Department of Internal Medicine and Geriatrics, University Hospital of Montpellier, Montpellier University, France; MACVIA, France; EA 2991, Euromov, Montpellier University, France; Department of Medical Information, University Hospital of Montpellier, Montpellier University, France.
Department of Internal Medicine and Geriatrics, University Hospital of Montpellier, Montpellier University, France.
Maturitas. 2019 Apr;122:80-86. doi: 10.1016/j.maturitas.2019.01.012. Epub 2019 Jan 25.
To evaluate whether a multifactorial programme delivered in a real practice setting would help prevent serious fall-related injuries in high-risk older patients.
A 6-month pre-post intervention study in 134 fallers (81.6 ± 7.2 years) consecutively referred to a fall prevention clinic after repeated falls in the previous year or after a fall associated with balance, gait, or strength disorders. The programme was delivered by a physiotherapist, an occupational therapist, a podiatrist, and a geriatrician based on a 3-hour fall risk assessment.
The proportion of patients with serious and moderate fall-related injuries was significantly lower in the 6 months after than in the 6-months preceding clinic attendance [8 (6.1%) vs 40 (30.5%), and 11 (8.2%) vs 19 (14.2%), respectively; p < 0.0001], as were the overall proportion of fallers (32.1% vs 95.4%; p < 0.0001) and the number of falls per patient (-5.2 ± -20.4; p < 0.0001). When compared with baseline, fear of falling at 6 months was reduced (p < 0.05), mobility was maintained, and the proportion of patients with an ADL score ≤ 2 was increased (5.6% vs 9.7% respectively; p < 0.001). Adherence to the main recommendations and satisfaction with the programme were > 75% at 6 months post-clinic.
A multifactorial fall prevention programme delivered by a multidisciplinary geriatric team in older patients at high risk of falling helps to reduce over a 6-month period the risk of serious and moderate injuries related to falls, the risk of falling, and the fear of falling, and helps to maintain mobility and improve functional status.
评估在真实实践环境中实施的多因素方案是否有助于预防高风险老年患者的严重跌倒相关伤害。
对 134 名跌倒者（81.6±7.2 岁）进行了 6 个月的干预前-干预后研究，这些患者在过去一年中反复跌倒或因平衡、步态或力量障碍而跌倒后，连续被转诊至跌倒预防诊所。该方案由物理治疗师、职业治疗师、足病医生和老年病医生根据 3 小时的跌倒风险评估来实施。
在就诊后 6 个月，严重和中度跌倒相关伤害的患者比例明显低于就诊前 6 个月[8（6.1%）比 40（30.5%），11（8.2%）比 19（14.2%）；p<0.0001]，跌倒者的总体比例（32.1%比 95.4%）和每位患者的跌倒次数（-5.2 比-20.4；p<0.0001）也降低了。与基线相比，就诊后 6 个月时的跌倒恐惧有所减轻（p<0.05），活动能力保持不变，ADL 评分≤2 的患者比例增加（分别为 5.6%比 9.7%；p<0.001）。就诊后 6 个月，对主要建议的依从性和对方案的满意度均>75%。
高跌倒风险老年患者由多学科老年病团队实施的多因素跌倒预防方案有助于在 6 个月内降低严重和中度跌倒相关伤害、跌倒风险和跌倒恐惧的风险，并有助于保持活动能力和改善功能状态。
