Level Of Functional Independence Research Articles

Return to work after spinal cord injury: a Singaporean pilot community-based rehabilitation program.

Retrospective analysis of data collected as part of a pilot program. The primary objective of our study was to document the return-to-work rate of individuals with SCI who participated in a community-based interdisciplinary vocational rehabilitation program. The secondary objectives were to assess changes in their levels of community integration and functional independence. A community-based rehabilitation center in Singapore. Participants were individuals with SCI between 21 and 55 years. They identified return to work as a rehabilitation goal, and were certified fit to undergo rehabilitation by their physicians. Primary outcome was the return-to-work rate at discharge from the program. Secondary outcomes were community integration and functional independence, measured by the Community Integration Questionnaire (CIQ) and the Spinal Cord Independence Measure III (SCIM-III), respectively. We summarized participants' clinical and socio-demographic characteristics descriptively, and used inferential statistics to compare pre- and postprogram scores for secondary outcome measures. Thirty-nine participants were included for this study. Thirty-two completed the program, of which 84% (n = 27) reported returning to work. Participants who completed the program had mean change in total CIQ and SCIM-III scores of 7 (95% CI, 5-8) and 11 (95% CI, 7-15), respectively. There were differences (p < 0.05) between pre- and postprogram scores for both secondary outcome measures. Our findings suggest that our vocational rehabilitation program facilitated participants with SCI in Singapore to return to work and was beneficial to enhance their levels of community integration and functional independence. Future interventional studies are recommended to estimate the efficacy of such programs.

The Impact of Functional Independence Level and Age on the Quality of Life of Mothers with Down Syndrome Children

The Impact of Functional Independence Level and Age on the Quality of Life of Mothers with Down Syndrome Children

Prognostic factors of intracerebral hematomas surgical removal and role for treatment strategy

Objective – to elaborate prognostic criteria of surgical treatment of patients with intracerebral hematomas.Materials and methods. Sixty nine patients with intracerebral hematomas were operated by craniotomy or craniectomy with encephalotomy in Lviv Emergency Hospital, 8th Lviv City Hospital and Chervonohrad Central City Hospital in 2013–2018. The results of radiological (computed tomography, cerebral angiography) and clinical examination (neurological status before and after surgery) of patients who were operated, with the use of Glasgo coma scale (GCS), Functional Outcome in Patients with Primary Intracerebral Hemorrhage (FUNC), Intracerebral Hemorrhage Score (ICH Score) scales were analyzed. Such parameters as the duration and type of surgery, size and location of ICH, the level of consciousness, and neurological deficit at admission and the time of surgery were determined. Patients were divided into two groups depending on the degree of brain midline shift on computed tomograms obtained at the time of hospitalization: group I (≤5 mm) – 18 patients, group II (&gt;5 mm) – 51 patients. There were 22 women (31.9 %), 47 men (68.1 %). Twenty nine (42.0 %) patients died. The age of patients was as follows: 25–44 years – 9 (13.1 %), 45–60 years – 36 (52.2 %), 60–75 years – 21 (30.4 %), 75–90 years – 3 (4.3 %). Localization of intracerebral hematomas was as follows: subcortical – 15 (21.7 %), putaminal (lateral) – 36 (52.2 %), thalamic (medial) – 12 (17.4 %), cerebellar – 6 (8.7 %). Results. For the most part, surgical treatment of ICH required craniectomy with encephalotomy. When choosing method and timing of surgery, the data of brain CT scans (midline shift, size and location of ICH) were taken into account, based on which patients were divided into 2 groups. Expected recovery of operated patients was analyzed with the FUNC and ICH Score scales. It was determined that, taking into account the neurological status and CT scan data, patients from group 2 were operated 12.2 hours earlier than patients from group 1. Delay of surgery, when the condition of patients in group 2 worsened, led to the worsening in the 90-day functional independence level, but did not affect the 30-day mortality rate.Conclusions. Surgery by craniotomy or craniectomy with encephalotomy remains the method of choice to treat the intracerebral hematomas. Early computed diagnostics and appropriate treatment strategy provide improvement, better functional recovery of patients in postoperative period.

