Cervicothoracic Mechanical Impairment as Part of Complete Neurological Fall Risk Appraisal

2020 ◽  
pp. 1-9
Author(s):  
Janine L. Johnston ◽  
Graham Featherstone ◽  
Shane L. Harms ◽  
Glen T. D. Thomson
Keyword(s):  
Risk Factors ◽  
Soft Tissue ◽  
Fall Risk ◽  
Fear Of Falling ◽  
Musculoskeletal Symptoms ◽  
Risk Of Falling ◽  
Risk Appraisal ◽  
Fall Risk Factors ◽  
Increased Risk ◽  
Restricted Mobility

ABSTRACT: Background: Assessment of individuals at risk for falling entails comprehensive neurological and vestibular examinations. Chronic limitation in cervical mobility reduces gaze accuracy, potentially impairing navigation through complex visual environments. Additionally, humans with scoliosis have altered otolithic vestibular responses, causing imbalance. We sought to determine whether dynamic cervical mobility restrictions or static cervicothoracic impairments are also fall risk factors. Methods: We examined 435 patients referred for soft-tissue musculoskeletal complaints; 376 met criteria for inclusion (mean age 52; 266 women). Patients were divided into nonfallers, single fallers, and multiple fallers, less or greater than 65 years old. Subject characteristics, dynamic cervical rotations, and static cervicothoracic axial measurements were compared between groups. Fear of falling was evaluated using the Falls Efficacy Scale-International questionnaire. Results: Long-standing cervicothoracic pain and stiffness conferred increased risk of falling. Neck rotation amplitudes decreased with longer duration musculoskeletal symptoms and were significantly more restricted in fallers, doubling the risk of falling and contributing to increased fear of falling. Mid-thoracic scoliosis amplitudes increased over time, but static axial abnormalities were not greater among fallers, although thoracic kyphoscoliosis heightened fear of falling. Conclusion: In patients at fall risk, thoracic kyphoscoliosis and dynamic neck movements should be assessed, in addition to standard vestibular and neurological evaluations. Additionally, patients with soft tissue cervicothoracic pain and restricted mobility have increased fall frequency and fear of falling, independent of other fall risk factors and should undergo complete fall risk appraisal.

The Relationship Between Fear of Falling and Functional Fitness among Older Adults Living in Rest Home

2020 ◽  
Vol 16 (1) ◽  
Author(s):  
H Tuna ◽  
Ö Bozan ◽  
B Gürpınar ◽  
N İlçin
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Fall Risk ◽  
Fear Of Falling ◽  
Dynamic Balance ◽  
Upper Body ◽  
Functional Fitness ◽  
Fall Risk Factors ◽  
Rest Home ◽  
History Of

Objective: This study aimed to report the fear of falling and assess its associations with several fall-related characteristics and functional fitness parameters among older adults living in the rest home. Methods: Seventy-eight older adults aged between 65-94 years were included in the study. History of falling and the number of risk factors for falling were recorded. Fear of falling was evaluated with The Falls Efficacy ScaleInternational. Functional fitness was assessed with Senior Fitness Test, including tests for the functional measurement of strength, flexibility, aerobic endurance and dynamic balance. Result: The mean age of participants was 78.46±7.16 years. There were correlations exist between fear of falling and number of fall risk factors, dynamic balance, upper body flexibility and aerobic endurance (p<0.05). Multiple linear regression analysis showed that the parameters with the highest determinants of fear of falling were the dynamic balance and history of falling (p<0.05). Conclusions: In our study, history of falling, number of fall risk factors, flexibility for the upper body, aerobic endurance and dynamic balance were parameters related to fear of falling among older adults, but the most influential factors in fear of falling were dynamic balance and history of falling.

scholarly journals COGNITIVE APPRAISAL AND KNOWLEDGE AS RISK FACTORS FOR HIGH FEAR OF FALLING IN OLDER AND MIDDLE-AGED ADULTS IN SINGAPORE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S473-S473
Author(s):  
Pey June Tan ◽  
Reuben Ng ◽  
Angelique Chan ◽  
Jagadish U Mallya ◽  
Noor Hafizah Ismail ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Fall Risk ◽  
Cognitive Appraisal ◽  
Fear Of Falling ◽  
Age Groups ◽  
Fall Risk Factors ◽  
History Of ◽  
Middle Aged Adults ◽  
Balance Problems

