Pape Hans-Christoph, Schemmann Ulrike, Foerster Juergen, Knobe Matthias
Department of Orthopaedic Trauma, University of Aachen Medical Center, 30 Pauwelsstreet, 52074 Aachen, Germany.
Division of Physical Therapy at University of Aachen Medical Center, Aachen, Germany ; Harald Tscherne Lab for Orthopaedic Trauma, University of Aachen Medical Center, Aachen, Germany.
Patient Saf Surg. 2015 Feb 14;9:7. doi: 10.1186/s13037-014-0055-0. eCollection 2015.
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.
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.
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.
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.
老年人群跌倒的发生率难以确定，因此可能被低估。筛查算法通常的共同点是由医院环境中经过培训的人员进行评估。这导致纳入了高比例的低风险人群并造成资源浪费。使用简单的自我评估方法在个体自身环境中对高危个体进行预测试将是有利的。
我们的临床医生和物理治疗师团队的共识过程包括：1. 对地面跌倒风险概况和评估工具进行预备性文献综述；2. 选择涵盖跌倒风险增加所涉及的所有健康方面的适当问题；3. 选择一种无需医疗保健专业人员即可在家中使用的简单身体测试。因此，我们试图开发一种可供跌倒风险较高的老年人使用的量表。本手稿总结了该综述、共识和选择过程的结果。
文献检索于2013年3月至8月1日进行。所使用问题（第一部分）的选择过程持续了2013年3月至2014年1月。在所有评估的测试中，20秒站立测试（第二部分）被认为即使是有跌倒风险的个体进行也很安全，因为它与日常生活活动非常相似。“亚琛跌倒预防量表”最终使用一种自我评估工具，个体在完成第一部分和第二部分后自行将跌倒风险评为1至10级。总之，我们提出了一种量表，可能为改善老年公民跌倒预防措施提供自我评估选项。
引入结合简单问卷和安全快速平衡工具的“亚琛跌倒预防量表”，符合识别是否存在平衡问题的标准——评估跌倒风险的第一步。进一步的研究将必须评估个体在纵向基础上估计其个人跌倒风险的能力，并可能引发由医生进行评估的必要性。
