Web-based home-hazard modification app for falls prevention: the views of those at risk of falling and their carers

2020 ◽  
Vol 14 (3) ◽  
pp. 141-156
Author(s):  
Nikki Holliday ◽  
Gillian Ward ◽  
Aimee Walker-Clarke ◽  
Rachael Molitor
Keyword(s):  
At Risk ◽  
Online Survey ◽  
Fear Of Falling ◽  
Behavioural Change ◽  
Falls Prevention ◽  
Risk Of Falling ◽  
Content Type ◽  
Risk Of Falls ◽  
Web App ◽  
The Web

Purpose The purpose of the study is to assess the usability and acceptability of FallCheck, a Web app that allows users to complete home-hazard assessments within their own home, with a group of people at risk of falling and their carers. Design/methodology/approach This mixed method study used an online survey followed by semi-structured telephone interviews to collect both qualitative and quantitative data. A Think-Aloud study was used to test usability of the Web app through structured tasks. Findings Findings showed that FallCheck was easy to use with few usability issues. The Web app was deemed appropriate to use by people at risk of falling (young or old) or by carers if appropriate. The depth of knowledge provision and breadth of content was acceptable, and many participants reported subsequently making changes to their home environment to reduce their risk of falling. Overall, the majority of participants reported feelings of improved confidence and safety with an increased awareness of fall risks and a reduction in fear of falling at home. Practical implications FallCheck has good acceptability and usability with people at risk of falling and their carers and has the potential to improve access to home-hazard assessment and affect behavioural change regarding fall risk hazards and behaviour. Originality/value This study describes successful use of an app that may be helpful in identifying home-hazards and making changes to reduce risk of falls, particularly in the absence of occupational therapy intervention and has the potential for integration into falls care pathways.

scholarly journals Assessment of muscle mass, risk of falls and fear of falling in elderly people with diabetic neuropathy

2015 ◽  
Vol 28 (4) ◽  
pp. 677-683 ◽  
Author(s):  
Hudson Azevedo Pinheiro ◽  
Karla Helena Coelho Vilaça ◽  
Gustavo de Azevedo Carvalho
Keyword(s):  
Diabetic Neuropathy ◽  
Lean Body Mass ◽  
Muscle Mass ◽  
Body Mass ◽  
Fear Of Falling ◽  
Berg Balance Scale ◽  
Elderly Adults ◽  
Risk Of Falling ◽  
Risk Of Falls ◽  
History Of

Abstract Objective : To assess muscle mass, risk of falls and fear of falling in elderly adults with diabetic neuropathy (DNP). Methods : 50 elderly patients with diabetes mellitus (DM) and diabetic neuropathy (NPD) participated in this study. Risk of falling was assessed using the Berg Balance Scale (BBS). Fear of falling was assessed by means of the Falls Efficacy Scale-International (FES-I). Muscle mass was assessed by tetrapolar bioimpedance analysis (BIA) and Janssen's equation. Subjects were divided into two groups: one with a history of falls in the six months before study enrollment (G1) and the other without history of falls (G2). Results : There were statistically significant differences between G1 and G2 regarding lean body mass (p < 0.05), risk of falls as measured by the BBS (p < 0.01), and fear of falling as measured by the FES-I (p < 0.01). In addition, there was a significant correlation between the BBS and BIA (r = 0.45 and p < 0.01), showing that the greater the lean body mass, the lower the risk of falling. Conclusions : We found an association between lean mass, risk of falls and fear of falling in elderly adults with DNP and a history of falls from own height.

scholarly journals Instrumented Analysis of the Sit-to-Stand Movement for Geriatric Screening: A Systematic Review

2020 ◽  
Vol 7 (4) ◽  
pp. 139
Author(s):  
Brajesh Shukla ◽  
Jennifer Bassement ◽  
Vivek Vijay ◽  
Sandeep Yadav ◽  
David Hewson
Keyword(s):  
Systematic Review ◽  
At Risk ◽  
Older People ◽  
Search Strategy ◽  
Risk Of Falling ◽  
Sit To Stand ◽  
Risk Of Falls ◽  
Geriatric Screening ◽  
Meta Analyses ◽  
Future Work

