fragile obstacle than when avoiding the solid obstacle. Older adults at higher risk of falling had their feet closer when avoiding the obstacle, and both groups raised their limbs higher to avoid a fragile obstacle. Older adults at higher risk of falling were closer to obstacles after avoiding them. CONCLUSION: For the participants in this study, the physical characteristics of the obstacle did not interfere with the locomotor performance of older adults during obstacle avoidance. This study found that older adults at higher risk of falls modulated their locomotor pattern before avoiding the obstacles, presenting lower velocity, shorter step length, and greater step width compared with older adults at lower risk of falling.

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OBJECTIVE: Falls are a serious cause of morbidity and mortality among older people. One of the underlying causes of falls is dehydration. Therefore, ultrasonography has become an essential tool for evaluating volume status in the emergency department. However, the effect of volume status on falls in older people has not been evaluated before. The aim of this study was to determine the relationship between the inferior vena cava collapsibility index and the injury severity score in older patients who presented with fall-related injuries to the emergency department. METHODS: A total of 66 patients were included in the study. The injury severity score was used as the trauma severity score, and the Edmonton Frail Scale was used as the frailty scale. Volume status was evaluated with inferior vena cava collapsibility index. The primary outcome measure was defined as the correlation between inferior vena cava collapsibility index and injury severity score. Secondary outcome measures were defined as the effect of inferior vena cava collapsibility index and injury severity score on hospitalization and mortality. RESULTS: There was no significant correlation between injury severity score and inferior vena cava collapsibility index (p=0.342). Neither inferior vena cava collapsibility index nor injury severity score was an indicator of the mortality of these patients. However, injury severity score was an indicator of hospitalization. The mean Edmonton Frail Scale score was an indicator of mortality among older people who experienced falls (p=0.002). CONCLUSION: Inferior vena cava collapsibility index cannot be used to predict trauma severity in older patients who have experienced falls admitted to the emergency department.

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This work aims at proposing an affordable, non-wearable system to detect falls of people in need of care. The proposal uses artificial vision based on deep learning techniques implemented on a Raspberry Pi4 4GB RAM with a High-Definition IR-CUT camera. The CNN architecture classifies detected people into five classes: fallen, crouching, sitting, standing, and lying down. When a fall is detected, the system sends an alert notification to mobile devices through the Telegram instant messaging platform. The system was evaluated considering real daily indoor activities under different conditions: outfit, lightning, and distance from camera. Results show a good trade-off between performance and cost of the system. Obtained performance metrics are: precision of 96.4%, specificity of 96.6%, accuracy of 94.8%, and sensitivity of 93.1%. Regarding privacy concerns, even though this system uses a camera, the video is not recorded or monitored by anyone, and pictures are only sent in case of fall detection. This work can contribute to reducing the fatal consequences of falls in people in need of care by providing them with prompt attention. Such a low-cost solution would be desirable, particularly in developing countries with limited or no medical alert systems and few resources.

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BACKGROUND: Acknowledging the relationship between postural control and muscle strength in lower limbs is important to find persons with high fall risk and to design fall prevention exercise programs. OBJECTIVE: To investigate the connection between knee muscle strength, semi-static postural balance, and functional mobility in irregularly active older women. METHODS: One hundred and ten older women aged 60 to 85 years underwent a semi-static postural balance test in a force and functional mobility measured by Timed Up & Go (TUG) with and without Cognitive Tasks (CT). Muscle strength of the knee was assessed by isokinetic dynamometry at 60°/s. RESULTS: A negative correlation between the functional mobility (TUG with and without CT) and the muscular strength of the knee was observed. Regarding semi-static balance, there was a low negative correlation with peak torque corrected for body weight of the extensors with the following variables with eyes open: Mean Velocity Dominant limb (D) (r = -0.19; p = 0.03); and anteroposterior range Non-Dominant limb (ND) (r = -0.19; p = 0.04); with eyes closed: mediolateral range ND limb (r = -0.21; p = 0.02) and Mean Velocity ND limb (r = -0.18; p = 0.05). CONCLUSIONS: This study found that better functional mobility was associated with greater muscle strength in the knee in elderly women. There were weak negative correlations between knee extensor strength and some measures of semi-static postural balance, suggesting that different motor control actions are required to maintain semi-static balance and mobility. In the case of semi-static balance, a lower level of muscle response is required than in functional mobility.

