Falls in the Rehabilitation Setting: Incidence and Characteristics

Abstract

A prospective six-month study was conducted to determine a high-risk index for medical rehabilitation patients who fall. Variables studied for all patients included demographics, medical conditions, associated symptoms, orthostatic blood pressure measurements, physical function, posture control, proprioception, use of physical restraints, and medications, A detailed examination of the fall events was also conducted. Of the 143 patients studied, 46 (32%) fell at least once, making a total of 84 falls. Impaired ability to follow directions, impaired judgment, impaired proprioception, presence of physical restraints, use of major tranquilizers, use of sedatives, and presence of psychiatric diagnosis were all individually associated with patients who fell. Males fell more than females. Logistic regression identified altered proprioception as the only major predictor of falling. Of those who fell, only 26% called for assistance prior to the fall. Sixty-eight percent of the falls were from wheelchairs. Importantly, no patients had serious injury or morbidity from the falls.

Evaluation of risperidone in the treatment of behavioral and psychological symptoms and sleep disturbances associated with dementia

“…wandering, agitation) have been linked to increased falls in this population (Kiely et al, 1998;Marx et al, 1990;Mion et al, 1989). Falls can have serious consequences for the elderly patient, including bone fractures and subsequent death or discharge to a nursing home (Fuller, 2000).…”

“…Indeed, sleep disruptions and reduced functional abilities of the patient have been associated with nursing home placement (Chenier, 1997). Night-time wandering is not uncommon in this population (Kiely et al, 1998;Mion et al, 1989), putting patients at risk of getting lost or falling, which may result in fractures or other injuries (Klein et al, 1999).…”

Effectiveness of targeted falls prevention programme in subacute hospital setting: randomised controlled trial

“…Falls are a common occurrence among elderly inpatients in subacute hospitals and are generally reported to affect between 13% and 32% of admitted patients 1 2. In stroke rehabilitation units, falls have been reported in up to 47% of patients 3.…”

Aging effects on joint proprioception: the role of physical activity in proprioception preservation

“…Thus, impaired proprioception could be a contributing factor to falls. Mion et al [42] identified impaired proprioception as a contributing factor to falls among patients in a rehabilitative setting. Moreover, Camicioli et al [13] showed that the disruption of proprioceptive input was the most important determinant of quantitative balance performance in subjects older than 80 years.…”