期刊论文详细信息
Patient Safety in Surgery
The ‘Aachen Falls Prevention Scale’ - development of a tool for self-assessment of elderly patients at risk for ground level falls
Matthias Knobe1  Juergen Foerster3  Ulrike Schemmann1  Hans-Christoph Pape2 
[1] Harald Tscherne Lab for Orthopaedic Trauma, University of Aachen Medical Center, Aachen, Germany;Department of Orthopaedic Trauma, University of Aachen Medical Center, 30 Pauwelsstreet, Aachen, 52074, Germany;Division of Physical Therapy at University of Aachen Medical Center, Aachen, Germany
关键词: Balance assessment;    Fall prevention;    Geriatric trauma center;    Fractures in the elderly;    Co-managed care;    Orthogeriatrics;   
Others  :  1132111
DOI  :  10.1186/s13037-014-0055-0
 received in 2014-10-17, accepted in 2014-12-24,  发布年份 2015
PDF
【 摘 要 】

Background

The incidence of falls in the elderly population is difficult to determine and therefore potentially underestimated. Screening algorithms usually have in common that the evaluation is undertaken by trained individuals in a hospital setting. This leads to the inclusion of a high proportion of low-risk people and a waste of resources. It would be advantageous to pretest the individuals at risk in their own environment using a simple self-assessment approach.

Methods

The consensus process of our group of clinicians and physical therapists included: 1. a preparative literature review about risk profiles and assessment tools for ground level falls; 2. a selection of appropriate questions that cover all health aspects involved in an increased risk for falling; and 3. a selection of a simple physical test that can be used at home without the need of a health care professional. We thus searched to develop a scale that can be used by older citizen at higher risk of falling. The current manuscript summarizes the results of this review, consensus and selection process.

Results

The literature search was undertaken between March and August 1, 2013. The selection process for the questions used (Part I) lasted between March 2013 and January 2014. Among all tests evaluated the 20 second standing test (Part II) was deemed to be safe to be performed even by an individual at risk for a fall, as it closely resembles activities of daily living. The `Aachen Falls Prevention Scale` finally uses a self-assessment tool grading falls risk on a scale of 1 to 10 by the individual itself after completion of Part I and Part II. In summary, we present a scale that might offer a self-assessment option to improve the measures of falls prevention pass for elderly citizens.

Conclusions

The introduction of the `Aachen Falls Prevention Scale` which combines a simple questionnaire with a safe and quick balance tool, meets the criteria to identify whether or not a balance problem exists – the first step in evaluation of falls risk. Further studies will have to assess the ability of an individual to estimate his or her individual falls risk on a longitudinal basis and possibly trigger the necessity for the assessment by a physician.

