Hospital Sírio-Libanês, São Paulo, Brazil.
Research Institute, Hospital Sírio-Libanês, São Paulo, Brazil.
PLoS One. 2024 Jul 31;19(7):e0304397. doi: 10.1371/journal.pone.0304397. eCollection 2024.
Older adults have higher rates of emergency department (ED) admissions when compared to their younger counterparts. Mobility is the ability to move around, but also encompasses the environment and the ability to adapt to it. Walking aids can be used to improve mobility and prevent falls. According to international guidelines, they must be available in Geriatric EDs. This study aims to evaluate the efficacy of a program of training and provision of walking aids (WA), associated or not with telemonitoring, on fear of falling, mobility, quality of life and risk of falls up to 3 and 6 months in older adults cared for in an ED. A randomized controlled trial will be carried out in the ED. Participants will be randomized and allocated into three groups, as follows: A) walking aid group will be trained for the use of a walking aid and receive guidance on safe gait; B) walking aid and telemonitoring group will receive training for the use of a walking aid, guidance on safe gait, and telemonitoring (every two weeks for first three months); C) Control group will receive only guidance on safe gait. Patients will undergo a baseline evaluation encompassing sociodemographic and clinical data, mobility in life spaces, gait speed, muscle strength, functionality, quality of life, fear of falling, history of falls, cognition and mood before the intervention. Gait time and fear of falling will be assessed again after the intervention in ED. Finally, mobility in life spaces, functionality, quality of life, fear of falling, history of falls, cognition, and mood will be assessed 3 and 6 months after discharge from the geriatric ED through a telephone interview. Provision of walking aids in the geriatric ED is currently recommended. This study will be the first randomized controlled trial that will evaluate the impact of training and provision of these devices in the ED. Trial registration number: NCT05950269.
老年人因急诊(ED)就诊的比例高于年轻人。活动能力是指四处走动的能力,但也包括环境和适应环境的能力。助行器可用于提高活动能力和预防跌倒。根据国际指南,老年 ED 必须配备助行器。本研究旨在评估 ED 中对老年人进行助行器培训和提供助行器(WA)的方案(无论是否与远程监测相结合)对跌倒恐惧、活动能力、生活质量和跌倒风险的疗效,直至 3 个月和 6 个月。将在 ED 中进行一项随机对照试验。参与者将随机分组并分配到以下三个组:A)助行器组将接受助行器使用培训,并接受安全步态指导;B)助行器和远程监测组将接受助行器使用培训、安全步态指导和远程监测(前三个月每两周一次);C)对照组仅接受安全步态指导。患者将在干预前进行基线评估,包括社会人口统计学和临床数据、生活空间活动能力、步态速度、肌肉力量、功能、生活质量、跌倒恐惧、跌倒史、认知和情绪。干预后 ED 中再次评估步态时间和跌倒恐惧。最后,通过电话访谈在 3 个月和 6 个月后评估生活空间活动能力、功能、生活质量、跌倒恐惧、跌倒史、认知和情绪。目前推荐在老年 ED 中提供助行器。这将是第一项评估 ED 中培训和提供这些设备的影响的随机对照试验。试验注册号:NCT05950269。