International Journal of Environmental Research and Public Health

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13 pages, 542 KiB

Open AccessArticle

Health Economic Challenge: Geriatric Trauma—An Age-Based Observational Analysis of Treatment Costs and Reimbursement Issues

by Cora Rebecca Schindler, Mathias Woschek, Nils Mühlenfeld, Lukas Seifert, Ingo Marzi, Philipp Störmann and René Danilo Verboket

Int. J. Environ. Res. Public Health 2022, 19(14), 8270; https://doi.org/10.3390/ijerph19148270 - 06 Jul 2022

Cited by 1 | Viewed by 1244

Abstract

Demographic change is having a major impact on the economic and structural development of the healthcare system. People stay active longer and the number of mild traumatic brain injury [mTBI] in patients ≥ 65 years of age consequently increases. The aim of this [...] Read more.

Demographic change is having a major impact on the economic and structural development of the healthcare system. People stay active longer and the number of mild traumatic brain injury [mTBI] in patients ≥ 65 years of age consequently increases. The aim of this comparative analysis is to illustrate the impact of demographic change and the increasing treatment of geriatric trauma patients on the cost structure of the health care system using mTBI as an example diagnosis. Patients and Methods: The 12-month retrospective analysis included 220 in-patients treated with mTBI and remunerated under the German Diagnosis Related Group [G-DRG] B80Z. For comparative analysis, the patient population was divided into two study groups according to age [U65 18–64 years, G65 ≥ 65 years]. For the cost and proceeds calculation, itemized cost reports (personnel, supply, material, and equipment costs, etc.) were created. Results: 163 patients U65 and 57 patients G65 were included. In the G65 group, the most frequent accident mechanism was a fall from a short distance (84.1 vs. U65 36.7%; p = 0.007). For the inpatient admission of G65, the use of anticoagulants (p < 0.001) and comorbidity (p = 0.002) played a primary role, while for younger patients it was more neurological symptoms (p < 0.001) and alcohol (p < 0.001) that led to inpatient monitoring. The mean length of hospitalization of G65 patients was significantly longer than that of younger patients (G65 2.4 ± 1.9 days > U65 1.7 ± 0.8 days; p = 0.007) and radiological examinations (G65 94.7% > U65 23.3%; p = 0.013) were performed more frequently. Comparing analysis of the cost and proceeds of U65 vs. G65 results in a proceeds difference of €51,753.91 per year for the G-DRG B80Z compared to U65. Conclusions: It has been shown that there is a difference in costs and proceeds when comparing younger and older patients, resulting in a reimbursement deficit. In view of the demographic development in Europe, flat-rate remuneration will lead to a considerable discrepancy between DRG reimbursement and the coverage of hospitals’ running costs. Providing health care to an increasingly aging society represents one of the major personnel and financial challenges for the public health system in the coming decades. Further adaptation of the DRG system to the growing costs caused by older patients is imperative. Full article

(This article belongs to the Special Issue Movement Disorders and Falls in Older Persons)

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8 pages, 349 KiB

Open AccessArticle

Can an Eight-Session Multicomponent Physical Exercise Program Reduce Fall Risk and Fear of Falling among the Elderly?

by Antony G. Philippe, Aurélie Goncalves, Christophe Martinez, Maxime Deshayes and Elodie Charbonnier

Int. J. Environ. Res. Public Health 2022, 19(14), 8262; https://doi.org/10.3390/ijerph19148262 - 06 Jul 2022

Cited by 5 | Viewed by 2006

Abstract

In older populations, falls are responsible for decrease autonomy and increased pain and injuries. With aging, fall risk is multifactorial and associated with sarcopenia, impaired balance, falls themselves and psychological factors such as fear of falling. The objectives of the present study were: [...] Read more.

In older populations, falls are responsible for decrease autonomy and increased pain and injuries. With aging, fall risk is multifactorial and associated with sarcopenia, impaired balance, falls themselves and psychological factors such as fear of falling. The objectives of the present study were: (a) to test the effects of a short multicomponent physical exercise program on fall risk and fear of falling; and (b) to analyze the relationship between fall risk and fear of falling. The participants were thirty-five older persons who were engaged in an eight-session physical exercise program. Balance (i.e., One-leg Balance Test, and Functional Reach Test), lower-limb endurance (i.e., Wall-sit Test) and fear of falling were measured before and after the multicomponent physical exercise program. Results indicated an increase in balance and a diminution of fear of falling after the end of the physical exercise program (p < 0.05). The program has an effect on lower limb endurance (p > 0.05). Gains in balance were correlated to the diminution of fear of falling (p < 0.05). An 8-week multicomponent physical exercise program based on balance is efficient to reduce fall risk and fear of falling among the elderly. Full article

