Falls Efficacy Scale Scores Research Articles

Patient referral pathways to leisure providers: impacts on physical activity and falls risk

Abstract Background Physical activity aids prevention and management of noncommunicable diseases. Yet many UK adults, particularly those with long-term health conditions, do not meet recommended activity levels. In 2021, West Suffolk Foundation Trust commissioned local leisure provider Abbeycroft to offer 24 week tailored physical activity programs as part of respiratory and frailty patient pathways. Objectives Evaluation of activity and outcome data for all 1670 individuals referred between January - December 2023 to determine future commissioning decisions. Results 256 participants had completed a 24 week pathway by the time of analysis. Compared to baseline, they demonstrated statistically significant (p < 0.05) self-reported improvements on the Short Warwick Edinburgh Mental Well-being Scale (median 25 to 27) amongst 68.9% of participants; and on the self-reported International Physical Activity Questionnaire 62.1% reduced time spent sitting (average 436 to 300 minutes/ week), 75% increased metabolically active minutes (average 955 to 2632 minutes/week) and the proportion of participants with a low (inactive) score decreased by 61%. Of 40 frailty patients, 87.5% lowered their self-reported Short Falls Efficacy Scale Score (14.6 to 10.4) and observed Timed Get up and Go (13.55 to 9.53 seconds), indicative of moving from a higher risk to lower falls risk (p < 0.05). 24 week retention exceeded 80% for all ages except 16-20 years. 17.8% of participants were >75 years. Lessons Both pathways have been recommissioned and new tailored pathways for Parkinson’s disease, COPD and cancer are planned. This partnership working is a sustainable, integrated way to embed prevention in the community but needs time to build relationships and streamline data sharing. Key messages • Hospital and community referral pathways to leisure providers significantly improve patient well-being, physical activity and falls risk. • These pathways are affordable, adaptable across conditions and show high retention.

Consolidating Integrated Care: A Joint Falls Prevention Initiative between Community and Hospital Based Physiotherapy Services

Abstract Background Physiotherapists from Primary Care, Integrated Care Programme for Older Persons (ICPOP) and hospital-based Frailty Intervention Team services came together to establish a community working group with the aim of reducing the incidence of falls of those in their collective catchment area. The agreed objective being to pilot a 6 week falls prevention initiative between community and hospital-based services. Methods 7 Physiotherapists across 3 services formed a community working group. A 6-week physiotherapy led, multifaceted intervention program involving exercise, education and an opportunity for socializing was developed. The class was accessible to persons over the age of 65 years who had or were at risk of falling. Participants were recruited from the caseloads of the physiotherapists involved. Objective assessments of gait speed, grip strength and balance were carried out via hand grip dynamometry, Timed Up and Go (TUAG) and Short Physical Performance Battery (SPPB). Subjective measures of participant’s quality of life were assessed via the EQ 5D 5L, Falls Efficacy Scale (FES) and Sarc-F. On completion of the intervention participants were retested. Results 10 participants were recruited to the pilot from both community and hospital based, out-patient services. Over 80% of participants attended 4 out of 6 sessions. Participants grip strength improved by 3.4kg, TUAG by 6.43% (1.03 seconds) and SPPB by 13.3%. EQ 5D 5L scores improved by 15%, FES score improved by 17.81% and SARC-F scores improved by 6%. 40% of participants went on to engage with a follow-on exercise group delivered by the local Sports Partnership. Conclusion Overall, there was a notable improvement in participant’s physical function and quality of life and self-efficacy scores post intervention. This highlights the positive impact of multimodal group interventions, which incorporate both exercise and education to promote self-efficacy within frail older population at risk of falling.

Fall Risk, Postural Control, Muscle Strength and Cognitive Function in Patients with Liver Cirrhosis

Aim: Falls and fall-related injuries are common in liver cirrhosis. Studies mostly focus on minimal hepatic encephalopathy manifested by cognitive dysfunction as a predisposing factor for increased fall risk and postural instability in this population. Our aim was to investigate fall risk, postural control, muscle strength and cognitive function in patients with liver cirrhosis. Materials and Methods: Twenty-four patients and 24 healthy controls were enrolled in the study. Postural control was assessed using a posturographic system. Fall risk was assessed with Falls Efficacy Scale (FES) and Timed Up and Go Test (TUGT). Lower extremity muscle strength was assessed using a dynamometer. Cognitive function was evaluated with Stroop test. Results: Postural sway velocity (PSV) on foam surface eyes open (FSEO), FES score and TUGT duration were higher in patient group (p

Hand Grip Strength as a Predictive Tool for Upper Extremity Functionality, Balance, and Quality of Life in People With Multiple Sclerosis.