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BACKGROUND AND PURPOSE: Assessing lower limb strength, balance, and fall risk are crucial components of rehabilitation, especially for the older adult population. With the growing interest in telehealth, teleassessment has been investigated as an alternative when in-person assessments are not possible. The Five Times Sit-to-Stand test (5TSTS) provides a quick measure of balance during chair transfers, muscle power, endurance, and the hability to change and maintain body position, and is highly recommended by guidelines. However, the literature is unclear about the viability and safety of teleassessment using the 5TSTS in older adults with and without Parkinson's disease (PD). This study aimed to evaluate the reliability of teleassessment using the 5TSTS and to determine its feasibility and safety for older adults with and without PD. METHODS: This cross-sectional study included older adults with and without PD who were evaluated remotely through a videoconference platform. To ensure effective and comprehensive instructions for the test, we developed a guideline called OMPEPE (an acronym for: Objective; Materials; Position-Start; Execution; Position-End; Environment). We assessed the 5TSTS intra- and inter-rater reliability by comparing scores obtained from the same examiner and from different examiners, respectively. Participants and examiners completed online surveys to provide information about feasibility and safety. RESULTS: Twelve older adults with PD and 17 older adults without PD were included in this study (mean ages 69.0 and 67.6 years, respectively). Based on the participants' perspectives and the absence of adverse effects, teleassessment using the 5TSTS is feasible and safe for older adults with and without PD. Excellent intra- and inter-rater reliability (intraclass correlation coefficient >0.90) was found for all measurements of the 5TSTS. DISCUSSION: This study demonstrated the feasibility, safety, and reliability of teleassessment using the 5TSTS. The guidelines developed may help health professionals minimize barriers and safely conduct an online assessment that includes a physical test such as the 5TSTS in older adults with or without PD. In addition to addressing technological barriers, the OMPEPE guideline might ensure the optimal execution of evaluations. CONCLUSION: Teleassessment using the 5TSTS for older adults with and without PD is feasible and safe. Both synchronous (i.e., live) and asynchronous (i.e., recorded) online 5TSTS tests demonstrate excellent intra- and inter-rate reliability.

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This study analyzed hospital safety and the risk of falls in elderly people in a university hospital in Brazil. The Morse Falls Scale was used to stratify the risk of falls in 45 hospitalized elderly individuals, and two checklists were used to analyze the hospital environment. The analysis was based on the Chi-square test and multiple regression. The moderate risk of falls was predominant (51.1%). The variable age group (p-value = 0.024) showed statistical evidence of association with the risk of falls. However, the multiple regression analysis showed no difference between the age groups and the risk situation for falls. The hospital wards showed an adequate arrangement of furniture, but some aspects had inadequacies, such as objects in the corridors, non-functional bells in some beds, inadequacy of the toilet bowls in terms of the recommended height, and an absence of non-slip flooring and the support bar in some bathrooms. In conclusion, the moderate risk of falls among the elderly and the adequacy of the hospital environment to technical standards were evident with the exception of failures in the emergency communication system and sanitary installation.