Abstract Fear-of-falling (FOF) can be adaptive or maladaptive depending on one’s appraisal of knowledge and beliefs, but few have elucidated this cognitive process in older adults surrounding falls. We aim to identify risk factors for high FOF amongst community-dwelling older adults (OA) and middle-aged adults (MA) in Singapore. This was a cross-sectional survey of a nationally-representative sample of OA (≥60 years) and MA (40-59 years) identified by stratified random sampling. Primary outcome was high FOF measured by a single-item (4-point scale). Independent variables were history-of-falls, quality-of-life, fall-related cognitive appraisal (balance problems, importance to restrict activities to prevent falls) and knowledge indicators (knowledge of other OA who fell, ability to identify out of 13 fall risk factors). MA were also asked if they’re caregivers. Multiple logistic regressions identified risk factors for high FOF separately by age-groups, adjusting for socio-demographics and comorbidities. The final analysis included 549 OA (70.6±6.88 years) and 309 MA (49.7±5.89 years). No differences in high FOF was found among OA and MA (37% vs. 38%, p=0.305), but there were more falls among OA (19% vs 12%, p=0.010). Higher knowledge of fall risk factors and self-reported balance problems were significant risk factors for high FOF among OA only, while a history-of-falls and being a caregiver were significant among MA only. Perceived importance to restrict activities was associated with high FOF in both age-groups. Although findings suggest differences in the mechanism of high FOF between OA and MA, both age-groups have maladaptive appraisal tendencies related to restrict activities to prevent falls.

scholarly journals EXPLORING GAIT, BALANCE PERFORMANCE AND FEAR OF FALLING AMONG ELDERLY PEOPLE LIVING IN RURAL AREAS OF THAILAND

1970 ◽  
Vol 7 (3) ◽  
pp. 142-145
Author(s):  
Pummarak S ◽  
Samrongtong R ◽  
Ramesh Kumar
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Elderly People ◽  
Prevention Program ◽  
Fall Risk ◽  
Fear Of Falling ◽  
The Elderly ◽  
Balance Performance ◽  
Fall Risk Factors

Background: Previous evidence indicates that older people allocate more of their attentional resources toward their gait and that the attention-related changes that occur during aging increase the risk of falls. Methods: A cross sectional study was conducted in Banna District and Ongkarak District, Nakornnayok Province, Thailand. One hundred elderly people participated in this study. Gait was assessed by a Time Up and Go Test (TUGT) while the One legged stance test (OLST) assessed balance performance. The Falls Efficacy Scale (FES) measured fear of falling of the elderly people. A WHOQOL-BREF instrument assessed the quality of Life among elderly people. Results: The findings revealed that 58% of the participants were female, aged between 60-74 years (mean = 66.39, SD 3.65). Over a 12 month period, 57% of participants had experienced a fall once, 41% had experienced 2 falls while 2% had experienced 3 or more falls. One-third of the elderly people who participated in the study had a fear of falling. Almost all of the elderly participants (76%) had a moderate fall risk perception score. The mean score of total quality of life was moderate (80.43). Conclusion: Study concluded that the elderly people face a valid risk of falling based on prevalent risk factors that results in a fear of falling. An assessment of fall risk factors are important in establishing a fall prevention program for the elderly faced with fall risk factor from fear of falling and. Assessment fall risk factors are important to provide the suitable falls prevention program for the elderly.

scholarly journals Factors that influence the risk of falling after spinal cord injury: a qualitative photo-elicitation study with individuals that use a wheelchair as their primary means of mobility

BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e034279 ◽  
Author(s):  
Hardeep Singh ◽  
Carol Y Scovil ◽  
Karen Yoshida ◽  
Sarah Oosman ◽  
Anita Kaiser ◽  
...  
Keyword(s):  
Risk Factors ◽  
Spinal Cord ◽  
Fall Prevention ◽  
Fall Risk ◽  
Photo Elicitation ◽  
Risk Of Falling ◽  
Wheelchair Users ◽  
Fall Risk Factors ◽  
Cord Injury ◽  
Fall Risks