Upper extremity strength and function are rarely assessed in routine multiple sclerosis (MS) care. This study aimed to evaluate hand muscle strength and functionality in individuals with MS and investigate correlations with upper extremity function, cognitive status, health-related quality of life (HRQOL), and balance. A cross-sectional study was conducted with 45 consecutive individuals with MS between the ages of 18 and 65. Upper limb motor strength was evaluated using a hand grip strength dynamometer. Upper limb functional capacity was assessed using the Nine-Hole Peg Test (9HPT) and the Duruoz Hand Index (DHI). Balance, coordination, and falls were measured with the Berg Balance Scale (BBS), Falls Efficacy Scale (FES), and the 30-Second Chair Stand Test (30CST). Cognitive function was evaluated using the Montreal Cognitive Assessment instrument and the Symbol Digit Modalities Test. Level of HRQOL was assessed using the self-reported 54-item MS Quality of Life-54 questionnaire. Out of the 45 participants (80% women, mean age 36.6 ± 8.6 years), higher hand grip dynamometer measures were strongly correlated with better DHI, 9HPT, BBS, FES, and 30CST scores. In the regression analysis, a 1-unit increase in dynamometer measures led to a 0.383 increase in overall HRQOL score. This study demonstrates that increased hand grip strength (HGS) is associated with better hand functionality, balance, and HRQOL in individuals with MS. It provides evidence to support more systematic measurement of HGS in the care of people with MS.

Measurement properties of the falls efficacy scale in patients on hemodialysis

BackgroundThe measurement properties of the falls efficacy scale have not been evaluated in patients on hemodialysis. This study determined the inter- and intrarater reliability, standard error of measurement, minimal detectable change, and limits of agreements of the falls efficacy scale in patients on hemodialysis.MethodsA cross-sectional study was conducted with 65 patients (57.5 ± 13.9 years, 63.1% male) on hemodialysis. The fear of falling was assessed by two previously trained raters using the falls efficacy scale. The intraclass correlation coefficient, standard error of measurement, minimal detectable change, and Bland–Altman plot were calculated to assess the inter- and intrarater reliability of the falls efficacy scale.ResultsThe interrater intraclass correlation coefficient was 0.91, and the intrarater intraclass correlation coefficient was 0.78, representing excellent interrater and good intrarater reliability. The standard error of measurement for inter- and intrarater assessments were 2.99 and 4.46, and the minimal detectable change for inter- and intrarater assessments were 9.26 and 12.33, respectively. The interrater mean difference score was 0.26 (95% limits of agreement: − 8.01 to 8.53), and the intrarater mean difference score was − 1.06 (95% limits of agreement: − 13.39 to 11.27).ConclusionIn patients on hemodialysis, the falls efficacy scale showed excellent and good inter- and intrarater reliability, respectively. Additionally, standard error of measurement, minimal detectable change, and limits of agreements of the falls efficacy scale score were satisfactory.

Determining the predictors associated with the difficulty of adaptation to ageing of hospitalized older adults. Difficulty of older adult to aging.

To determine the predictors associated with the difficulty of adaptation to ageing of hospitalized older adults. This descriptive cross-sectional study was carried out in a university hospital between October 2019 and March 2020. The sample consisted of 247 older adults. Research data were collected using a Visual Analogue Scale (VAS), the Falls Efficacy Scale (FES) International, Hospital Anxiety and Depression Scale, and Assessment Scale of Adaptation Difficulty for the Elderly (ASADE). The average age of the patients was 73.90 ± 7.38 years, 22.3% of the patients had a fall history in the last year, and 74.5% had a high fear of falling. The mean FES score of the older adult patients was 35.60 ± 11.09, and the mean VAS score was 1.40 ± 1.36. The mean scores for anxiety was 9.30 ± 2.32 and depression was 10.08 ± 1.96. The mean ASADE total score was 16.56 ± 10.7, role and the self-actualization mode score was 9.05 ± 4.66, interdependence mode score was 2.02 ± 1.02, physiological mode score was 3.00 ± 2.03 and self-concept score was 2.47 ± 2.07. The findings revealed that using walking aids, being single, pain, fear of falling, and anxiety affect adaptation difficulties to aging. Anxiety was found to have an effect on all sub-dimensions of adaptation difficulty to aging. There is a need for further studies to determine the correlation between anxiety and the adaptation difficulties experienced by older adults.

