Benhamou Jonathan, Espejo Tanguy, Riedel Henk B, Dreher-Hummel Thomas, García-Martínez Ana, Gubler-Gut Barbara, Kirchberger Joris, Overberg Jan-Arie, Perrot Guido, Bingisser Roland, Nickel Christian H
Emergency Department, University Hospital Basel, Petersgraben 2, 4031, Basel, Switzerland.
Emergency Department, Hospital Clínic, C. de Villarroel 170, 08036, Barcelona, Spain.
Eur Geriatr Med. 2025 Feb;16(1):205-217. doi: 10.1007/s41999-024-01091-x. Epub 2024 Nov 16.
Greater fear of falling (FOF) is associated with an increased risk of falling in patients aged 65 and older. This study aims to assess the impact of physiotherapy on FOF in older patients and investigates the feasibility of such an intervention in the emergency department (ED) setting.
All patients aged 65 or older, who presented to the ED of the University Hospital Basel after a fall between January 2022 and June 2023 were screened for inclusion. Participants were assigned to an intervention or control group depending on the randomized presence or absence of a physiotherapist at inclusion. Both groups received the same fall prevention booklet. Physiotherapists instructed and performed exercises with patients in the intervention group. The primary outcome was the difference in FOF between groups 7 days post inclusion, assessed by short Falls Efficacy Scale International (sFES-I). Secondary outcomes included feasibility, overall reduction of FOF, patient satisfaction, the occurrence of falls post inclusion and the use of medical resources.
Of the 1204 patients screened for inclusion, 104 older adults with a recent fall were enrolled (intervention: n = 44, control: n = 60); median age was 81 years and 59.1% were female. There was no between-group difference in FOF as measured by sFES-I within a week of inclusion (p = 0.663, effect size = 0.012 [95% confidence interval (CI) - 0.377 to 0.593]). Despite the intervention being deemed feasible from the physiotherapist's perspective, the study encountered challenges, such as low recruitment (with the planned sample size not being reached) and a notable dropout rate before the first follow-up.
A physiotherapy intervention in the ED showed no improvement in FOF when compared to a control group.
Trial registration number and date NCT05156944, 01.12.2021.
在65岁及以上的患者中，对跌倒的恐惧（FOF）加剧与跌倒风险增加相关。本研究旨在评估物理治疗对老年患者FOF的影响，并调查在急诊科（ED）环境中进行这种干预的可行性。
筛选2022年1月至2023年6月期间因跌倒后到巴塞尔大学医院急诊科就诊的所有65岁及以上患者，以确定是否纳入研究。根据纳入时是否随机配备物理治疗师，将参与者分为干预组或对照组。两组均收到相同的预防跌倒手册。物理治疗师指导干预组患者并为其进行锻炼。主要结局是纳入后7天两组之间FOF的差异，通过简短国际跌倒效能量表（sFES-I）进行评估。次要结局包括可行性、FOF的总体降低、患者满意度、纳入后跌倒的发生情况以及医疗资源的使用。
在筛选纳入的1204例患者中，有104例近期跌倒的老年人被纳入研究（干预组：n = 44，对照组：n = 60）；中位年龄为81岁，女性占59.1%。纳入后一周内，通过sFES-I测量的两组之间FOF无差异（p = 0.663，效应大小 = 0.012 [95%置信区间（CI）- 0.377至0.593]）。尽管从物理治疗师的角度来看该干预被认为是可行的，但该研究遇到了挑战，如招募率低（未达到计划样本量）以及首次随访前显著的失访率。
与对照组相比，急诊科的物理治疗干预在FOF方面没有改善。
试验注册号和日期NCT05156944，2021年12月1日。