(This article belongs to the Special Issue Movement Disorders and Falls in Older Persons)

9 pages, 694 KiB

Open AccessArticle

Effectiveness of a Tailored Fall-Prevention Program for Discharged Older Patients: A Multicenter, Preliminary, Randomized Controlled Trial

by Tetsuya Ueda, Yumi Higuchi, Gentoku Hattori, Hiromi Nomura, Gen Yamanaka, Akiko Hosaka, Mina Sakuma, Takato Fukuda, Takanori Fukumoto and Takashi Nemoto

Int. J. Environ. Res. Public Health 2022, 19(3), 1585; https://doi.org/10.3390/ijerph19031585 - 30 Jan 2022

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Abstract

This multicenter, preliminary, randomized controlled trial investigated the effect of a tailored fall-prevention program using home floor plans for discharged orthopedic patients aged ≥65 years who experienced ≥1 fall(s) in the past year (n = 72) at five acute-care hospitals. The control [...] Read more.

This multicenter, preliminary, randomized controlled trial investigated the effect of a tailored fall-prevention program using home floor plans for discharged orthopedic patients aged ≥65 years who experienced ≥1 fall(s) in the past year (n = 72) at five acute-care hospitals. The control group received standard care (exercise to prevent recurrent falls), whereas the intervention group received a tailored fall-prevention program in addition to usual care. A physical therapist conducted the tailored education program using each patient’s home floor plans before discharge. A follow-up survey of falls and near-falls at home was performed using a monthly fall calendar for the 1-month period after discharge. Data on 81.5% of participants remained for the final analyses. No falls occurred in the intervention group; however, 4.3% of those in the control group experienced a fall. Near-falls were reported by 3.7% and 26.9% of the participants in the intervention and control groups, respectively. The proportion of participants who did not experience near-falls in the 1st month after discharge was lower in the intervention than in the control group (p = 0.018). In conclusion, the tailored fall-prevention program using home floor plans in multiple acute-care hospitals was effective in reducing falls and near-falls in discharged orthopedic patients. Full article

(This article belongs to the Special Issue Movement Disorders and Falls in Older Persons)

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10 pages, 744 KiB

Open AccessArticle

The Effect of Body Composition on Gait Variability Varies with Age: Interaction by Hierarchical Moderated Regression Analysis

by Yungon Lee and Sunghoon Shin

Int. J. Environ. Res. Public Health 2022, 19(3), 1171; https://doi.org/10.3390/ijerph19031171 - 21 Jan 2022

Cited by 3 | Viewed by 2258

Abstract

Although body composition has been found to affect various motor functions (e.g., locomotion and balance), there is limited information on the effect of the interaction between body composition and age on gait variability. The purpose of this study was to determine the effect [...] Read more.

Although body composition has been found to affect various motor functions (e.g., locomotion and balance), there is limited information on the effect of the interaction between body composition and age on gait variability. The purpose of this study was to determine the effect of body composition on gait according to age. A total of 80 men (40 young and 40 older males) participated in the experiment. Body composition was measured using bioelectrical impedance analysis (BIA), and gait parameters were measured with seven-dimensional inertial measurement unit (IMU) sensors as each participant walked for 6 min at their preferred pace. Hierarchical moderated regression analysis, including height as a control variable and age as a moderator variable, was performed to determine whether body composition could predict gait parameters. In young males, stride length decreased as body fat percentage (BFP) increased (R² = 13.4%), and in older males, stride length decreased more markedly as BFP increased (R² = 26.3%). However, the stride length coefficient of variation (CV) of the older males increased significantly as BFP increased (R² = 16.2%), but the stride length CV of young males did not change even when BFP increased. The increase in BFP was a factor that simultaneously caused a decrease in gait performance and an increase in gait instability in older males. Therefore, BFP is more important for a stable gait in older males. Full article

(This article belongs to the Special Issue Movement Disorders and Falls in Older Persons)