Fear of falling and associated factors in older adults with heart failure.

This study aimed to evaluate the prevalence of fear of falling and associated factors in older adults with heart failure. A prospective, cross-sectional study. The study included 100 geriatric patients who were hospitalised and treated in the cardiology department of our hospital with ventricular ejection fraction (LVEF) lower than 50% for at least 1 year. A series of geriatric assessments were performed by face-to-face interview on the day of admission. Electrocardiography (ECG) and transthoracic echocardiography (TTE) were also performed on the day of admission. The median age of the patients was 72 years, and 72.0% were men. Falls Efficacy Scale scores indicated a fear of falling in 46 (46.0%) of the patients. Charlson Comorbidity Index (CCI) was significantly higher in patients with fear of falling (P < 0.001). Severe depression, severe clinical insomnia, daytime sleepiness, and malnutrition were significantly more frequent among patients with fear of falling. Fear of falling was associated with significantly lower LVEF (P = 0.001). The presence of severe depression increased the risk of fear of falling by 13.97 times (95% CI: 3.064-63.707; P = 0.001), and the presence of daytime sleepiness increased the risk by 3.49 times (95% CI: 1.012-12.037; P = 0.048). A one-unit increase in CCI increased the risk of fear of falling by 1.56 times (95% CI: 1.093-2.238; P = 0.014). Heart failure patients with concomitant depression, sleep disorders, and high comorbidities have greater fear of falling.

Effectiveness of virtual reality-based balance and gait in older adults with fear of movement: A systematic review and meta-analysis.

To summarize the current evidence from randomized controlled trials (RCTs) regarding the effectiveness of Virtual Reality (VR) training and functional mobility in older adults with fear of movement. TYPE: Systematic review and meta-analysis of randomized clinical trials. An electronic search was performed using PubMed, Embase, Medline, SPORTDiscus, Scopus, and CINAHL. A data search from January 2015 to December 2022 and a manual electronic literature search were conducted to identify published RCTs. The effectiveness of VR-based balance training for balance and gait was evaluated in older adults with a fear of movement, which was measured by the Timed Up and Go (TUG) test and the Falls Efficacy Scale (FES). Three reviewers independently performed the study selection, and the quality assessment of the included studies was performed using the Physiotherapy Evidence Database (PEDro) scale. The reporting was based on the new Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) Guidelines. The search product produced 345 results, from which 23 full text articles were studied. Seven RCTs of good methodological quality, including 265 participants, were included in the review. Overall, the studies reported that VR had a significant improvement on the TUG (Cohen's d=-0.91 [-1.38; -0.44], p=0.001), while the FES was not significantly different (Cohen's d=-0.54 [-1.80; 0.71] p=0.40). The average for PEDro scores (6.14) was good, and the risk of bias revealed that more than one-third of the studies correctly described the random sequence generation and allocation concealment procedures. VR-based training is effective on balance or gait training based on the TUG; however, there were mixed results to improve FES scores following VR intervention. These inconsistent results might be limited due to variations in the studies, including heterogeneous training paradigms, sensitive outcome measures, small sample sizes, and short intervention durations, which limit the validity of our findings. Future investigations should compare different VR protocols to help establish better guidelines for clinicians.

The gait parameters in patients with Parkinson’s Disease under STN-DBS therapy and associated clinical features