IntroductionFalls are a concern for wheelchair users with spinal cord injury (SCI). Falls can negatively impact the physical and psychological well-being of fallers. To date, the perspectives of wheelchair users with lived experiences of SCI on the contributors to falls has been understudied. Information about factors that influence fall risk would guide the development of effective fall prevention strategies.ObjectivesTo gain a comprehensive understanding of the factors that influenced the risk of falling as perceived by wheelchair users with SCI.DesignA qualitative study using photo-elicitation interviews.SettingA Canadian SCI rehabilitation hospital and the participants’ home/community environments.ParticipantsTwelve wheelchair users living in the community with chronic SCI.MethodsParticipants captured photographs of situations, places or things that they perceived increased and decreased their risk of falling. Semistructured photo-elicitation interviews were conducted to discuss the content of the photographs and explore perceptions of fall risk factors. A hybrid thematic analysis and the Biological, Behavioural, Social, Economic, and Environmental model were used as a framework to organise/synthesise the data.ResultsOverall, the findings indicated that the risk of falling was individualised, complex and dynamic to each person’s life situation. Four main themes were revealed in our analysis: (1) Falls and fall risk caused by multiple interacting factors; (2) Dynamic nature of fall risk; (3) Single factors were targeted to reduce falls and fall-related injuries; and (4) Fall prevention experiences and priorities.ConclusionsEach wheelchair user encountered numerous fall risk factors in their everyday lives. Information from this study can be used to set priorities for fall prevention. Fall prevention initiatives should consider a wheelchair user’s fall risks in a holistic manner, acknowledging that a person’s current situation, as well as anticipating their fall risks and fall prevention needs, will change over time.

scholarly journals The Effect of Parkinson’s Disease on the Step Response to a Backwards Pull

2008 ◽  
Author(s):  
Molly A. McVey ◽  
Antonis P. Stylianou ◽  
Carl W. Luchies ◽  
Kelly E. Lyons ◽  
Rajesh Pahwa ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Fall Risk ◽  
Fear Of Falling ◽  
Economic Impacts ◽  
Postural Instability ◽  
Step Response ◽  
Risk Of Falling ◽  
Effective Interventions ◽  
Increased Risk

Postural instability is one of the most disabling symptoms of Parkinson’s disease (PD) and often leads to falls. Falls can have severe physical, psychological, and economic impacts including fractures, fear of falling, and loss of independence [1]. Effective interventions to reduce fall risk exist [2, 3] and would be most effective if they could be implemented prior to a fall occurring. Unfortunately, the current methods to evaluate postural instability in PD are not sensitive enough to predict those who are at an increased risk of falling so it is difficult to identify the best time to begin fall interventions.

Relationship Between Level of Physical Activity and Fall Risk Factors in Older Women at Risk of Falling

2015 ◽  
Vol 69 (Suppl. 1) ◽  
pp. 6911515063p1
Author(s):  
Susan Nochajski ◽  
Sujata Nair ◽  
Machiko R. Tomita ◽  
Nadine M. Fisher ◽  
Dan K. Ramsay
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
At Risk ◽  
Older Women ◽  
Fall Risk ◽  
Risk Of Falling ◽  
Fall Risk Factors

Fall risk factors for individuals under the age of 65 years with type 2 diabetes mellitus

2019 ◽  
Vol 83 (3) ◽  
pp. 191-196
Author(s):  
Laura A Swink ◽  
Arlene A Schmid ◽  
Karen E Atler ◽  
Tara C Klinedinst ◽  
Tasha P Marchant ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Body Mass Index ◽  
Type 2 Diabetes Mellitus ◽  
Fall Risk ◽  
Fear Of Falling ◽  
Multivariate Logistic Regression ◽  
Fall Risk Factors

Introduction The purpose of this study was to examine self-reported falls and fall risk factors in people with type 2 diabetes mellitus aged under 65 years. Methods This study was a cross-sectional analysis of 64 participants at a primary care facility in the western United States of America. The following fall risk factors were examined for differences between groups (fallers vs. non-fallers): age, body mass index, depression, fear of falling, neuropathy, number of medications, sedentary behavior, and visual co-morbidities. Multivariate logistic regression was used to determine relationships with self-reported falls (yes/no recent fall as defined by the participant). Results Forty-five percent of participants reported a recent fall. The following fall risk factors produced significant differences between fallers and non-fallers: depression scores ( p = .01), fear of falling ( p < .01), and number of medications currently being taken ( p = .04). Through multivariate logistic regression, the fear of falling score ( p < .01) was the only significant relationship with self-reported falls in the model that included age, body mass index, depression, fear of falling, neuropathy, number of medications, sedentary behavior, and visual co-morbidities. Conclusion Psychological fall risk factors such as fear of falling are factors that should be considered early on in a diagnosis of type 2 diabetes mellitus because they may have an effect on falls, as evidenced in this sample of adults with type 2 diabetes mellitus aged under 65 years.

Sex Differences in Modifiable Fall Risk Factors

2021 ◽  
Author(s):  
Yuta Kubo ◽  
Keisuke Fujii ◽  
Takahiro Hayashi ◽  
Naoki Tomiyama ◽  
Akira Ochi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Sex Differences ◽  
Fall Risk ◽  
Fall Risk Factors
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