scholarly journals Exploratory fall risk and preventive intervention in acute vestibular neuritis

2021 ◽  
Vol 49 (9) ◽  
pp. 030006052110442
Author(s):  
Euyhyun Park ◽  
Sung Kyun Kim ◽  
Jinnyeong Jang ◽  
Hye Min Han ◽  
Jae Jun Song ◽  
...  
Keyword(s):  
Fall Prevention ◽  
Fall Risk ◽  
Preventive Intervention ◽  
Fear Of Falling ◽  
Vestibular Function ◽  
Vestibular Neuritis ◽  
Sensory Organization Test ◽  
Canal Paresis ◽  
Sensory Organization ◽  
Positive Effect

Objective To analyze recovery from dizziness in patients with acute vestibular neuritis (AVN) after applying the “Dizziness & Fall Risk Assessment and Intervention (DFRAI)”. Methods This prospective study involved patients with AVN who underwent a survey of dizziness and fall risk. The patients received medical treatment and customized vestibular rehabilitation, and vestibular function was evaluated at the initial attack and 3 months later. Results Forty-one patients underwent subjective questionnaire assessments, which showed significant improvement in visual analog scale-dizziness handicap inventory-fear of falling (VAS-DHI-FOF) results from the initial vertigo attack to 3 months later. In the sensory organization test (SOT), the initial composite score was 63 ± 13.1, which improved to 77.5 ± 4.9 3 months later. In caloric testing, the canal paresis (CP) score was 42.9 ± 35.2, which improved to 29.9 ± 23.5 3 months later. Conclusions Subjective improvement in dizziness and objective recovery of vestibular function were confirmed. DFRAI is a comprehensive solution for dizziness, and appropriate application of the DFRAI is expected to have a positive effect on recovery from dizziness and fall prevention in patients with AVN.

scholarly journals EXPERIENCES AND FACILITATORS OF FALLS PREVENTION AMONG ETHNICALLY DIVERSE OLDER ADULTS: A QUALITATIVE STUDY

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S854-S854
Author(s):  
Ladda Thiamwong ◽  
Norma E Conner
Keyword(s):  
Older Adults ◽  
Fall Prevention ◽  
Fall Risk ◽  
Fear Of Falling ◽  
Ethnically Diverse ◽  
Role Identity ◽  
Community Dwelling ◽  
Falls Prevention ◽  
Facilitators And Barriers ◽  
And Behaviors

Abstract Background: Falls increase as people age and decrease the quality of life. Even though fall interventions have received great attention, fall incidence rates have still arisen. In order for older adults to reap the benefits of evidence-based fall interventions, a challenge of implementation in the real world and right context must be met. Understanding experiences, facilitators, and barriers of fall prevention among four major ethnic groups in the Unites States could be extremely valuable. Objective: The aim of this study was to describe experiences and highlight facilitators and barriers on fall and fear of falling interventions among ethnically diverse community-dwelling older adults. Methods: Four ethnically specified (African American, Asian, Hispanic and Non-Hispanic White) focus groups were conducted. A total of 28 older adults and four family caregivers were interviewed. Interviews covered experiences on falls and fear of falling, attitudes, factors, consequences, risk assessment, and interventions. Data were organized and analyzed with the NViVo software. Results: Falls related experiences and behaviors were multifaceted and varied. Three themes related to falls experiences and behaviors were identified, 1) falls prevention versus fear of falling amplification; 2) role identity, culture and family considerations; and 3) take care of you, take care of me. Facilitators of fall prevention were integration of individual learning within a group meeting, providing appropriate assistive devices and promoting environmental safety. Barriers were inconsistent fall risk assessments, low fall risk awareness and acknowledgment, and balance and visual impairment.

scholarly journals 111 Disparities between Actual and Perceived Fall Risk Affect Participation in 5 Fall Prevention Interventions

2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv18-iv27
Author(s):  
Pey June Tan ◽  
Silvia Sim ◽  
Noor Hafizah Ismail ◽  
Jagadish Mallya ◽  
Angelique Chan ◽  
...  
Keyword(s):  
Older Adults ◽  
Fall Prevention ◽  
Fall Risk ◽  
Help Seeking ◽  
Fear Of Falling ◽  
Community Dwelling ◽  
Falls Prevention ◽  
Risk Level ◽  
Prevention Interventions ◽  
Aware Group