ABSTRACT Objective We aimed to investigate the gait parameters in patients with subthalamic nucleus deep brain stimulation (STN-DBS) therapy using quantitative gait analyses and reveal the associated clinical features. Methods Parkinson’s disease (PD) subjects with STN-DBS who applied to our movement disorders outpatient clinics between December/2021 and March/2022 were enrolled. In addition to the evaluation of the demographic data and the clinical features; clinical scales measuring the freezing of gait (FOG), falls and quality of life were performed. A gait analyzer program was used to perform gait analysis. Results Thirty patients with a mean age of 59.4 ± 8.3 (F/M = 7/23) were enrolled. The comparative analyses between the tremor-dominant and akinetic-rigid (AR) subtype patients showed that the step time asymmetry measures were higher in the AR group. The comparative analyses according to the symptom onset side showed that the step length was smaller in those with left-side symptom onset. The correlation analyses showed that there were correlations between the quality-of-life indexes and FOG questionnaire and falls efficacy scale (FES) scores. Finally, the correlation analyses between clinical scales and gait parameters revealed that there were significant correlations between the FES scores and the step length asymmetry (SLA). Conclusion We found a strong relationship between falls and quality of life indexes of our patients under STN-DBS therapy. In this patient group, particular evaluation of fallings and the follow-up of SLA in gait analysis may constitute important points during the evaluation of patients in routine clinical practice.

Characteristics of falls and their fear in older adults requiring long-term care.

[Purpose] Older adults requiring long-term care have a higher rate of falls than older adults who do not. This study aimed to examine the relationship between falls and fear of falling and their characteristics from the perspective of older adults requiring long-term care based on a sub-item in the Modified Falls Efficacy Scale. [Participants and Methods] This study included 51 older adults who were certified as needing long-term care. Fear of falling was measured using the Modified Falls Efficacy Scale. The Modified Falls Efficacy Scale and basic information, such as cognitive function, history of falls, level of care required, and age, were collected and analyzed based on the fall or non-fall groups. [Results] The fall and non-fall groups had 27 and 24 participants, respectively. Comparisons between the groups showed significant differences in the Modified Falls Efficacy Scale scores. Binomial logistic regression analysis results showed that "crossing the street (pedestrian crossing)" was significantly associated with falls (odds ratio=0.75). [Conclusion] In this study, falls were associated with fear of falling; specifically, among the Modified Falls Efficacy Scale items, "crossing the street (pedestrian crossing)" was significantly associated with falls.

Yaşlı bireylerde tek-görev, çift-görev ve ardışık fiziksel-bilişsel eğitimin düşme riski ve denge performansı üzerine etkileri: randomize çalışma

Purpose: This study aimed to examine the effects of single-task, dual-task and successive physical-cognitive training on fall risk, balance, and gait performances in elderly.Methods: A total of 45 healthy older adults (73.0±4.6 years; 6 male and 39 female) underwent one of three interventions 3 times a week for 4 weeks. Group-1 performed single-task balance and gait exercises. Group-2 performed cognitive activity, balance, and gait exercises simultaneously. Group-3 performed successive cognitive activities and balance and gait exercises. Gait speed under single-task and dual-task conditions, Berg Balance Scale, Timed up and Go test, and Tinetti's Falls Efficacy Scale scores were evaluated before and after 4 weeks of interventions.Results: Gait speed under single-task condition, Timed up and Go Test, and Berg Balance Scale scores were improved in all groups (p&amp;lt;0.05). Gait speed under dual-task condition was improved in Groups-2 and 3 (p&amp;lt;0.05). Group-3 had greater improvement in Berg Balance Scale and Timed up and Go test scores than Group-2. Tinetti's Falls Efficacy Scale was improved in Group-1 and 3 after training while the improvement was greater in Group-3 (p=0.001).Conclusion: The present study suggests that an intervention involving cognitive and physical activities results in greater improvement in gait speed than interventions involving physical activities alone. However, successive physical-cognitive training may be more effective in reducing fear of fall and improving balance skills in elderly.

The relationship of Vitamin D levels with disease severity, balance, and falls in Parkinson’s disease

Purpose: To evaluate the relationship between serum vitamin D levels with disease severity, balance problems and fear of falling in Parkinson’s disease. Materials and Methods: This was a retrospective, cross-sectional study. Participants with Parkinson’s disease and healthy controls aged 45-80 years were included in the study. The outcomes of the study were serum 25(OH) vitamin D levels, Hoehn&Yahr Scale, Unified Parkinson’s Disease Rating Scale-III, Berg balance scale, Tinetti test, and International Falls Efficacy Scale scores. Results: Seventy-two participants with Parkinson’s disease and sixty healthy controls were included in the study. The mean 25(OH) vitamin D level was 17.8±8.2 ng/ml in the PD group, while it was 22.2±9.7 ng/ml in the control group. There was a statistically significant difference in terms of 25(OH) vitamin D levels between the groups (p=0.005). The participants in the PD group were divided into two groups according to the HY scale scores (Early-stage group: Stage 1-2; Advanced-Stage group: Stage 3-4). The mean 25(OH) vitamin D level was 18.6±7.8 ng/ml in the early-stage group, it was 16.5±8.8 ng/ml in the advanced-stage group. No statistically significant differences were identified in both groups (p=0.299). There was no correlation between 25(OH) vitamin D levels, HY stages, BBS, TT, FES-I, and UPDRS-III in PD group (p>0.05). Conclusion: Vitamin D levels were lower in PD than that in healthy controls. However, no significant relationship was found between vitamin D levels and disease severity, balance problem, and fear of falling in PD.