The effects of music therapy on gross motor functions, pain and level of functional independence in children with cerebral palsy

The effects of music therapy on gross motor functions, pain and level of functional independence in children with cerebral palsy

Participation Following Inpatient Rehabilitation for Traumatic Disorders of Consciousness: A TBI Model Systems Study.

Severe traumatic brain injury (TBI) may result in a disorder of consciousness (DoC) and lead to substantial long-term disability. While level of independence with activities of daily living, especially for persons who recover consciousness during inpatient rehabilitation, generally improves over time, the degree of change in participation remains unknown. We determined level of participation among persons with TBI between 2005 and 2017 who were admitted to inpatient rehabilitation unable to follow commands and subsequently enrolled in the TBI Model Systems National Database. Participation on the Participation Assessment with Recombined Tools-Objective (PART-O) Productivity, Social Relations, and Out and About subscales was evaluated at 1–5 years post-injury. We used a mixed-effects model to longitudinally compare participation between persons who did and did not regain command-following during inpatient rehabilitation. We further explored the level of participation associated with increasing levels of functional independence (FIM). The analysis included 333 persons (229 recovered command-following during rehabilitation, mean age = 35.46 years, 74.9% male). Participation across groups, at all follow-up time points, on all PART-O subscales, was remarkably low (mean range = 0.021–1.91, maximum possible score = 5). Performance was highest on the Social Relations subscale and lowest on the Productivity subscale. Longitudinal analyses revealed no difference in level of participation or change in participation across time for persons who regained command-following during rehabilitation compared to those who did not. While productivity increased over time, social participation did not and participation outside the home increased more for younger than for older persons. Across all three PART-O subscales, FIM Motor scores positively predicted participation. FIM Cognitive scores positively predicted level of participation on the Productivity and Social Relations subscales. Exploratory analyses revealed that even persons who achieved independence on the FIM Motor and Cognitive subscales had low levels of participation across domains and follow-up years. In summary, persons with severe TBI who were admitted to inpatient rehabilitation unable to follow commands were found to be unlikely to participate in productive tasks, social endeavors, or activities outside of the home up to 5 years post-injury, even if functional independence was recovered.

Dynamics of blood lipid-phospholipid profile indicators in elderiy patients with stroke

Objective. To study dynamics of blood lipid-phospholipid profile indicators in elderly patients with stroke for criteria optimization of differential diagnosis, treatment and prognosis.Material and methods. Sixty patients, aged from 60 to 74 years with new-onset hemispheric stroke were examined. 34 patients of them were diagnosed with ischemic stroke (IS); 26 patients had intracerebral hemorrhage (ICH). Patient’s status was assessed using the NIHSS, the Rivermead mobility index, the modified Renkin scale, the Barthel ADL index. We measured blood levels of phosphotidylinosits in patients with acute IS and ICH. The percentage absorption of lipid-phospholipid complexes was also studied in the infrared spectrum of blood serum. The control group consisted of 20 healthy individuals.Results. Dynamics of lipid-phospholipid complexes in blood serum is associated with the type of stroke. The blood levels of phosphotidylinosits in patients with acute IS and ICH were strongly correlated with degree of neurological deficit, levels of daily activity and functional independence (p &lt; 0,05–0,01).Conclusion. The received data may be important for individualization of diagnostics and therapeutic interventions in elderly patients with acute IS and ICH.