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INTRODUCTION: Falls in older adults are a common and serious threat to health and functional independence. It can cause psychological distress, inability to participate in activities of daily living, brain injury, fractures, and even death. The aim was to analyze the psychometric properties of the self-assessed fall risk scale (FRS) that measures the risk of falls in older adults in a central region of Chile, as well as to verify the concurrent validity against functional fitness tests. MATERIALS AND METHODS: A descriptive cross-sectional study was carried out in 222 older adults (OA) [34 males and 188 females] with an age range of 65 to 85 years. The 13-item self-perceived fall risk scale (FRS) was validated. Anthropometric measures (weight, height and waist circumference) were assessed. Five functional fitness tests were measured (right and left hand grip strength, biceps curl, up-and-go, agility and 6-minute walk test). Validation was performed by construct validation [(exploratory factor analysis (EFA) and confirmatory factor analysis (CFA)] and concurrent validity. RESULTS: The EFA revealed 4 factors in the FRS scale [1: fear of falling (variance 27.1%), 2: use of assistive devices (variance 10.6%), 3: loss of sensation (variance 9.3%), and 4: limited mobility (variance 8.3%)]. Factor loadings ranged from ∼ 0.50 to 0.83 across the 4 components. The Kaiser-Meyer Olkin sample adequacy test (KMO) reflected adequate adequacy (KMO = 0.79, chi-square (X2) = 498.806, gl = 78, p = 0.00). The CFA showed a satisfactory final fit [chi-square (X2) = 126.748, Root mean squared error of approximation (RMSEA) = 0.042, Tucker-Lewis Index (TLI) = 0.946, Comparative fit index (CFI) = 0.935 y Normed fit index (NFI) = 0.90. The relationships between the FRS scale and functional fitness tests (right and left hand grip strength, biceps curl, up-and-go, agility and 6-minute walk test) ranged from low to moderate (r= -0.23 to 0.41). CONCLUSION: The FRS scale showed acceptable validity and reliability in older adults in central region of Chile. It is expected that this scale will be useful for assessing fall risk in clinical and epidemiological settings in the aging Chilean population.

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The present study aimed to determine whether a remotely delivered intervention, based on an individual case management, can reduce falls and their consequences in community-dwelling older people with a history of multiple falls. In this randomized controlled trial, 32 participants were randomized to the intervention group, which comprised a 16-week case management program involving a multidimensional assessment, targeted interventions according to the identified fall risk factors, and development of individualized care plans. The intervention was performed by trained gerontologists, under weekly supervision of professionals with experience in falls. The control group (n = 30) received usual care. Falls were monitored over 12 months with monthly falls calendars and telephone calls. Remotely delivered case management presented an 82 % uptake of recommendations. There was a trend toward a reduced fall incidence in the intervention vs control group, with lower fall, fall injury and fracture rates in the intervention group compared with the control group at both the 16-week and 12-month time-points, with the difference statistically significant for injurious fall rates at 12 months - IRR=0.18 (95 % CI = 0.04 to 0.74).

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OBJECTIVE: The objective was to describe the social, environmental, and cultural adaptations to an existing falls program and assess acceptability and preliminary effectiveness of the program in reducing fear, reducing falls, and improving function among individuals poststroke in Guyana. METHODS: A quasi-experimental pilot study with a pretest/posttest in-group design was developed through a collaboration of researchers in Guyana and the US. Participants took part in the falls prevention program for 8 weeks. Outcome measures included a 10-m walk test, the Five Times Sit to Stand Test, and subjective questionnaires for falls incidence and balance confidence at the beginning and end. RESULTS: Twenty participants completed the study. One participant experienced medical complications, and their data were excluded from analysis. Fifteen participants (78.9%) demonstrated improvements in comfortable and fast walking speed. Twelve participants completed the Five Times Sit to Stand Test. Eleven (91.67%) improved their time at the posttest, with 9 (81.8%) demonstrating a clinically important improvement. Nineteen participants had sustained at least 1 fall prior to the study. Only 1 participant reported a fall during the program. Initially, the majority of participants (11/19) were very concerned about falling. At the end, only 1 was very concerned about falling, and the majority (15/19) were not concerned at all. Posttest surveys of participants indicated acceptability of the program. CONCLUSIONS: This pilot program helped reduce fall risk and improve confidence, gait speed, and community mobility of the study participants. Future research at other rehabilitation departments in Guyana would help increase the generalizability of the program. IMPACT: The program can be used clinically by physical therapists in Guyana, both in departments and as a home program. Shared knowledge and experience of researchers considering research evidence and the environmental, social, and economic conditions of people living in Guyana were important in developing an effective program.