The Sit-to-Stand (STS) is a widely used test of physical function to screen older people at risk of falls and frailty and is also one of the most important components of standard screening for sarcopenia. There have been many recent studies in which instrumented versions of the STS (iSTS) have been developed to provide additional parameters that could improve the accuracy of the STS test. This systematic review aimed to identify whether an iSTS is a viable alternative to a standard STS to identify older people at risk of falling, frailty, and sarcopenia. A total of 856 articles were found using the search strategy developed, with 12 articles retained in the review after screening based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Six studies evaluated the iSTS in fallers, five studies in frailty and only one study in both fallers and frailty. The results showed that power and velocity parameters extracted from an iSTS have the potential to improve the accuracy of screening when compared to a standard STS. Future work should focus on standardizing the segmentation of the STS into phases to enable comparison between studies and to develop devices integrated into the chair used for the test to improve usability.

scholarly journals Assessment of Risk Factors for Falls among Patients with Parkinson’s Disease

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Jacek Wilczyński ◽  
Magdalena Ścipniak ◽  
Kacper Ścipniak ◽  
Kamil Margiel ◽  
Igor Wilczyński ◽  
...  
Keyword(s):  
Risk Factors ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
High Risk ◽  
Fear Of Falling ◽  
External Factors ◽  
Low Risk ◽  
Risk Of Falling ◽  
Risk Of Falls ◽  
Risk Factors For Falls

Introduction. The aim of this study was to assess the risk factors for falls in patients with Parkinson’s disease. Materials and Methods. The study comprised 53 participants (52.8% women and 47.2% men). The Hoehn and Yahr 5-point disability scale was used to assess the severity of Parkinson’s disease. The Tinetti Balance and Gait Scale were used to evaluate the risk of falls. The Katz scale was used to test the independence of people with PD. The Falls Efficacy Scale-International Short Form (FES-I) was implemented to assess fear of falling. Results. The majority of participants was at a high risk of falls, being at the same level for women and men. A significant relationship was noted between the risk of falls and subjective assessment of mobility ( χ 2 = 31.86 , p < 0.001 ), number of falls ( χ 2 = 37.92 , p < 0.001 ), independence of the subjects ( χ 2 = 19.28 , p < 0.001 ), type of injury suffered during the fall ( χ 2 = 36.93 , p < 0.001 ), external factors ( χ 2 = 33.36 , p < 0.001 ), and the level of fear of falling ( χ 2 = 8.88 , p < 0.001 ). A significant relationship also occurred between the number of falls and the fear of falling ( χ 2 = 33.49 , p < 0.001 ) and between the number of falls and disease severity ( χ 2 = 45.34 , p < 0.001 ). The applied physiotherapy did not reduce the risk of falls ( χ 2 = 3.18 , p = 0.17 ). Conclusions. Individuals who rated their mobility as good or excellent were at a low risk of falls. People who fell more times were at a high risk of falling. People more independent were at a low risk of falls. Previous injuries were the most associated with being at risk of falling. Uneven surfaces and obstacles on one’s path are the external factors most associated with the risk of falling. People with low levels of fall anxiety were at a low risk of falls. Most people with low fall anxiety have never fallen. Additionally, the majority of patients with stage 1 of the disease have not fallen at all. The reason for the ineffectiveness of physiotherapy may be due to the exercise programs used and the lack of systematic implementation of them. PD is different for each patient; thus, it is important to select individually customized physiotherapy depending on motor and nonmotor symptoms, as well as general health of a patient.

scholarly journals Investigation of Older Adults’ Participation in Exercises Following Completion of a State-wide Survey Targeting Evidence-based Falls Prevention Strategies

2015 ◽  
Vol 23 (2) ◽  
pp. 256-263 ◽  
Author(s):  
Den-Ching A. Lee ◽  
Lesley Day ◽  
Caroline F. Finch ◽  
Keith Hill ◽  
Lindy Clemson ◽  
...  
Keyword(s):  
Observational Studies ◽  
Falls Prevention ◽  
Baseline Survey ◽  
Prevention Strategies ◽  
Risk Of Falling ◽  
Exercise Behaviors ◽  
Risk Of Falls ◽  
One Year ◽  
Behavior Models