Scoping review of acute stroke care management and rehabilitation in low and middle-income countries

BackgroundStroke is a major public health concern, affecting millions of people worldwide. Care of the condition however, remain inconsistent in developing countries. The purpose of this scoping review was to document evidence of stroke care and service delivery in low and middle-income countries to better inform development of a context-fit stroke model of care.MethodsAn interpretative scoping literature review based on Arksey and O’Malley’s five-stage-process was executed. The following databases searched for literature published between 2010 and 2017; Cochrane Library, Credo Reference, Health Source: Nursing/Academic Edition, Science Direct, BioMed Central, Cumulative Index to Nursing and Allied Health Literature (CINNAHL), Academic Search Complete, and Google Scholar. Single combined search terms included acute stroke, stroke care, stroke rehabilitation, developing countries, low and middle-income countries.ResultsA total of 177 references were identified. Twenty of them, published between 2010 and 2017, were included in the review. Applying the Donebedian Model of quality of care, seven dimensions of stroke-care structure, six dimensions of stroke care processes, and six dimensions of stroke care outcomes were identified. Structure of stroke care included availability of a stroke unit, an accident and emergency department, a multidisciplinary team, stroke specialists, neuroimaging, medication, and health care policies. Stroke care processes that emerged were assessment and diagnosis, referrals, intravenous thrombolysis, rehabilitation, and primary and secondary prevention strategies. Stroke-care outcomes included quality of stroke-care practice, functional independence level, length of stay, mortality, living at home, and institutionalization.ConclusionsThere is lack of uniformity in the way stroke care is advanced in low and middle-income countries. This is reflected in the unsatisfactory stroke care structure, processes, and outcomes. There is a need for stroke care settings to adopt quality improvement strategies. Health ministry and governments need to decisively face stroke burden by setting policies that advance improved care of patients with stroke. Stroke Units and Recombinant Tissue Plasminogen Activator (rtPA) administration could be considered as both a structural and process necessity towards improvement of outcomes of patients with stroke in the LMICs.

Nutritional and Rehabilitation goals in Acquired Brain Injury patients: a new decannulation protocol

Abstract Background One of the first goals for the rehabilitation of patients with Acquired Brain Injury (ABI) is the removal of the tracheocannula: the aim is not only to allow respiration by airways and reduce respiratory complications but also to obtain rehabilitation of dysphagia and verbal communication: for this purpose from July 2017 the ABI unit of the Institute of Physical and Rehabilitation Medicine ’Gervasutta” adopted a new decannulation protocol, recommended by the Italian Society of Physical Medicine and Rehabilitation (SIMFER). Methods Clinical data of ABI patients with tracheal cannula from May 2014 were collected as both process and outcome indicators associated with the adoption of the new protocol were defined. ABI patients were therefore divided into two groups depending on whether they were treated with or without the new procedure. Data have been processed with “Simple Interactive Statistical Analysis” (SISA) software. Results A sample of 141 patients with tracheocannula was analyzed; among these 57 (40.4%) were treated with the new decannulation protocol. No statistical significant differences were found between the two groups in terms of systemic or respiratory complications, Functional Independence Measure (FIM) or Level of Cognitive Functioning (LCF) at the entrance as well as for both the time (days) between entry or tracheotomy and decannulation. However decannulation rate is significantly higher when the new protocol is applied (OR = 1.8; 95% CI = 1.2- 9.8; p = 0.01) as the time (days) between entry and oral feeding resumption (p &amp;lt; 0.001; 95% CI = -10 - -34 days). Conclusions The introduction of the new protocol has allowed the achievement of both nutritional and rehabilitation goals with a significantly faster oral feeding resumption and an increase of decannulation rate and. Further efforts are needed to support its use in the future, with the aim of further improving of either process or outcome performances. Key messages Promising prospects for the decannulation of patients with acquired brain injury. Achievement of nutritional and rehabilitation goals.