An Evaluation of the Fear of Falling, Balance Levels, and Prognostic Blood Parameters Among the Geriatric Population With Hip Fractures

BackgroundIn this study, we determined that among patients who had been operated upon for hip fractures at our hospital, prognostic factors for mortality and functional recovery in the preoperative period were indicated via laboratory parameters using the International Falls Efficacy Scale (FES-I) and Berg Balance Scale (BBS) scores.MethodologyBetween January 2020 and January 2021, the results of 64 patients who had been surgically treated for a hip fracture and 57 patients who had scheduled elective surgery were compared retrospectively. The groups’ demographic data and blood parameters were compared. We used the FES-I and BBS scores to determine patients’ physical functional status and fear of falling.ResultsThe case group’s statistically significant FES-I score was high, and its BBS score was low (p = 0.001/0.001). As expected, the case group’s D-dimer measurement was higher than the control group’s (p = 0.001). In addition, hemoglobin, platelet, lymphocyte, albumin, total protein, and calcium levels were lower in the case group (p = 0.001 for all levels). No significant difference was found for other parameters.ConclusionsThe scales are used by physical therapy, neurology, and orthopedics professionals to evaluate the geriatric population’s physical functional status and fear of falling. We believe prevention and cost-effective treatments for hip fractures can be achieved by determining geriatric patients’ hemoglobin, platelet, lymphocyte, albumin, total protein, and calcium levels upon hospital admission and by directing these patients to relevant clinics using the fear-of-falling and balance scales.

The Effect of 2 Different Dual-Task Balance Training Methods on Balance and Gait in Older Adults: A Randomized Controlled Trial.

The purpose of this study was to compare the effects of integrated and consecutive cognitive dual-task balance training in older adults on balance, fear of falling, and gait performance. Fifty-eight participants (age >65years) were randomly assigned to an integrated dual-task training group (IDTT) (n = 29) and consecutive dual-task training group (CDTT) (n = 29). Balance exercises and cognitive tasks were performed simultaneously by the IDTT group and consecutively by the CDTT group for 8weeks. Balance was assessed using the Berg Balance Scale as a primary outcome measure and the Timed "Up & Go" Test (TUG) (standard-cognitive), fear of falling was assessed using the Tinetti Falls Efficacy Scale, and gait speed was assessed using the 10-Meter Walk Test (10MWT) (under single-task and dual-task conditions). All tests were performed before and after the training. There was no difference in group-time interaction in the Berg Balance Scale, TUG-standard, 10MWT-single task, and 10MWT-dual task tests. Group-time interaction was different in the TUG-cognitive and Tinetti Falls Efficacy Scale scores. Also, the effect of time was significantly different in all scales except for the 10MWT-single task in both groups. At the end of the 8-week training period, the impact of integrated and consecutive dual-task balance training on balance and gait performance in older adults was not statistically significantly different. This study suggests that consecutive dual-task balance training can be used as an alternative method to increase balance performance and gait speed in older adults who cannot perform integrated dual-task activities. There were no significant differences between the effects of the 2 dual-task training methods on balance and gait speed, suggesting that the consecutive dual-task balance training method can be used to improve the balance and gait of older adults. CDTT can be performed safely and considered as an alternative method for use in many rehabilitation training programs with older adults who cannot perform simultaneous activities.

The effects of arm crank training on aerobic capacity, physical performance, quality of life, and health-related disability in patients with Parkinson's disease.