This paper examines whether involvement in an observational study may prompt participants to change their exercise behaviors. Data were collected from 394 older community dwellers in Victoria, Australia using a baseline survey, and 245 of these participated in a follow-up survey one year later. Survey domains were drawn from constructs of relevant health behavior models. Results showed that the proportion of respondents who were currently participating in exercises to prevent falls at follow-up was 12% higher than at baseline (Wilcoxon p value < .001). Twenty-nine percent reported they had changed their perceptions about falls and their risk of falls, with comments focused on threat appraisal. Forty-four percent reported having taken strategies to reduce their risk of falling, with comments based on implementation of different preventive strategies. Respondents who held favorable views toward exercises for the prevention of falls appear to change their behaviors that might address falls when participating in observational studies.

scholarly journals 12 Exploring Hospital Discharge as An Opportunity for Falls Prevention Exercise Referral

2020 ◽  
Vol 49 (Supplement_1) ◽  
pp. i1-i8
Author(s):  
C Buckland ◽  
J Whitney
Keyword(s):  
Older Adults ◽  
At Risk ◽  
Hospital Discharge ◽  
Behaviour Change ◽  
Fall Prevention ◽  
Falls Prevention ◽  
Good Opportunity ◽  
Risk Of Falls ◽  
Exercise Referral ◽  
Sustainability Model

Abstract Topic Proactive prevention is at the core of the NHS Long Term plan and falls prevention is an important public health priority. National guidance recommends that all health professionals have competence in falls assessment and prevention and advise that older adults at risk of falls are considered for strength and balance exercise. With rising numbers of older adults occupying inpatient beds, some clinicians may not have the skills to identify these opportunities to prevent falls. Previously, physiotherapy staff on a respiratory medicine ward were not delivering best practice in falls prevention. Aim Within 3 months, to achieve a 30% increase in older adults at risk of falls, being offered exercise referral at hospital discharge. Intervention Quality improvement methodology including stakeholder engagement and Plan-Do-Study-Act cycles were used to influence behaviour change amongst physiotherapy staff on a respiratory ward. Interventions included training and a documentation sticker. For evaluation, the weekly number of older adults at risk of falls with evidence of offer for falls prevention exercise was collected over 13 weeks and evaluated on a Statistical Process Control chart. Staff confidence scores and cohort data were also recorded and described using descriptive statistics. The NHS Improvement Sustainability Model was used to measure project sustainability. Improvement At baseline, 0/18 (0%) older adults had an offer for fall prevention exercise. Over the intervention period, this increased to 22/37 (59.5%) and demonstrated special cause variation that was confidently assigned to the interventions. There was a 44.5% improvement in staff confidence in offering fall prevention exercise. The project scored 53.7% using the NHS sustainability model. Discussion This project demonstrated favourable behaviour change in falls prevention practice amongst physiotherapy staff on a respiratory ward. There was variability in the improvement possibly as a result of contextual influences of staffing and seasonality. Hospital discharge is a good opportunity to assess falls risk in older adults and offer information and referral for exercise. Wider implementation may be useful to help older adults optimise health outcomes but will depend on organisational stakeholder support to improve sustainability.

Nudging physical activity in offices

2019 ◽  
Vol 17 (4) ◽  
pp. 317-330
Author(s):  
Iris Van der Meiden ◽  
Herman Kok ◽  
Gerben Van der Velde
Keyword(s):  
Online Survey ◽  
Behavioural Change ◽  
Test Case ◽  
Survey Questionnaire ◽  
Content Type ◽  
Post Test ◽  
Stair Use ◽  
Office Environments ◽  
The Impact

Purpose This paper aims to investigate whether and why nudging interventions in an office environment are effective to stimulate stair use of employees. Design/methodology/approach This paper is based on a pre-test/post-test case study design at the headquarters of a Dutch online retailer. Observations were conducted to test the impact of two nudge interventions, being footprints and posters, on employees’ stair use in two consecutive pre-test/post-test weeks. An online survey questionnaire was used to assess employees’ overall experience with the nudging interventions after the fifth and again neutral week. Findings A total of 14,357 observations were recorded during five weeks. This research shows that footprints as nudging intervention significantly increase stair use of employees, and after removal, significantly decrease stair use again. Moreover, footprints were more effective than posters, of which the latter did not impact stair use significantly. Results from the survey questionnaire, completed by 46.2 per cent of the employees, showed that, in terms of degree of perception, footprints (91.4 per cent) were more noticeable than posters (46.3 per cent). Originality/value This paper contributes to the non-conclusive research regarding the effectiveness of nudging interventions on stair use in office environments. It clearly shows that perceptibility in combination with a positive attitude towards the nudge leads to a higher degree of initial behavioural change, yet not to a change of mind.