2330. Acute Flaccid Myelitis Recovery: Filling in the Gaps and Assessing Likelihood for Independent Living

BackgroundReports of Acute Flaccid Myelitis (AFM) typically describe outcomes according to full recovery of strength and function. Full recovery rates remain low (20–30%), but most children with AFM show some degree of improvement. Data are lacking describing the ability of children with AFM to perform activities of daily living (ADL) needed to eventually live as independent adults.MethodsThis is telephone survey-based study of parents with children diagnosed with AFM in 2018 at a free-standing children’s hospital in Central Texas. The survey assesses the level of functional independence in areas of eating, bathing, dressing, toileting, and mobility. Cases diagnosed in 2018 were surveyed at 6 months from diagnosis.ResultsFour cases were diagnosed with AFM during the 2018 season. All four patients with AFM who were called to answer the survey consented to participation. Figure 1 shows degree of residual weakness and recovery in each area of ADL for all 4 patients. Despite residual weakness in half of the cases, three of the four cases had either no deficit or mild functional deficit in all areas of ADLs. One case continues to require moderate assistance in 4 areas of ADLS. Of note, this case was also the only case in the 2018 season with identified enterovirus D68 at our institution. None reported total deficit in any ADL.ConclusionIn this sample significant functional deficits were seen in one of the four cases. This child continues to develop adaptive skills using stronger extremities to compensate for flaccid weakness. While the hope is always for full recovery, it is important to give parents a realistic picture of partial recovery and likelihood of independence. Given the success of the survey locally, we plan to expand the study to the Texas AFM Collaborative and prospectively survey cases diagnosed in 2018 every 6 months for a period of 2 years. Disclosures All authors: No reported disclosures.

Evaluating the effectiveness of aquatic therapy on mobility, balance, and level of functional independence in stroke rehabilitation: a systematic review and meta-analysis

Objective: To meta-analyze and systematically review the effectiveness of aquatic therapy in improving mobility, balance, and functional independence after stroke. Data Sources: Articles published in Medline, Embase, CINAHL, PsycINFO, and Scopus up to 20 August 2019. Study Selection: Studies met the following inclusion criteria: (1) English, (2) adult stroke population, (3) randomized or non-randomized prospectively controlled trial (RCT or PCT, respectively) study design, (4) the experimental group received >1 session of aquatic therapy, and (5) included a clinical outcome measure of mobility, balance, or functional independence. Data Extraction: Participant characteristics, treatment protocols, between-group outcomes, point measures, and measures of variability were extracted. Methodological quality was assessed using Physiotherapy Evidence Database (PEDro) tool, and pooled mean differences (MD) ± standard error and 95% confidence intervals (CI) were calculated for Functional Reach Test (FRT), Timed Up and Go Test (TUG), gait speed, and Berg Balance Scale (BBS). Data Synthesis: Nineteen studies (17 RCTs and 2 PCTs) with a mean sample size of 36 participants and mean PEDro score of 5.6 (range 4–8) were included. Aquatic therapy demonstrated statistically significant improvements over land therapy on FRT (MD = 3.511 ± 1.597; 95% CI: 0.381–6.642; P = 0.028), TUG (MD = 2.229 ± 0.513; 95% CI: 1.224–3.234; P < 0.001), gait speed (MD = 0.049 ± 0.023; 95% CI: 0.005–0.094; P = 0.030), and BBS (MD = 2.252 ± 0.552; 95% CI: 1.171–3.334; P < 0.001). Conclusions: While the effect of aquatic therapy on mobility and balance is statistically significant compared to land-based therapy, the clinical significance is less clear, highly variable, and outcome measure dependent.

Mobility bridges a gap in care: Findings from an early mobilisation quality improvement project in acute care.

