A simple tool predicted probability of falling after aged care inpatient rehabilitation

Sherrington, Catherine; Lord, Stephen R.; Close, Jacqueline C.T.; Barraclough, Elizabeth D.; Taylor, Mark E.; O'Rourke, Sandra; Kurrle, Susan; Tiedemann, Anne; Cumming, Robert G.; Herbert, Robert D.

doi:10.1016/j.jclinepi.2010.09.015

Cited by 27 publications

(24 citation statements)

References 36 publications

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“…Previous studies by our research group have found that lasting disability and falls are common among older people who have recently been hospitalized10,11 and that pain is associated with poorer stair negotiation,12 6-minute walk distance,13 6 m walking speed,14 and sit-to-stand15 performance among community-dwelling older people. However, the influence of pain on the physical performance of older people who have been hospitalized has not been well investigated.…”

Section: Introductionmentioning

confidence: 79%

“…We attempted to include all eligible inpatients in the study but as outlined in our previous publications from this study,10,11–16 a total of 1,127 people were admitted to the wards during the study period. We experienced some logistical difficulties in that research personnel could not always be present when patient assessments were required.…”

Section: Discussionmentioning

confidence: 99%

“…This cross sectional study involved secondary analysis of predischarge assessment data from a prospective cohort study conducted at two inpatient aged care rehabilitation units in Sydney, Australia 10,11–16…”

Section: Methodsmentioning

confidence: 99%

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Self-reported chronic pain is associated with physical performance in older people leaving aged care rehabilitation

Pereira¹,

Sherrington²,

Ferreira³

et al. 2014

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Background/objectivesThe impact of pain on the physical performance of patients in aged care rehabilitation is not known. The study sought to assess 1) the prevalence of pain in older people being discharged from inpatient rehabilitation; 2) the association between self-reported pain and physical performance in people being discharged from inpatient rehabilitation; and 3) the association between self-reported pain and physical performance in this population, after adjusting for potential confounding factors.MethodsThis was an observational cross-sectional study of 420 older people at two inpatient aged care rehabilitation units. Physical performance was assessed using the Lower Limb Summary Performance Score. Pain was assessed with questions about the extent to which participants were troubled by pain, the duration of symptoms, and the impact of chronic pain on everyday activity. Depression and the number of comorbidities were assessed by questionnaire and medical file audit. Cognition was assessed with the Mini-Mental State Examination.ResultsThirty percent of participants reported chronic pain (pain lasting more than 3 months), and 17% reported that this pain interfered with daily activities to a moderate or greater extent. Chronic pain (P=0.013) and chronic pain affecting daily activities (P<0.001) were associated with a poorer Lower Limb Summary Performance Score. The relationship between chronic pain affecting daily activities and Lower Limb Summary Performance Score remained significant (P=0.001) after adjusting for depression, age, comorbidities, and Mini-Mental State Examination score. This model explained 10% of the variability in physical performance.ConclusionOne-third of participants reported chronic pain, and close to one-fifth reported that this pain interfered with daily activities. Chronic pain was associated with impaired physical performance, and this relationship persisted after adjusting for likely confounding factors.

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Section: Introductionmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 99%

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Self-reported chronic pain is associated with physical performance in older people leaving aged care rehabilitation

Pereira¹,

Sherrington²,

Ferreira³

et al. 2014

CIA

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“…Seven of the included studies in the review provided a formula from which falls risk could be calculated,3 12 13 21–24 while four of these provided a simplified score 3 21–23. The categorisation of continuous predictors has been justified in several previous prognostic studies, citing the need for clinical simplicity and to avoid assumptions about linear relationships 33 34. Recent guidelines strongly caution against discarding information through dichotomisation, and instead advise carrying out non-linear transformations where indicated 15 17.…”

Section: Discussionmentioning

confidence: 99%

Systematic review of risk prediction models for falls after stroke

Walsh

Horgan

Walsh

et al. 2016

J Epidemiol Community Health

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What this study adds?This review identifies risk prediction models for falls after stroke that require validation and impact measurement. It will facilitate future researchers in the appropriate measurement of prognostic factors for model validation, a key step in the development process of models that can be incorporated into clinical decisionmaking post stroke. 4 ABSTRACTBackground: Falls are a significant cause of morbidity after stroke. The aim of this

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“…Older people recently discharged from hospital are at a particularly high risk of falls [1] and disability [2]. Previous studies have reported that 14% of older people fall in the first month after discharge from hospital [3] and 34% fall within three months of discharge from rehabilitation care [4].…”

Section: Introductionmentioning

confidence: 99%

A Post-Hospital Home Exercise Program Improved Mobility but Increased Falls in Older People: A Randomised Controlled Trial

et al. 2014

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BackgroundHome exercise can prevent falls in the general older community but its impact in people recently discharged from hospital is not known. The study aimed to investigate the effects of a home-based exercise program on falls and mobility among people recently discharged from hospital.Methods and FindingsThis randomised controlled trial (ACTRN12607000563460) was conducted among 340 older people. Intervention group participants (n = 171) were asked to exercise at home for 15–20 minutes up to 6 times weekly for 12 months. The control group (n = 169) received usual care. Primary outcomes were rate of falls (assessed over 12 months using monthly calendars), performance-based mobility (Lower Extremity Summary Performance Score, range 0–3, at baseline and 12 months, assessor unaware of group allocation) and self-reported ease of mobility task performance (range 0–40, assessed with 12 monthly questionaries). Participants had an average age of 81.2 years (SD 8.0) and 70% had fallen in the past year. Complete primary outcome data were obtained for at least 92% of randomised participants. Participants in the intervention group reported more falls than the control group (177 falls versus 123 falls) during the 12-month study period and this difference was statistically significant (incidence rate ratio 1.43, 95% CI 1.07 to 1.93, p = 0.017). At 12-months, performance-based mobility had improved significantly more in the intervention group than in the control group (between-group difference adjusted for baseline performance 0.13, 95% CI 0.04 to 0.21, p = 0.004). Self-reported ease in undertaking mobility tasks over the 12-month period was not significantly different between the groups (0.49, 95% CI −0.91 to 1.90, p = 0.488).ConclusionsAn individualised home exercise prescription significantly improved performance-based mobility but significantly increased the rate of falls in older people recently discharged from hospital.Trial RegistrationAustralian New Zealand Clinical Trials Registry ACTRN12607000563460

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A simple tool predicted probability of falling after aged care inpatient rehabilitation

Cited by 27 publications

References 36 publications

Self-reported chronic pain is associated with physical performance in older people leaving aged care rehabilitation

Self-reported chronic pain is associated with physical performance in older people leaving aged care rehabilitation

Systematic review of risk prediction models for falls after stroke

A Post-Hospital Home Exercise Program Improved Mobility but Increased Falls in Older People: A Randomised Controlled Trial

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