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10 pages, 927 KiB

Open AccessArticle

Effects of Ai-Chi Practice on Balance and Left Cerebellar Activation during High Working Memory Load Task in Older People: A Controlled Pilot Trial

by Michal Nissim, Abigail Livny, Caroline Barmatz, Galia Tsarfaty, Yitshal Berner, Yaron Sacher, Raffaella Bodini and Navah Z. Ratzon

Int. J. Environ. Res. Public Health 2021, 18(23), 12756; https://doi.org/10.3390/ijerph182312756 - 03 Dec 2021

Cited by 2 | Viewed by 2593

Abstract

Background: Normal aging is associated with balance and working memory decline. From a neurobiological standpoint, changes in cerebellar functional plasticity may mediate the decline in balance and working memory for older adults. Mounting evidence suggests that physical activity is beneficial for decreasing aging [...] Read more.

Background: Normal aging is associated with balance and working memory decline. From a neurobiological standpoint, changes in cerebellar functional plasticity may mediate the decline in balance and working memory for older adults. Mounting evidence suggests that physical activity is beneficial for decreasing aging effects. Previous studies have focused on land-based physical activity and research concerning the aquatic environment is scarce. This study investigated the effectiveness of Ai-Chi on balance abilities and cerebral activation during a high working memory load task among community-dwelling older people. Methods: A total of 19 people aged 65–86 years were allocated to receive Ai-Chi practice (n = 6), structured on-land Ai-Chi practice (n = 7) or guided-imagery of Ai-Chi practice (n = 6) for a bi-weekly, 30-min exercise session for 12 weeks. Balance was measured by the Tinetti balance sub-test and working memory was measured by the N-back test during functional-MRI scan. Results: The Ai-Chi practice group presented a significant change in balance between pre and post intervention (balance t = −4.8, p < 0.01). In the whole-brain analysis, during high working memory load task, the Ai-Chi practice group presented a decrease in left cerebellar activation. Region of interest analyses yielded similar results by which pre-cerebellar activation was higher than post-intervention (t = 2.77, p < 0.05). Conclusions: Ai-Chi is an available, non-invasive intervention method that may serve as a tool to improve cerebellar activation that in turn might improve balance. In addition, our findings may provide new insights into the neuronal mechanisms that underlie both motor and cognitive abilities. Full article

(This article belongs to the Special Issue Movement Disorders and Falls in Older Persons)

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14 pages, 1577 KiB

Open AccessArticle

What Explains Successful or Unsuccessful Postural Adaptations to Repeated Surface Perturbations among Older Adults?

by Jimmy Falk, Viktor Strandkvist, Irene Vikman, Mascha Pauelsen and Ulrik Röijezon

Int. J. Environ. Res. Public Health 2021, 18(22), 12069; https://doi.org/10.3390/ijerph182212069 - 17 Nov 2021

Cited by 1 | Viewed by 1806

Abstract

As we age there are natural physiological deteriorations that decrease the accuracy and flexibility of the postural control system, which increases the risk of falling. Studies have found that there are individual differences in the ability to learn to manage repeated postural threats. [...] Read more.

As we age there are natural physiological deteriorations that decrease the accuracy and flexibility of the postural control system, which increases the risk of falling. Studies have found that there are individual differences in the ability to learn to manage repeated postural threats. The aim of this study was to investigate which factors explain why some individuals are less proficient at adapting to recurrent postural perturbations. Thirty-five community dwelling older adults performed substantial sensory and motor testing and answered surveys regarding fall-related concerns and cognitive function. They were also subjected to three identical surface perturbations where both kinematics and electromyography was captured. Those that were able to adapt to the third perturbation were assigned to the group “Non-fallers” whereas those that fell during all perturbations were assigned to the group “Fallers”. The group designation dichotomized the sample in a hierarchical orthogonal projection of latent structures— the discriminant analysis model. We found that those who fell were older, had poorer physical performance, poorer strength and longer reaction times. The Fallers’ postural control strategies were more reliant on the stiffening strategy along with a more extended posture and they were less skillful at making appropriate feedforward adaptations prior to the third perturbation. Full article

(This article belongs to the Special Issue Movement Disorders and Falls in Older Persons)

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11 pages, 346 KiB

Open AccessArticle

Gait Ability and Muscle Strength in Institutionalized Older Persons with and without Cognitive Decline and Association with Falls

by Maria dos Anjos Dixe, Carla Madeira, Silvia Alves, Maria Adriana Henriques and Cristina Lavareda Baixinho

Int. J. Environ. Res. Public Health 2021, 18(21), 11543; https://doi.org/10.3390/ijerph182111543 - 03 Nov 2021

Cited by 4 | Viewed by 2007

Abstract

Falls are a complex problem, given their multifactorial nature, the comorbidities involved, and due to the dependency of older persons living in nursing homes. Risk, fear of falling, falls themselves, and their recurrence are the main factors behind fragility fractures, lack of independence, [...] Read more.

