Nantes Université, CHU Nantes, Movement - Interactions - Performance, MIP, UR 4334, Nantes, France.
IFM3R, School of Physiotherapy, St-Sebastien-sur-Loire, France.
PLoS One. 2024 May 8;19(5):e0303362. doi: 10.1371/journal.pone.0303362. eCollection 2024.
The use of physiotherapy (PT) in the hospital emergency department (ED) has shown positive results including improvements in patient waiting time, treatment initiation, discharge type, patient outcomes, safety and acceptability of the intervention by medical staffs. These findings originate from studies that primarily focus on musculoskeletal and orthopaedic conditions. Despite a significant number of people visiting the ED, there is a shortage of literature evaluating PT in the ED for elderly populations. The objective of this study is the evaluate the effect of delivering PT in the ED (versus no delivery) in patients aged 75 and over with 'falls' complaints. The main objective is the evaluate the effect on the discharge disposition (discharge home, hospitalization). Secondarily, we will evaluate the effect delivering PT on patient-length of stay, the number of falls at 7 days after admission to the ED, changes between the initial and final medical decision regarding patient orientation, and medical staff satisfaction. This study will follow a prospective longitudinal design involving participants aged 75 years and over. We plan to recruit a total n = 336 patients admitted to the ED with a 'fall' chief complaint. After consent, participants will be randomized into either the 'PT-group' (receiving a prescription and execution of PT within the ED), or to the 'no-PT group' (no delivery of PT within the ED). The PT intervention will involve a standardized assessment of motor capacities using validated clinical examinations, and the delivery of rehabilitative exercises based on individual needs. Outcomes will be recorded from the patient's medical record, and a phone call at 7 days. A questionnaire will be sent to medical staff. The results of this study will help to determine whether PT might be beneficial for the management of this increasing proportion of individuals who come to the ED. Trial registration: (Trial registration number: ClinicalTrials.gov NCT05753319). https://classic.clinicaltrials.gov/ct2/show/NCT05753319.
在医院急诊部（ED）使用物理治疗（PT）已显示出积极的结果，包括改善患者等待时间、治疗开始、出院类型、患者结局、医务人员对干预措施的安全性和可接受性。这些发现源于主要关注肌肉骨骼和骨科疾病的研究。尽管有相当多的人到 ED 就诊，但评估老年人 PT 在 ED 中的应用的文献却很少。本研究的目的是评估在 ED 中为 75 岁及以上的“跌倒”患者提供 PT（与不提供相比）的效果。主要目的是评估对出院处置（出院回家、住院）的影响。其次，我们将评估在 ED 入院后 7 天内跌倒次数、患者初始和最终医疗决策之间的方向变化、以及医务人员满意度等方面，PT 的提供对患者住院时间的影响。这项研究将采用前瞻性纵向设计，涉及 75 岁及以上的参与者。我们计划招募总共 n = 336 名因“跌倒”主诉而被收入 ED 的患者。在获得同意后，参与者将被随机分配到 PT 组（在 ED 内接受处方并执行 PT）或无 PT 组（在 ED 内不提供 PT）。PT 干预措施将包括使用经过验证的临床检查对运动能力进行标准化评估，并根据个人需求提供康复锻炼。结果将从患者的病历中记录，并在 7 天时进行电话随访。将向医务人员发送一份问卷。这项研究的结果将有助于确定 PT 是否可能有益于管理越来越多的来到 ED 的人群。试验注册：（试验注册号：ClinicalTrials.gov NCT05753319）。https://classic.clinicaltrials.gov/ct2/show/NCT05753319。