Abstract Introduction Older adults have been found to under- or overestimate their fall risk. However, no studies have investigated implications on help-seeking behaviours in falls prevention. This study examines how disparities between actual and perceived fall risk affects participation in 5 fall prevention interventions among community-dwelling older adults in Singapore. Methods This was a cross-sectional survey of a nationally representative sample of community-dwelling adults aged ≥60 years in Singapore identified by stratified random sampling. Having previous falls in the past 12 months (faller/non-faller) indicated actual fall risk. Level of fear-of-falling (cut-off ≥23 on 16-item Falls Efficacy Scale International) was used as perceived fall risk (high/low). Four profiles based on combinations of actual and perceived risk were associated with participation in 5 fall prevention interventions in a multiple logistic regression. The model was adjusted for age, gender, ≥2 comorbidities and knowledge that the intervention is to prevent falls. Results Final analysis included 549 older adults (mean age 70.6±6.9 years, 61% females). Majority (46%) were in the Vigorous group (no falls, low fear), 35% Anxious (no falls, high fear), 11% Frail Aware (falls, high fear) and 8% Stoics (falls, low fear). Only those in Anxious and Frail Aware group were significantly more likely to have talked to a healthcare professional on strategies to avoid falls [OR 1.8 (1.1-3.1) and 3.2 (1.6-6.4) respectively] and made home modifications [OR 1.9 (1.3-2.8) and 2.0 (1.1-3.6)] after adjustments. No association was found for participation in exercise, medication review and falls education. Discussion Individual profiles with high fear-of-falling component have different help-seeking behaviours compared to those with low fear regardless of history of falls. However, individuals in Frail Aware group have higher likelihood to uptake the interventions compared to Anxious group. Future research should examine other drivers of behaviour that will influence participation in other interventions.

Effectiveness of two methods of rehabilitation in patients after vestibular neuronitis and vestibular neurectomy

2017 ◽  
Vol 6 (4) ◽  
pp. 47-54
Author(s):  
Iwona Makowska
Keyword(s):  
Subjective Assessment ◽  
Vestibular Neuritis ◽  
Sensory Organization Test ◽  
Vestibular Organ ◽  
Vestibular Neurectomy ◽  
Sensory Organization ◽  
Group I ◽  
Acute Vestibular Syndrome ◽  
Group Ii ◽  
Vestibular Neuronitis

Acute vestibular syndrome is a syndrome of clinical symptoms associated with sudden damage to the periphery of the vestibular organ. The most important element in the treatment of patients with vestibular syndrome is motor rehabilitation, which is beneficial for central compensatory processes. The aim of the study was to compare the effectiveness of two methods of rehabilitation (training habituation versus sensory conflicts) in patients after vestibular neuronitis and vestibular neurectomy. The material includes the results of the overall balance of the Sensory Organization Test and subjective assessment of the severity of dizziness before and after rehabilitation performed by various methods. Twenty subjects after vestibular neuritis (Group I) and 20 patients after vestibular neurectomy (Group II) were included in the study. In group I, the patients were admitted to the Otolaryngology Clinic Medical University of Warsaw Emergency Room with the diagnosis of vestibular neuritis. In group II, patients had vestibular neurectomy due to Meniere disease with strong untreated vertigo. Both types of rehabilitation lead to a significant improvement in the overall balance of the Sensory Organization Test and subjective assessment of the severity of vertigo irrespective of the extent of injury in the vestibular organ. Better results were obtained in the group after vestibular neuritis treated with sensory conflicts.

scholarly journals Effects of Torso-Weighting on Standing Balance and Falls During the Sensory Organization Test in People with Multiple Sclerosis

2018 ◽  
Vol 20 (2) ◽  
pp. 68-75 ◽  
Author(s):  
Kristin K. Horn ◽  
Diane D. Allen ◽  
Cynthia Gibson-Horn ◽  
Gail L. Widener
Keyword(s):  
Multiple Sclerosis ◽  
Fear Of Falling ◽  
Group Versus ◽  
Assessment Method ◽  
Sensory Organization Test ◽  
Post Intervention ◽  
Activity Restriction ◽  
Sensory Organization ◽  
Quasi Experimental ◽  
Composite Scores