COVID-19 could precipitate a new African debt crisis

2020 ◽  
Keyword(s):  
At Risk ◽  
Debt Crisis ◽  
Debt Relief ◽  
Economic Conditions ◽  
Risk Of Falling ◽  
Content Type ◽  
Bilateral Negotiations ◽  
The Impact

Subject The impact of the COVID-19 crisis on Africa's debt landscape. Significance African finance ministers, backed by the UN, have called for a coordinated debt relief package to avert a looming debt crisis that could be precipitated by the COVID-19 pandemic. In parallel, individual countries such as Nigeria have begun separate bilateral negotiations with their creditors, underscoring the region’s more complicated debt landscape since the first wave of debt relief in the 2000s. Impacts Hopes of a rebound in global economic conditions in 2021 will limit the extent of any debt relief offered. Countries with already high debt burdens and weak external accounts (Angola, Zambia) are most at risk of falling into debt distress. Disorderly defaults could trigger a 1980s-style debt crisis, which froze access to commercial capital for two decades.

The Role of Podiatry in the Prevention of Falls in Older People

2013 ◽  
Vol 103 (6) ◽  
pp. 452-456 ◽  
Author(s):  
Bijan Najafi ◽  
Eling D. de Bruin ◽  
Neil D. Reeves ◽  
David G. Armstrong ◽  
Hylton B. Menz
Keyword(s):  
Older Adults ◽  
Surgical Intervention ◽  
Fear Of Falling ◽  
Falls Prevention ◽  
Foot And Ankle ◽  
Special Issue ◽  
Age Related ◽  
Risk Of Falls ◽  
Foot Problems

Given the age-related decline in foot strength and flexibility, and the emerging evidence that foot problems increase the risk of falls, established guidelines for falls prevention recommend that older adults have their feet examined by a podiatrist as a precautionary measure. However, these guidelines do not specify which intervention activities might be performed. Published in this special issue of JAPMA are nine high-quality articles, including seven original studies and two basic science reviews, focusing on the benefit and impact of footwear and foot and ankle interventions in reducing the risk of falling. The selected studies discuss various relevant questions related to podiatric intervention, including adherence to intervention; preference and perception of older adults in selecting footwear; benefit of insoles, footwear, and nonslip socks in preventing falls; fear of falling related to foot problems; benefit of podiatric surgical intervention; and benefit of foot and ankle exercise in preventing falls. (J Am Podiatr Med Assoc 103(6): 452–456, 2013)

Why modelling a complex intervention is an important precursor to trial design: lessons from studying an intervention to reduce falls-related injuries in older people

2005 ◽  
Vol 10 (3) ◽  
pp. 133-142 ◽  
Author(s):  
Sandra Eldridge ◽  
Anne Spencer ◽  
Colin Cryer ◽  
Suzanne Parsons ◽  
Martin Underwood ◽  
...  
Keyword(s):  
At Risk ◽  
Older People ◽  
Complex Intervention ◽  
Model Building ◽  
Cost Effective ◽  
Study Data ◽  
Falls Prevention ◽  
Sensitivity Analyses ◽  
Risk Of Falling ◽  
The Impact

Objectives: To develop a cost-effectiveness model of a complex intervention from pilot study data in order to inform the viability and design of a subsequent falls prevention trial. Methods: We used two models; the first estimated the probability of falling over a 12-month period based on a probability tree; the second used Markov simulation to assess the impact of the programme over time. Results: The first model indicated that our intervention would reduce the proportion falling by only 2.8% over a 12-month period. The major reason for this small effect was that less than a quarter of older people at risk of falling were assessed using our screening tool. Even if policy-makers were willing to spend £30,000 per quality-adjusted life-year gained, there is only a 40% chance that the intervention would be cost-effective. Sensitivity analyses showed that the only scenarios that produced a substantial increase in the effect of the intervention were those in which all older people are assessed. Conclusions: The model-building approach described in this paper is vital when designing complex trials and where a trial is not possible. Information from the modelling can be used to re-design the intervention. The effectiveness of our proposed intervention appears very small due to its inability to reach those at risk of falling. It is most likely not to be cost-effective. If inability to reach the target group is a weakness common to other similar interventions, this suggests an area for further research.

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