Aerobic exercise training contributes to improvement of cardiopulmonary capacity, mobility, neurological function, and quality of life. To investigate the effects of arm crank ergometer training on aerobic capacity, quality of life, and Parkinson's disease (PD)-related disability METHODS: Seventeen patients with PD were recruited to study. Assessments were performed at baseline and at the end of an 8-week arm crank ergometer (ACE) training program (3days/week; 1h per session, 50-70% VO2peak) with patients acting as their own control. Outcome measures included aerobic capacity assessment, 6-min walk test (6MWT), timed up and go test (TUG), Unified Parkinson's Disease Rating Scale (UPDRS), Parkinson's Disease Questionnaire-39 (PDQ-39), Beck Depression Index (BDI), the Falls Efficacy Scale (FES), and Montreal Cognitive Assessment (MoCA). At the end of the study, an increase of 30.49% in aerobic capacity was observed. Statistically significant improvements were found for the 6MWT (p = 0.001), TUG test (p = 0.001), UPDRS total score (p = 0.002), quality of life assessed with PDQ-39 (p = 0.006), BDI (p = 0.001), and FES scores (p = 0.002) after an 8-week ACE training. No significant effect on MoCA was found (p = 0.264). An 8-week ACE training led to significant improvement in aerobic capacity, physical performance, and PD-related disabilities.

Investigation of the relationship between physical activity, kinesiophobia and fear of falling in older adults with chronic pain

Aims This study aims to investigate the relationship between physical activity, fear of movement and fear of falling in older adults with chronic pain. Materials and methods The study includes 163 older adults aged 65 years and over, who live in a private nursing home. The cognitive functions of the individuals who participated in the study were evaluated with the mini-mental examination scale (MMES), fears of movement with the Tampa Scale of Kinesiophobia (TSK), fear-avoidance behaviour with the Fear-avoidance Beliefs Questionnaire (FABQ), physical activity levels with the Physical Activity Scale for Older (PASE), and the fears of falling were assessed with Tinetti’s Falls Efficacy Scale (FES). Results In the correlation analysis, there was a weak correlation between age and fall risk (r = 0.349, p < 0.001), and PASETotal score (r = –0.020, p = 0.011). There was a weak positive correlation between Tinetti FES and FABQ scores (r = 0.349, p < 0.001), and kinesiophobia value (r = 0.259, p < 0.001), there was a weak negative correlation between Tinetti FES and PASETotal (r = –0.241, p = 0.002). A positive mid correlation was determined between kinesiophobia and the FABQ scores (r = 0.41, p < 0.001). The established regression model was found to be significant (F = 12.175; p < 0.001). Among the independent variables included in the model, FABQTotal (t = 3.589; p < 0.0001) and PASETotal (t = –3.325; p < 0.0001) significantly affected the fear of falling. Conclusion The presence of chronic pain in older adults who have problems related to physical activity, fear of falling, and kinesiophobia due to advancing age may affect social participation, functional level, and quality of life significantly. Therefore, pain should be addressed in older adults and should be considered as an important issue in rehabilitation programs.

Analysis of Falls Efficacy Scale and Vulnerable Elders Survey as Predictors of Falls.

IntroductionFalls are the leading cause of injury-related death among older adults according to the Centers for Disease Control and Prevention (CDC). The Falls Efficacy Scale (FES) and Vulnerable Elder Survey (VES-13) are validated screening tools used to assess concern of falling, health deterioration and functional decline. We set out to determine if the FES or VES-13 could serve as a predictor of falls among older adults in the Emergency Department (ED) setting.MethodsThis prospective pilot cohort study was conducted at a Level 1 Trauma Center. ED patients aged ≥65 were eligible for the study if they had a mechanical fall risk defined by CDC criteria. After consent and enrollment, FES and the VES surveys were completed. Participants were followed by phone quarterly, and results of the one-year follow-up self-report of fall history described. ResultsThere were 200 subjects enrolled and after excluding those that were withdrawn, deceased, or lost to follow-up, 184 were available for analysis of their follow-up visit at 12 months. A greater proportion of the participants were women (108 (58.7%) vs 76 (41.3%); P=0.88). The average age of the study participants was 74.2±7.3 years. There was no significant difference in age between men and women (median: 73 vs 73; p=0.47). At the follow-up visit, 33 (17.9%) had a reported fall. The mean age did not significantly differ when comparing those with versus without a fall (75.6 vs 73.9; p=0.24). There was no significant difference in the proportion with a VES-13 ≥ 3 when comparing those with and without a reported fall (45.5% vs 37.8%; p = 0.41). The median FES score did not differ among those with as compared to without a fall (11 vs 10; p=0.12).ConclusionsSubjects who had a VES-13 score of ≥3 were statistically no more likely to have fallen than those with a score of <3. Additionally, the FES score did not statistically differ when comparing those who had fallen to those who had not. Further research into alternative screening methods in the ED setting for fall risk is recommended.