Background: In people with multiple sclerosis (MS), common gait and balance impairments can lead to falls, fear of falling, activity restriction, and social isolation. Sensory augmentation in the form of torso-weighting has resulted in improvement in gait and balance, but research on its effect on falls in MS is lacking. Methods: 60 people with MS and 10 bin-matched controls completed the Sensory Organization Test (SOT) while nonweighted and again while weighted using the Balance-Based Torso-Weighting assessment method. This was a quasi-experimental pre-post intervention study. The SOT composite scores, equilibrium scores, and number of falls occurring across six SOT conditions were compared between and within groups using 2-way analysis of variance, α = .05 with planned t test analyses of weighting effects. Results: A significant increase in composite score of 9.14 points nonweighted to weighted occurred in the MS group (P < .001) but not in controls (P = .626). Equilibrium scores were significantly higher with weights in the MS group (P < .001) but not in controls (P = .5). Falls during the SOT were reduced by 35% with weights in the MS group versus without weights (P < .001), with the greatest number of falls occurring in the most challenging SOT conditions. Conclusions: During a single testing session, torso-weighting produced significant improvements in postural stability and fall reduction during the SOT for people with MS but no change in controls. Further research is needed to determine whether torso-weighting has the potential to reduce falls in MS during real-world activities.

scholarly journals Effects of a Fall Prevention Program on Fall Risks, Fear of Falling, and Depression in Older Active Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 234-234
Author(s):  
James Karnes ◽  
Victoria Bates ◽  
Ashley Chafin ◽  
Sarah Fisher ◽  
Kelcie Gilmore ◽  
...  
Keyword(s):  
Older Adults ◽  
Fall Prevention ◽  
Prevention Program ◽  
Fall Risk ◽  
Fear Of Falling ◽  
Exercise Frequency ◽  
Balance Test ◽  
Chair Stand ◽  
Fall Risk Factors ◽  
Fall Risks

Abstract Falls are the leading cause of injury in older adults; one in four older adults fall each year. The Otago Exercise Program (OEP) is an evidence-based fall prevention program that has been shown to reduce fall risk factors. However, exercise dosage is not known. The purpose of this study was to investigate the effectiveness of different frequencies of an OEP-based program on fall risk factors, fear of falling, and depression in older adults. Of 62 subjects initially recruited at community centers, 28 subjects met inclusion criteria and were assigned to control (Con), once-weekly (Grp 1), or twice-weekly (Grp 2) intervention groups based on subject attendance. Intervention consisted of a 12-week OEP-based program. Pre-intervention dependent variables included: 4-Stage Balance Test, 30-Second Chair Stand, Timed Up and Go (TUG), Geriatric Depression Scale (GDS), and Modified Fall Efficacy Scale (MFES). After 12 weeks, post-intervention testing assessed changes in these variables. Preliminary analysis of data using mixed design ANOVA (p.05) indicated significant changes between and within all groups for TUG and 30-Second Chair Stand. Results also suggested all groups improved on all variables with a direct relationship to exercise frequency. Furthermore, Grp2 improved more than Grp1 and Con in the 4-Stage Balance Test. These findings suggest an OEP-based falls prevention program performed 2x/week is more beneficial in decreasing fall risks and increasing lower extremity muscle strength than 1x/week. Moreover, results imply exercise frequency may be important in improving the magnitude of select falls risks variables.

scholarly journals Relying on Myself: The Lived Experience of Being at Risk for Falling in the Hospital Among Older Adults

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 958-958
Author(s):  
Hanne Dolan ◽  
Cindy Rishel ◽  
Jessica Rainbow ◽  
Ruth Taylor-Piliae
Keyword(s):  
Older Adults ◽  
At Risk ◽  
Nursing Staff ◽  
Fall Prevention ◽  
Fall Risk ◽  
Phenomenological Study ◽  
Fear Of Falling ◽  
Persistent Problem ◽  
Hospitalized Older Adults ◽  
Balance Problems

Abstract Inpatient falls are a persistent problem and despite research efforts during the last decade, inpatient fall rates have not significantly decreased. Older adults have an estimated 50% greater inpatient fall rate than younger adults. How older adults perceive their own fall risk affects their adherence to fall prevention recommendations. The aim of this phenomenological study was to gain a deeper understanding of the lived experiences of being at risk for falling in the hospital among older adults aged 65 years and older (N=9). Participants (female=55%, age range=67 – 86) were interviewed twice using video conferencing within two weeks of hospital discharge. The audio-recorded interviews were transcribed, and then analyzed using van Manen’s interpretive phenomenological method. The Health Belief Model expanded with the concepts of independence, fear of falling, embarrassment, dignity, and positivity effect served as the theoretical framework. Five major interpretive themes emerged: Relying on Myself, Managing Balance Problems in an Unfamiliar Environment, Struggling to Maintain Identity, Following the Hospital Rules, and Maintaining Dignity in the Relationships with Nursing Staff. These themes describe how the participants thoughtfully planned their mobilization to avoid falls. This process was influenced by their struggling to remain independent, following the hospital fall prevention rules out of politeness, and experiencing both positive and negative relationships with nursing staff. Hospitalized older adults employed their self-efficacy to manage balance problems in the hospital. These findings have not been previously documented in the literature. Fall prevention interventions supporting hospitalized older adults’ self-management of fall risk are needed.