【 授权许可】

   
2015 Pape et al.; licensee BioMed Central.

【 预 览 】
附件列表
Files Size Format View
20150303142944148.pdf 381KB PDF download
【 参考文献 】
  • [1]Moore L, Turgeon AF, Sirois MJ, Lavoie A: Trauma centre outcome performance: a comparison of young adults and geriatric patients in an inclusive trauma system. Injury 2012, 43(9):1580-5.
  • [2]Vlaeyen E, Deschodt M, Debard G, Dejaeger E, Boonen S, Goedemé T, et al.: Fall incidents unraveled: a series of 26 video-based real-life fall events in three frail older persons. BMC Geriatr 2013, 13:103. BioMed Central Full Text
  • [3]Liem IS, Kammerlander C, Suhm N, Blauth M, Roth T, Gosch M, et al.: Identifying a standard set of outcome parameters for the evaluation of orthogeriatric co-management for hip fractures. Injury 2013, 44(11):1403-12.
  • [4]Kammerlander C, Gosch M, Blauth M, Lechleitner M, Luger TJ, Roth T: The Tyrolean Geriatric Fracture Center: an orthogeriatric co-management model. Z Gerontol Geriatr 2011, 44(6):363-7.
  • [5]Bielza Galindo R, Ortiz Espada A, Arias Muñana E, Velasco Guzmán de Lázaro R, Mora Casado A, Moreno Martín R, et al.: Opening of an Acute Orthogeriatric Unit in a general hospital. Rev Esp Geriatr Gerontol 2013, 48(1):26-9.
  • [6]Patel NK, Sarraf KM, Joseph S, Lee C, Middleton FR: Implementing the National Hip Fracture Database: An audit of care. Injury 2013, 44(12):1934-9.
  • [7]Ungar A, Rafanelli M, Iacomelli I, Brunetti MA, Ceccofiglio A, Tesi F, et al.: Fall prevention in the elderly. Clin Cases Miner Bone Metab 2013, 10(2):91-5.
  • [8]Nevitt MC, Cummings SR, Kidd S, Black D: Risk factors for recurrent nonsyncopal falls. A prospective study. JAMA 1989, 261(18):2663-8.
  • [9]Tinetti ME, Kumar C: The patient who falls: "It's always a trade-off". JAMA 2010, 303(3):258-66.
  • [10]Gates S, Smith LA, Fisher JD, Lamb SE: Systematic review of accuracy of screening instruments for predicting fall risk among independently living older adults. J Rehabil Res Dev 2008, 45(8):1105-16.
  • [11]Mancini M, Horak FB: The relevance of clinical balance assessment tools to differentiate balance deficits. Eur J Phys Rehabil Med 2010, 46(2):239-48.
  • [12]Guideline for the prevention of falls in older persons. American Geriatrics Society, British Geriatrics Society, and American Academy of Orthopaedic Surgeons Panel on Falls Prevention. J Am Geriatr Soc. 2001; 49(5):664–72.
  • [13]Runge M, Hunter G: Determinants of musculoskeletal frailty and the risk of falls in old age. J Musculoskelet Neuronal Interact 2006, 6(2):167-73.
  • [14]Ganz D, Bao Y, Shekelle PG, Rubenstein LZ: Will my patient fall? JAMA 2007, 297(1):77-86.
  • [15]Baker DI, King MB, Fortinsky FH, Graff LG, Gottschalk M, Acampora D, et al.: Dissemination of an evidence-based multi-component fall risk assessment and management strategy throughout a geographic area. J Am Geriatr Soc 2005, 53(4):675-80.
  • [16]Tinetti ME, Gordon C, Sogolow E, Lapin P, Bradley EH: Fall-risk evaluation and management: challenges in adopting geriatric care practices. Gerontologist 2006, 46(6):717-25.
  • [17]Berg K, Norman KE: Functional assessment of balance and gait. Clin Geriatr Med 1996, 12:705-23.
  • [18]Kopke S, Meyer G: The Tinetti test: Babylon in geriatric assessment. Z Gerontol Geriatr 2006, 39(4):288-91.
  • [19]Yelnik A, Bonan I: Clinical tools for assessing balance disorders. Neurophysiol Clin 2008, 38:439-45.
  • [20]Berg K, Wood-Dauphinee S, Williams JI: The Balance Scale: reliability assessment with elderly residents and patients with an acute stroke. Scand J Rehabil Med 1995, 27:27-36.
  • [21]Zampieri C, Salarian A, Carlson-Kuhta P, Aminian K, Nutt JG, Horak FB: An instrumented Timed Up and Go Test characterizes gait and postural transitions in untreated Parkinson´s disease. J Neurol Neurosurg Psychiatry 2010, 81:171-6.
  • [22]Stel VS, Pluijm SM, Deeg DJ, Smit JH, Bouter M, Lips P: A classification tree for predicting recurrent falling in community-dwelling older persons. J Am Geriatr Soc 2003, 51(10):1356-64.
  • [23]Murphy MA, Olson SL, Protas EJ, Overby AR: Screening for falls in community-dwelling elderly. J Aging Phys Activity 2003, 11:66-80.
  • [24]Bachmann S, Finger C, Huss A, Egger M, Stuck AE, Clough-Gorr KM: Inpatient rehabilitation specifically designed for geriatric patients: systematic review and meta-analysis of randomised controlled trials. BMJ 2010, 340:c1718.
  • [25]Handoll HH, Cameron ID, Mak JC, Finnegan TP: Multidisciplinary rehabilitation for older people with hip fractures. Cochrane Database Syst Rev 2009., 4Article ID CD007125
  • [26]Kammerlander C, Roth T, Friedman SM, Suhm N, Luger TJ, Kammerlander-Knauer U, et al.: Ortho-geriatric service— a literature review comparing different models. Osteoporos Int 2010, 21(Suppl 4):637-46.
  • [27]Knobe M, Siebert CH: Hip fractures in the elderly: Osteosynthesis versus joint replacement. Orthopade 2014, 43(4):314-24.
  • [28]Pape HC, Friess T, Liener U, Ruchholtz S, Schmucker U, Sturm JA, et al.: Development of geriatric trauma centers - An effort by the German Society for Trauma and Orthopaedics. Injury 2014, 45(10):1513-5.
  文献评价指标  
  下载次数:8次 浏览次数:17次