To qualitatively evaluate an early mobilisation quality improvement project implemented on a general medicine unit. Early mobility quality improvement projects show promising quantitative results yet have failed to collect data from patient and staff experience associated with physical activity during illness and the impact of this change in clinical practice. A mixed methods case study was used to evaluate a mobility quality improvement project. Quantitative results will be published separately. The qualitative evaluation used a phenomenological lens to explore the patient and staff experience. Semi-structured interviews with twelve participants (four patients and eight staff) were performed during the project. Data were analysed using open coding, direct interpretation and then categorised into an overarching and four supporting themes. Findings are reported per the Standards for Reporting Qualitative Research. Participants reported that early mobilisation bridged a gap in care. Staff understood the benefits of early mobility. Patients expressed how mobility aligned with personal preferences and their need to prepare for hospital discharge. Greater functional independence and higher mobility levels in patients on the unit reduced staff level of care. When patients were consistently presented with opportunities to be mobile and active, they expected mobility to be a part of their daily care plan. Findings suggest that early mobility quality improvement projects have the potential to transform clinical practice and improve the quality of care for patients in acute care. All members of the healthcare team, including the patient, recognise the importance of maintaining mobility and function during hospitalisation yet focus on these needs are often delayed or missed. Early mobility quality improvement projects help to set patient expectations and build a culture that promotes patient mobility and function during acute illness.

The relationship between the level of health literacy and the physical health status of the elderly in Bojnurd city

Nowadays, the health literacy topic has become an important issue in the world, and because of its important role in people’s decision-making in the health-related areas has been taken into consideration by policy-makers as one of the basic tools for improving the health ofthe community and increasing the quality of providing health services. Considering the importance of health literacy and the level of functional independence in daily activities, which are important indicators of physical health evaluation, and the importance of examining the relationship between them, this research was performed to investigate the relationship between health literacy level and physical health status of elderly people in Bojnurd. In this cross-sectional descriptive-analytic study, which was performed in 1396, 190 elderly residents of Bojnurd were selected by multistage sampling method (stratified and cluster sampling method). A threepart questionnaire was used for data collection. Data analysis was performed by SPSS 20 software and using statistical tests of one-way analysis of variance and t-test. The mean age of the elderly who were studied were 66.3 ± 5.67 years. Most of the elderly who were studied had an inadequate level of health literacy (40.5%). 23.3% of the elderly had a borderline health literacy level. Only 36.3% of the elderly had adequate health literacy. Men's literacy level was significantly higher than that of women. There was a statistically significant difference between the health literacy levels of elderly people with different educational levels. 1% of the elderly studied were dependent, 3.7% needed help and 95.2% were independent in terms of the daily activity of life. No significant relationship was seen between the levels of autonomy of performance in daily activities of life, occupation, marriage, age. The results of this study showed that the elderly who were studied are lacking adequate health literacy, which is a serious challenge for health care providers and all providers of health services,regarding the growing number of the elderly population in the country.

Early term effects of robotic assisted gait training on ambulation and functional capacity in patients with spinal cord injury

Background/aimThe aim of the study was to determine the effects of robotic-assisted gait training on ambulation and functional capacity in patients with spinal cord injury.Materials and methods In total, 88 patients were included and were randomly divided into two groups. The first group underwent 16 sessions of robotic therapy training for 8 weeks and conventional therapy for 5 days a week. The second group underwent conventional treatment. The Walking Index for Spinal Cord Injury II was used to evaluate functional ambulation, and the functional independence measure score was used to assess patients’ functional independence levels in a blind manner.Results A significant improvement was observed in both groups according to Walking Index for Spinal Cord Injury II and functional independence measure scores (P < 0.001). However, a significantly higher improvement according to the Walking Index for Spinal Cord Injury II (P = 0.011) and functional independence measure scores (P = 0.022) was seen in the robotic group than in the control group.ConclusionsRobotic-assisted gait training combined with conventional therapy was found to be superior to the conventional therapy in terms of gait function and level of disability.

Rehabilitation Technology: Assistance from Hospital to Home.

Rehabilitation is essential for disabled people to achieve the highest level of functional independence, reducing or preventing impairments. Nonetheless, this process can be long and expensive. This fact together with the ageing phenomenon has become a critical issue for both clinicians and patients. In this sense, technological solutions may be beneficial since they reduce the costs and increase the number of patients per caregiver, which makes them more accessible. In addition, they provide access to rehabilitation services for those facing physical, financial, and/or attitudinal barriers. This paper presents the state of the art of the assistive rehabilitation technologies for different recovery methods starting from in-person sessions to complementary at-home activities.