scholarly journals Fall prevention in Dutch general practices: A descriptive study

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
W M A Meekes ◽  
C J Leemrijse ◽  
J C Korevaar ◽  
L A M van de Goor
Keyword(s):  
The Netherlands ◽  
Older People ◽  
Preventive Care ◽  
Fall Prevention ◽  
Fall Risk ◽  
Fear Of Falling ◽  
Daily Practice ◽  
Frail Older People ◽  
Important Health ◽  
Underlying Causes

Abstract Background Falls are an important health threat among frail older people. GPs are often the first to contact for health issues and therefore they can be seen as the designated professional to offer fall prevention. At the moment, it is unknown what GPs in the Netherlands exactly do regarding fall prevention. This study aims to describe what GPs in the Netherlands do during daily practice in regards to fall prevention. Methods Thirty-four GP practices located throughout the Netherlands were followed for a period of 12 months. When a GP entered specific ICPC-codes related to frailty and falls in the Hospital Information System, the GP received a pop-up with the question “Is this patient frail?”. If according to the GP the patient was frail, the GP subsequently completed a short questionnaire. Results About 65 GPs completed 1396 questionnaires. More than half (n = 726) of the patients had experienced a fall in the previous year and/or had a fear of falling (FOF). Of 276 patients, GPs did not know if they had experienced a fall and of 408 patients if they had a FOF. Of the patients that had experienced a fall in the previous year and/or had a FOF, 37% received fall preventive care. Reasons for not offering such care were i) GP and patient did not think that the patient had a high fall risk (38%), ii) the patient finds treatment too intensive or too much of a hassle (21%) and iii) the patient was not convinced (s)he had a high fall risk and so treatment was not necessary (12%). The three most often treated underlying causes were mobility problems, FOF and cardiovascular risk factors. Conclusions The results show that GPs are not always aware of a patient's fall history or FOF and that only part of the patients that had experienced a fall and/or had a FOF receives fall preventive care. Hence, it is important to develop and implement strategies for GP practices to systematically screen for fall risk and to offer fall preventive care to reduce falls among frail older people. Key messages Thirty-seven percent of the frail older people that experienced a fall in the previous year and/or had a fear of falling, received fall preventive care. The three most treated underlying causes are mobility problems, fear of falling, cardiovascular factors.

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 Identifying Fall Risk Predictors by Monitoring Daily Activities at Home Using a Depth Sensor Coupled to Machine Learning Algorithms

Sensors ◽  
2021 ◽  
Vol 21 (6) ◽  
pp. 1957
Author(s):  
Amandine Dubois ◽  
Titus Bihl ◽  
Jean-Pierre Bresciani
Keyword(s):  
Machine Learning ◽  
Fall Prevention ◽  
Fall Risk ◽  
Learning Algorithms ◽  
Step Length ◽  
Machine Learning Algorithms ◽  
Daily Activities ◽  
Sitting Time ◽  
Behavioral Parameters ◽  
At Home

Because of population ageing, fall prevention represents a human, economic, and social issue. Currently, fall-risk is assessed infrequently, and usually only after the first fall occurrence. Home monitoring could improve fall prevention. Our aim was to monitor daily activities at home in order to identify the behavioral parameters that best discriminate high fall risk from low fall risk individuals. Microsoft Kinect sensors were placed in the room of 30 patients temporarily residing in a rehabilitation center. The sensors captured the patients’ movements while they were going about their daily activities. Different behavioral parameters, such as speed to sit down, gait speed or total sitting time were extracted and analyzed combining statistical and machine learning algorithms. Our algorithms classified the patients according to their estimated fall risk. The automatic fall risk assessment performed by the algorithms was then benchmarked against fall risk assessments performed by clinicians using the Tinetti test and the Timed Up and Go test. Step length, sit-stand transition and total sitting time were the most discriminant parameters to classify patients according to their fall risk. Coupling step length to the speed required to stand up or the total sitting time gave rise to an error-less classification of the patients, i.e., to the same classification as that of the clinicians. A monitoring system extracting step length and sit-stand transitions at home could complement the clinicians’ assessment toolkit and improve fall prevention.

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