Geriatric Research, Education, Clinical Center, Veteran's Affairs Puget Sound Health Care System, 1660 S. Columbian Way, S-182-GRECC, Seattle, WA, 98108, USA.
Rehabilitation Care Services, Veteran's Affairs Puget Sound Health Care System, 1660 S. Columbian Way, S-117-RCS, Seattle, WA, 98108, USA.
Arch Osteoporos. 2017 Oct 31;12(1):96. doi: 10.1007/s11657-017-0393-5.
Fall prevention is an important way to prevent fractures in person with osteoporosis. We developed and implemented a fall screening program in the context of routine osteoporosis care. This program was found to be feasible and showed that a significant proportion of persons with osteoporosis are at risk of falling.
Falls are the most common cause of fracture in persons with osteoporosis. However, osteoporosis care rarely includes assessment and prevention of falling. We thus sought to assess the feasibility of a fall screening and management program integrated into routine osteoporosis care.
The program was developed and offered to patients with osteoporosis or osteopenia seen at an outpatient clinic between May 2015 and May 2016. Feasibility was measured by physical therapist time required to conduct screening and ease of integrating the screening program into the usual clinic workflow. Self-report responses and mobility testing were conducted to describe the fall and fracture risk profile of osteoporosis patients screened. Effects on fall-related care processes were assessed via chart abstraction of patient participation in fall prevention exercise.
Of the 154 clinic patients who presented for a clinic visit, 68% met screening criteria and completed in two thirds of persons. Screening was completed in a third of the time typically allotted for traditional PT evaluations and did not interfere with clinic workflow. Forty percent of those screened reported falling in the last year, and over half had two or more falls in the past year. Over half reported a balance or lower extremity impairment, and over 40% were below norms on one or more performance tests. Most patients who selected a group exercise fall prevention program completed all sessions while only a quarter completed either supervised or independent home-based programs.
Implementation of a fall risk screening program in an outpatient osteoporosis clinic appears feasible. A substantial proportion of people with osteoporosis screened positive for being at risk of falling, justifying integration of fall prevention into routine osteoporosis care.
预防跌倒对于骨质疏松症患者预防骨折至关重要。我们在常规骨质疏松症护理的背景下制定并实施了跌倒筛查计划。该计划被证明是可行的，并且表明相当一部分骨质疏松症患者存在跌倒风险。
跌倒是骨质疏松症患者骨折最常见的原因。然而，骨质疏松症护理很少包括跌倒评估和预防。因此，我们试图评估将跌倒筛查和管理计划纳入常规骨质疏松症护理的可行性。
该计划于 2015 年 5 月至 2016 年 5 月期间在门诊诊所为骨质疏松症或低骨量患者制定并提供。通过物理治疗师进行筛查所需的时间以及将筛查计划轻松整合到常规诊所工作流程来衡量可行性。通过对骨质疏松症患者的跌倒和骨折风险概况进行自我报告的反应和移动性测试来描述。通过对患者参与跌倒预防运动的图表摘录来评估对与跌倒相关的护理过程的影响。
在 154 名就诊的诊所患者中，有 68%符合筛查标准，其中三分之二的人完成了筛查。筛查时间完成了三分之一，通常用于传统的 PT 评估，并且不干扰诊所的工作流程。40%的筛查者报告在过去一年中跌倒，超过一半的人在过去一年中有两次或更多次跌倒。超过一半的人报告平衡或下肢受损，超过 40%的人在一项或多项性能测试中低于标准。大多数选择小组运动跌倒预防计划的患者完成了所有课程，而只有四分之一的人完成了监督或独立的家庭计划。
在门诊骨质疏松症诊所实施跌倒风险筛查计划似乎是可行的。相当一部分筛查出的骨质疏松症患者存在跌倒风险，这证明将跌倒预防纳入常规骨质疏松症护理是合理的。