Memorizing Al Quran Improves Quality of Life Stroke Patients with Motoric Aphasia Disorders

Background and purpose. Empowering stroke patients with motor aphasia through memorizing the Al Quran to improve quality of life. Stroke causes neurological disorders that cause changes in quality of life. Quality of life is healthy physically, mentally, socially, environmentally and healthily, regardless of illness and can maintain health status. The purpose of the study was to determine the effect of memorizing the Al Quran and family support on stroke patients with motor aphasia disorder on functional communication skills, level of independence and quality of life. Materials and methods. The study was conducted at Ja’far Medika General Hospital Karanganyar, Central Java, Indonesia. The number of subjects was 102 stroke patients with motor aphasia, as evidenced by the results of head CT scan. Type of quantitative research, using experimental design, simple randomized the pretest-posttest control group design. Results. The effect of memorizing the Al Quran, family support, functional communication skills and the level of independence of the combined quality of life in stroke patients with motor aphasia impairment got the value of r square = 0.982 with p = 0.000 (p <0.001) which means that memorizing the Al Quran, support family, functional communication skills and level of independence affect the quality of life combined in stroke patients with motoric aphasia with very strong levels. Or it can be said that 98.2% of the quality of life is influenced by memorizing the Al Quran, family support, functional communication skills and level of independence. Partially it is known that the most influential effect on the quality of life in stroke patients with motor aphasia is memorizing Al Quran (r = 0.735; p = 0.000) compared to family support (r = 0.321; p = 0.000), while functional communication skills (r = 0.017; p = 0.618) and independence (r = 0.035; p = 0.305) had no significant effect on quality of life. Conclusion. That the direct influence of the variable memorizing the Al Quran and family support for the quality of life is better, without having to go through functional communication skills and the level of independence as mediation.

THE CORELATION BETWEEN GRIP MUSCLES’ STRENTGH AND A LEVEL OF FUNCTIONAL ABILITY AMONG THE ELDERLY WOMEN IN TISTA KERAMBITAN, TABANAN

The aging process affects the skeletal muscle structure and disability of the musculoskeletal system which resulted in limited and slowed motion. One characteristic of the aging process is a decrease in muscle strength. Muscle strength affects almost all daily activity. Decreased muscle strength can lead to limitations in daily activities, independence and quality of life. This study aims to determine the relationship between handgrip muscles’ strength and level of functional ability among elderly women in Tista, Kerambitan Tabanan. To assess the strength of the relationship and assess the direction of the relationship between the variables. The research design was used cross sectional study with Simple Random Sampling and got 73 samples. The strength of handgrip muscles was measured using Hand-grip dynamometer, while the functional independence level was assessed by Intermediate Activity Daily Living (IADL) questionnaire interview. Result of research by using Spearman correlation test got value P = 0,000 (P &lt;0,05) and Coefficient correlation value equal to 0,489 indicate that there is a significant correlation between handgrip muscles’ strength with functional ability independence level, this relation is positive and medium. In conculsion that handgrip muscles’s strength and level of functional ability are positively correlated and medium. The stronger the muscle strength of the handgrip, the higher the level of functional ability independence and vice versa. Therefore, handgrip muscle’s strength can be used in identifying disabilities in the elderly.&#x0D; Keywords: elderly, handgrip muscles’ strength, functional capabilities, disability.

Independencia funcional en la recuperación de pacientes sometidos a cirugía cardiaca.