Falls are a complex problem, given their multifactorial nature, the comorbidities involved, and due to the dependency of older persons living in nursing homes. Risk, fear of falling, falls themselves, and their recurrence are the main factors behind fragility fractures, lack of independence, and increases in pain prevalence, and other comorbidities in older populations. The objectives of the present quantitative and longitudinal study were: (a) to characterize the cognitive state and fall frequency of older persons living in nursing homes; (b) to analyze the relationship between cognitive status and some fall risk factors; and (c) to associate cognitive decline, gait ability, and muscle strength of the examined institutionalized older persons with fall occurrence and recurrence over 12 months. The participants were 204 older persons who lived in Portuguese nursing homes, and data were collected from January 2019 to February 2020 by consulting medical records and applying the following instruments: the Mini-Mental State Examination, Timed Up and Go Test, and Medical Research Council Manual Muscle Testing Scale. Fall prevalence, assessed in two periods, 12 months apart, was similar in both samples (with and without cognitive decline) and close to 42%, and the annual recurrence rate was 38.3%. Older persons with no cognitive decline showed an association between gait speed and occurrence of first fall and recurrent fall (p < 0.05). Muscle strength and use of gait aid devices were not related to falls and their recurrence, regardless of mental state. Full article

(This article belongs to the Special Issue Movement Disorders and Falls in Older Persons)

10 pages, 342 KiB

Open AccessArticle

Positive Self-Perceptions of Aging Play a Significant Role in Predicting Physical Performance among Community-Dwelling Older Adults

by Emma Nilsson, Helena Igelström, Irene Vikman, Agneta Larsson and Mascha Pauelsen

Int. J. Environ. Res. Public Health 2021, 18(21), 11151; https://doi.org/10.3390/ijerph182111151 - 23 Oct 2021

Cited by 5 | Viewed by 2407

Abstract

Self-perceptions of aging (SPA) is associated with various health-related outcomes, including physical performance. No previous study has investigated the potential predictive influence of SPA on physical performance among Swedish community-dwelling older adults. This was a cross-sectional study using a random sample of 153 [...] Read more.

Self-perceptions of aging (SPA) is associated with various health-related outcomes, including physical performance. No previous study has investigated the potential predictive influence of SPA on physical performance among Swedish community-dwelling older adults. This was a cross-sectional study using a random sample of 153 Swedish community-dwelling individuals aged 70 and older. Multiple logistic regression analysis was performed, using the subscale “Attitude Towards Own Aging” of the Philadelphia Geriatric Center Morale Scale, as a measure of SPA. The Short Physical Performance Battery (SPPB) was dichotomized and used as the outcome variable. SPA was a significant predictor (OR = 1.546, CI = 1.066–2.243) of physical performance, adjusted for age, cognitive function, and life-space mobility. Further analyses revealed significant sex differences, with SPA not being included in the model for the men whilst it was still a significant predictor (OR = 1.689, CI = 1.031–2.765) of physical performance in the group of women. SPA plays a significant role in predicting physical performance among Swedish community-dwelling older adults. To further clarify this relationship and its consequences, future longitudinal research should focus on the relationship between SPA, physical performance, and fall risk. Full article

(This article belongs to the Special Issue Movement Disorders and Falls in Older Persons)

10 pages, 669 KiB

Open AccessArticle

Exploring the Environment behind In-Patient Falls and Their Relation to Hospital Overcrowdedness—A Register-Based Observational Study

by Dimitrios Stathopoulos, Eva Ekvall Hansson and Kjerstin Stigmar

Int. J. Environ. Res. Public Health 2021, 18(20), 10742; https://doi.org/10.3390/ijerph182010742 - 13 Oct 2021

Cited by 2 | Viewed by 2747

Abstract

(1) Background: Inpatient falls are a serious threat to patients’ safety and their extrinsic factors are, at present, insufficiently described. Additionally, hospital overcrowdedness is known for its malicious effects but its relation to the inpatient falls is currently underexplored. The aim of this [...] Read more.

