Mengurangi Risiko Jatuh pada Lanjut Usia dengan Latihan Keseimbangan

Background: Population of elderly in Indonesia continues to grow. Physical changes in the elderly cause balance disturbances, increasing the risks of falling. Objective: To determine balance training effectiveness on reducing risks of falls in elderly. Methods: This study used a quasi-experimental design with control and intervention groups. Functional Reach Test (FRT) and Falls Efficacy Scale-International (FES-I) were used to assess balance function. The elderly in this study had risks of falling according to FRT and FES-I. Timed Get-up and Go Test was used to assess physical function. Education and balance exercises were given for 3 weeks to the intervention group. Pre-test data were taken at the beginning of the study, while post-test data after the balance training was given to the intervention group. Paired t-test was used to compare the pre-test and post-test data. Results: Research was conducted in Warungboto and Giwangan Kampongs, Umbulharjo District, Yogyakarta Municipality. Data from 60 elderly: 30 in the intervention and 30 in the control groups. Paired t-test showed a significant difference between pre-test and post-test results in the intervention group on FRT (t=-16,301, p<0.001, and FES-I (t=-24,457, p<0.001). The three-week-balance-training significantly reduced the risk of falling in the intervention group. Significant difference was not found in the control group on FRT (t=-0.126, p=0.901), and FES-I (t=-0.764, p=0.451). There was no significant reduction in the risks of falls in the control group. Conclusion: Balance training is effective in reducing the risk of falls in elderly.

Prehospital treatment of rhabdomyolysis in people who fall

Of people aged 65 and older, 30% will fall at least once per year—for people aged over 80, this rises to 50%. Patients who remain on the floor for a long time are at risk of developing rhabdomyolysis. If a person cannot move or get off the floor, tissue necrosis can occur at the point of contact and skeletal muscle is destroyed, releasing its contents into the bloodstream. This can eventually lead to crush syndrome, which includes rhabdomyolysis, hyperkalemia, dysrhythmias and acute kidney injury, and can be fatal. There are no guidelines for a time period when rhabdomyolysis is more likely to occur nor international consensus on how to best treat this condition in and out of hospital. This article looks at rhabdomyolysis resulting from falls in elderly people, and how to recognise and manage it. The aim is to improve awareness of rhabdomyolysis among prehospital practitioners so they can improve its management and advise patients at home.

Fear of Falling, Recurrence of Falls, and Quality of Life in Patients with a Low Energy Fracture—Part II of an Observational Study

Background and objective: Falls in elderly cause injury, mortality, and loss of independence, making Fear of Falling (FoF) a common health problem. FoF relates to activity restriction and increased fall risk. A voluntary intervention including fall risk assessment and prevention strategies was implemented to reduce falls in elderly patients with low energy fractures (LEF). The primary purpose of this study was to evaluate FoF and the number of subsequent falls in trauma patients one year after a LEF. The secondary aim was to examine how FoF affects patients’ lives in terms of Quality of Life (QoL), mobility, and activity levels. Finally, participation in the voluntary fall prevention program (FPP) was evaluated. Materials and Methods: Observational cohort study in one Swiss trauma center. LEF patients, treated between 2012 and 2015, were analyzed one year after injury. Primary outcomes were Falls-Efficacy Score-International (FES-I) and number of subsequent falls. Secondary outcomes were EuroQoL-5-Dimensions-3-Levels (EQ5D-3L), mobility, activity levels, and participation in the FPP. Subgroup analysis was performed for different age categories. Results: 411 patients were included for analysis. Mean age was 72 ± 9.3, mean FES-I was 21.1 ± 7.7. Forty percent experienced FoF. A significant negative correlation between FoF and QoL (R = 0.64; p < 0.001) was found. High FoF correlated with lower activity levels (R= −0.288; p < 0.001). Six percent visited the FPP. Conclusions: At follow-up, 40% suffered from FoF which seems to negatively affect patients’ QoL. Nevertheless, participation in the FPP was low. Simply informing patients about their susceptibility to falls and recommending participation in FPPs seems insufficient to motivate and recruit patients into FPPs. We suggest implementing repeated fall risk- and FoF screenings as standard procedures in the follow-up of LEF, especially in patients aged over 75 years.