Objetivo: Evaluar el nivel de independencia funcional de los pacientes sometidos a cirugía cardiaca durante su proceso de recuperación. Materiales y Método: Investigación con enfoque cuantitativo y estudio de tipo analítico longitudinal prospectivo. La población de estudio estuvo conformada por personas mayores de 18 años, sometidas a cirugía cardiaca programada, en una institución de salud de la ciudad de Medellín, Colombia. Se aplicó un cuestionario para las variables sociodemográficas y el procedimiento quirúrgico, además se utilizó el instrumento de independencia funcional de Granger y Hamilton traducido al español por Paolinelli. Se realizó un análisis univariado, bivariado y se usó la regresión de la mediana como prueba multivariada no paramétrica. Resultados: El total de participantes fue de 33. El 50% tenía 64 años. El 66.7% fueron hombres. Se encontró que el 57.6% eran hipertensos y el 12.1% diabéticos. El 54.5% se sometió a bypass coronario. Se evidencia una diferencia estadísticamente significativa entre cada una de las mediciones de la independencia funcional (p&lt;0.05) y una relación directa entre la edad y la disminución de la autonomía (p 0.034). Conclusiones: La independencia funcional se afecta tras la realización de la cirugía cardiaca, pero se recupera con el paso del tiempo y está de alguna manera relacionada con la edad.

Sanator rehabilitation of patients after stenting of coronary arteries

The results of sanatorium rehabilitation of 56 patients (men) after stenting of the coronary arteries in the conditions of a specialized sanatorium are presented. Patients of the main group used a rehabilitation complex based on physical training in combination with dry air carbon dioxide baths, patients in the control group received a basic complex. A more effective effect of the developed complex with respect to the positive dynamics of clinical and hemodynamic parameters, blood lipid profile, increase in physical performance, improvement of quality of life parameters, decrease in the level of functional independence in patients of the main group, in contrast to patients against the background of the basic complex, was established.

Rehabilitation in Inclusion Body Myositis associated with human immunodeficiency virus (HIV) infection

Objective. To investigate the effects of a functional exercise program based on Proprioceptive Neuromuscular Facilitation techniques (PNF) on muscle strength and functional activities in a patient with inclusion body myositis (IBM) associated with human immunodeficiency virus (HIV) infection. Method. A patient with IBM was tested for muscle strength and functional capacities before and after a 16-week, patient-specific, home-based exercise program involving mild, daily and functional exercises. Results. Although real benefits of muscular force have been achieved, functional independence level was not modified. We believe the physical rehabilitation program served for minimization of the complications generated by the muscular weakness and optimization of motor abilities. Conclusion. The findings of this study indicate that an individually prescribed home exercise program, based on PNF techniques, can be safely implemented, since it respects the particularities of the patients and the disease, and is therefore beneficial in the management of patients with IBM, especially associated with HIV infection.

Prevalence, risk factors, circumstances for falls and level of functional independence among geriatric population - A descriptive study.

Falls is one of the common problems faced by elderly population and in preventing falls in India, research has largely focused on identification and management of risk factors, but the circumstances of the fall and its associated factors are sparsely researched. The primary objective is to find the prevalence of fall, investigate risk factors, and its circumstances for falls and level of functional independence in elderly population. The secondary objective is to find out fear of fall (FOF) and its association of demographic factors on elderly population. This was a cross-sectional study; 2049 elderly population of 60 years and above were recruited by one-stage cluster sampling technique within Mumbai, Panvel, and Thane cities, Maharashtra. Data were collected using a questionnaire, Fall Efficacy Scale-International, Barthel Index, and Kuppuswamy Scale. Obtained responses were analyzed using SPSS software; descriptive statistics and Chi-square test were applied. The prevalence of falls in this study found as 24.98%. Demographic factors such as age group, education, marital status, and socio-economic status had demonstrated a significant association with older adults (P < 0.05); 44.92% of falls occurred in the morning, the majority of falls (65.43%) occurred indoors, 56.45% of the fallers reported to had slips, and 60.55% of the fallers had sustained injuries. From the total participants, 34.70% of the fallers reported FOF, 23.67% of the fallers expressed reduced functional activities, and 18.06% of the fallers demonstrated affection in activities of daily living. This study reveals fall as a significant health problem and provides insight into the influencing risk factors for falls among older adults.