Authors (including presenting author) :
YEUNG PY (1), WONG SY (1), NG TK (2), LAM KS (3), WONG YL (2), CHEUNG Y (1), WU SF (1), MA KW (1), LI SW (3), LAU KM (3), WONG SM (2)
Affiliation :
(1) Department of Medicine & Geriatric, (2) Occupational Therapy Department, (3) Physiotherapy Department, Tung Wah Eastern Hospital
Introduction :
In Hong Kong, the annual fall rate among the elderly is about 19%, therein 7.2% suffered serious injuries and 25-40% have multiple falls1. A Cochrane review concluded that assessment of elderly with multifactorial interventions could reduce the number of falls by 24%2. Accordingly, Rehabilitation Day Hospital (RDH) fall prevention program is enhanced through more comprehensive fall risk assessment and advanced technology.
Objectives :
To examine the effectiveness of a multi-disciplinary fall prevention program for RDH patients at risk for falls.
Methodology :
Patients older than 60 years at risk for falls were recruited. Patients with poor vision, inability to express themselves, unstable fracture, non-full weight bearing walking, and terminal illness were excluded. In addition to conventional multi-disciplinary assessment, the Aspire Fall Risk Management System is used to assess risk factors and overall fall risk. Patients received 6-weeks intensive fall prevention training and education targeting intrinsic, extrinsic and behavioral factors and were assessed prior to and at completion of the program. Exercise compliance and fall rate were measured 1 month after program completion.
Result & Outcome :
32 patients (4 Male and 28 Female) with mean age 77.8 completed the study and significantly improved as follows:
Outcome Measurement
1. Ambulation (MFAC) from 5.38 to 6.16 (p-value <0.001)
2. Functional mobility (Time up and go) from 42.09 seconds to 28.03 seconds (p-value <0.001)
3. Prediction of fall risk (FRASE) from 11.09(medium) to 8.03(low) (p-value <0.001)
4. ADL function (MBI) from 76.03 to 87.28 (p-value <0.001)
5. Fall Risk Aspire Fall Risk Management from 2.59 to 3.54 (p-value 0.001)
6. Fall rate Patient self-report from 1.19 to 0
7. Inappropriate footwear Footwear checking from 28% to 0%
Conclusions:
Our program is effective in significantly improving patients’ function, mobility and reducing fall risk, falls and fall-related injuries.
Benefits and Implications:
Fall prevention is crucial to elder care, and RDH will continue to provide fall prevention training that incorporates advanced technologies to reduce the risk of falls and improve quality of life for patients at risk for falls.