(1) Background: Inpatient falls are a serious threat to patients’ safety and their extrinsic factors are, at present, insufficiently described. Additionally, hospital overcrowdedness is known for its malicious effects but its relation to the inpatient falls is currently underexplored. The aim of this study was to explore the distribution of falls and their extrinsic characteristics amongst a range of different clinics, and to explore the correlation and predictive ability of hospital overcrowding in relation to inpatient falls. (2) Methods: An observational, cross-sectional, registry-based study was conducted using retrospective data from an incidence registry of a hospital organization in Sweden during 2018. The registry provided data regarding the extrinsic factors of inpatient falls, including the clinics’ overcrowdedness. Simple descriptive statistics, correlation analysis and simple linear regression analysis were used. (3) Results: Twelve clinics were included. A total of 870 inpatient falls were registered during 2018. Overcrowdedness and total amount of falls were positively and very strongly correlated (r = 0.875, p < 0.001). Overcrowdedness was a significant predictor of the total amount of inpatient falls (p < 0.001, α = 0.05). (4) Conclusions: The characteristics regarding inpatient falls vary among the clinics. Inpatient overcrowding might have a significant role in the prevalence of inpatient falls, but further high-evidence-level studies are required. Full article

(This article belongs to the Special Issue Movement Disorders and Falls in Older Persons)

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14 pages, 1543 KiB

Open AccessArticle

One-Year Changes in Activities of Daily Living, Usability, Falls and Concerns about Falling, and Self-Rated Health for Different Housing Adaptation Client Profiles

by Agneta Malmgren Fänge, Carlos Chiatti and Anna Axmon

Int. J. Environ. Res. Public Health 2021, 18(18), 9704; https://doi.org/10.3390/ijerph18189704 - 15 Sep 2021

Cited by 1 | Viewed by 1534

Abstract

The purpose of this study was to investigate one-year changes and differences in changes in activities of daily living (ADL), usability, a history of falls, concerns about falling, and self-rated health across five housing adaptation (HA) client profiles identified previously using a cluster [...] Read more.

The purpose of this study was to investigate one-year changes and differences in changes in activities of daily living (ADL), usability, a history of falls, concerns about falling, and self-rated health across five housing adaptation (HA) client profiles identified previously using a cluster analysis approach: older adults with low level of disability (n = 59); older adults with medium/high level of disability (n = 26); adults with low level of disability (n = 10); adults with high level of disability (n = 8); and older adults with medium level of disability including at least moderate cognitive impairment (n = 5). Comparisons between the five profiles include secondary analyses aggregating those with low level of disability and those with medium/high level of disability. Changes within the client profiles demonstrate a complex pattern of improvements and declines, depending on outcome, with no profile showing consistent improvement or decline across all outcomes. The risks of deterioration over one year were the highest among those with cognitive impairments at baseline, but no recommendation of prioritization decisions based on baseline profiles can be made. Instead, it seems that all HA clients, independently of baseline profile, are at risk of increasing disability over time and require follow-up evaluations regularly. Full article

(This article belongs to the Special Issue Movement Disorders and Falls in Older Persons)

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11 pages, 327 KiB

Open AccessArticle

by Christina Brogårdh, Jan Lexell and Catharina Sjödahl Hammarlund

Int. J. Environ. Res. Public Health 2021, 18(13), 7202; https://doi.org/10.3390/ijerph18137202 - 05 Jul 2021

Cited by 4 | Viewed by 2396

Abstract

Falls are common among persons with late effects of polio (LEoP), which may lead to fear of falling and activity avoidance in everyday life. Here, we assessed the occurrence of fall-related activity avoidance among persons with LEoP and explored how these experiences influenced [...] Read more.

Falls are common among persons with late effects of polio (LEoP), which may lead to fear of falling and activity avoidance in everyday life. Here, we assessed the occurrence of fall-related activity avoidance among persons with LEoP and explored how these experiences influenced daily life. Fourteen ambulatory persons (seven women; mean age 70 years) with LEoP participated. They responded to the modified Survey of Activities and Fear of Falling in the Elderly (mSAFFE) and participated in individual interviews, which were analysed by systematic text condensation. Each quotation was deductively analysed from its representation with regard to mSAFFE. We found that many persons often avoided activities related to standing and walking, for example, taking a bath, performing household chores, walking outdoors, attending social events if there were stairs in the building and travelling by public transport, due to fear of falling, increased pain and fatigability. To facilitate the performance of daily activities participants expressed that strategic thinking and aids were important to use. In conclusion, fall-related activity avoidance is common in persons with LEoP, which negatively influence daily life and social participation. To increase daily functioning in this population, fall-related activity avoidance should be included in a multifaceted fall management program. Full article