Postural stability impairment in patients with bilateral hallux valgus: A case-control study using a stabilometer

BackgroundHallux valgus (HV) is an important risk factor for falls (in older people); however, the detailed relationship is less understood. We aimed to evaluate postural stability in bilateral HV patients. MethodsTwo groups of 20 female patients—an HV group and a C (i.e., non-HV) group—participated in this study. Evaluations were made using the Timed Up and Go (TUG) test, the Berg Balance Scale (BBS), the Falls Efficacy Scale (FES), track length (LNG), velocity (VEL), enveloped area (ENV), and root mean square area (RMS). ResultsTUG and FES scores were significantly higher and BBS scores were lower in the HV group than in the C group. LNG was significantly longer, VEL was higher, and ENV and RMS were wider in the HV group than in the C group. ConclusionsThe HV group exhibited impaired walking mobility, balance, and postural stability.

Japanese Community-Living Older Adults’ Perceptions and Solutions Regarding Their Physical Home Environments

This study examined perceived causes of accidental falls, the solutions implemented, and differences in scores on the Falls Efficacy Scale (FES) based on experiences of accidental falls, implementation of solutions, and experiences of problems in participants’ current environments. Data were collected individually from Japanese community-living older adults. Of the 41 participants, 71% experienced accidental falls, 41.5% implemented solutions, and 39.0% experienced problems in their current environments. Some solutions were implemented, including both appropriate and inappropriate ones. The FES scores differed significantly based on experiences of problems in participants’ current environments, suggesting that a consultation-style intervention would contribute toward improved FES scores among clients experiencing problems in their current environments.

Web-Based Telepresence Exercise Program for Community-Dwelling Elderly Women With a High Risk of Falling: Randomized Controlled Trial.

BackgroundWhile physical exercise is known to help prevent falls in the elderly, bad weather and long distance between the home and place of exercise represent substantial deterrents for the elderly to join or continue attending exercise programs outside their residence. Conventional modalities for home exercise can be helpful but do not offer direct and prompt feedback to the participant, which minimizes the benefit.ObjectiveWe aimed to develop an elderly-friendly telepresence exercise platform and to evaluate the effects of a 12-week telepresence exercise program on fall-related risk factors in community-dwelling elderly women with a high risk of falling.MethodsIn total, 34 women aged 68-91 years with Fall Risk Assessment scores >14 and no medical contraindication to physical training-based therapy were recruited in person from a senior citizen center. The telepresence exercise platform included a 15-inch tablet computer, custom-made peer-to-peer video conferencing server system, and broadband Internet connectivity. The Web-based program included supervised resistance exercises performed using elastic resistance bands and balance exercise for 20-40 minutes a day, three times a week, for 12 weeks. During the telepresence exercise session, each participant in the intervention group was supervised remotely by a specialized instructor who provided feedback in real time. The women in the control group maintained their lifestyle without any intervention. Fall-related physical factors (body composition and physical function parameters) and psychological factors (Korean Falls Efficacy Scale score, Fear of Falling Questionnaire score) before and after the 12-week interventional period were examined in person by an exercise specialist blinded to the group allocation scheme.ResultsOf the 30 women enrolled, 23 completed the study. Compared to women in the control group (n=13), those in the intervention group (n=10) showed significant improvements on the scores for the chair stand test (95% confidence interval -10.45 to -5.94, P<.001), Berg Balance Scale (95% confidence interval -2.31 to -0.28, P=.02), and Fear of Falling Questionnaire (95% confidence interval 0.69-3.5, P=.01).ConclusionsThe telepresence exercise program had positive effects on fall-related risk factors in community-dwelling elderly women with a high risk of falling. Elderly-friendly telepresence technology for home-based exercises can serve as an effective intervention to improve fall-related physical and psychological factors.Trial RegistrationClinical Research Information Service KCT0002710; https://cris.nih.go.kr/cris/en/search/ search_result_st01.jsp?seq=11246 (Archived by WebCite at http://www.webcitation.org/6zdSUEsmb)