(This article belongs to the Special Issue Movement Disorders and Falls in Older Persons)

13 pages, 2495 KiB

Open AccessArticle

Gait Flexibility among Older Persons Significantly More Impaired in Fallers Than Non-Fallers—A Longitudinal Study

by Eva Ekvall Hansson, Elina Valkonen, Ulrika Olsson Möller, Yi Chen Lin, Måns Magnusson and Per-Anders Fransson

Int. J. Environ. Res. Public Health 2021, 18(13), 7074; https://doi.org/10.3390/ijerph18137074 - 02 Jul 2021

Cited by 9 | Viewed by 2677

Abstract

Gait disorders are a relevant factor for falls and possible to measure with wearable devices. If a wearable sensor can detect differences in gait parameters between fallers and non-fallers has not yet been studied. The aim of this study was to measure and [...] Read more.

Gait disorders are a relevant factor for falls and possible to measure with wearable devices. If a wearable sensor can detect differences in gait parameters between fallers and non-fallers has not yet been studied. The aim of this study was to measure and compare gait parameters, vestibular function, and balance performance between fallers and non-fallers among a group of older persons. Participants were senior members (n = 101) of a Swedish non-profit gymnastic association. Gait parameters were obtained using an inertial measurement unit (IMU) that the participants wore on the leg while walking an obstacle course and on an even surface. Vestibular function was assessed by the Head-shake test, the Head impulse test, and the Dix–Hallpike maneuver. Balance was assessed by the Timed Up and Go, the Timed Up and Go manual, and the Timed Up and Go cognitive tests. Falls during the 12-month follow-up period were monitored using fall diaries. Forty-two persons (41%) had fallen during the 12-month follow-up. Fallers had more limited ability to vary their gait (gait flexibility) than non-fallers (p < 0.001). No other differences between fallers and non-fallers were found. The use of gait flexibility, captured by an IMU, seems better for identifying future fallers among healthy older persons than Timed Up and Go or Timed Up and Go combined with a cognitive or manual task. Full article

(This article belongs to the Special Issue Movement Disorders and Falls in Older Persons)

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10 pages, 333 KiB

Open AccessStudy Protocol

Assessing the Outcome of Rehabilitation after Hip Fracture with a Wearable Device—A Study Protocol for a Randomized Control Trial in Community Healthcare

by Eva Ekvall Hansson, Agneta Malmgren Fänge and Cecilia Rogmark

Int. J. Environ. Res. Public Health 2021, 18(19), 10165; https://doi.org/10.3390/ijerph181910165 - 27 Sep 2021

Cited by 2 | Viewed by 1965

Abstract

Background: The increase of the aging population is a challenge to society, as age is related to dependence. Injuries such as hip fractures cause morbidity, loss of independent life, and mortality. The purpose of this protocol is to describe a randomized control trial, [...] Read more.

Background: The increase of the aging population is a challenge to society, as age is related to dependence. Injuries such as hip fractures cause morbidity, loss of independent life, and mortality. The purpose of this protocol is to describe a randomized control trial, with three intervention arms, aiming at investigating if there are any differences in outcomes after hip fracture between different rehabilitation interventions including (1) High-Intensity Functional Exercise (HIFE), (2) HIFE with the addition of continuous measures of movement and body positions with a wearable device, or (3) standard rehabilitation. A secondary aim is to evaluate physiotherapists’ satisfaction with using the wearable device in rehabilitation. Method: Patients with hip fracture that require rehabilitation at home will be invited to participate and randomly assigned to one intervention arm. The primary outcome is balance, measured by postural sway using an Inertial Measurement Unit and by Functional Balance test for Geriatric patients. Secondary outcomes are functional independence in everyday activities, measured with the Barthel Index, and health-related quality of life measured with EuroQol 5 Dimension questionnaire and EuroQol Visual Analogue Scale for health and user satisfaction measured by the User Satisfaction Evaluation Questionnaire. Discussion: This study protocol is the first step in securing the research process before performing a full randomized controlled trial. The next step will be a pilot- and feasibility study. Full article

(This article belongs to the Special Issue Movement Disorders and Falls in Older Persons)

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