Prevention of falls in the elderly trial (PROFET): a randomised controlled trial

Close, Jacqueline C. T.; Ellis, Margaret; Hooper, Richard; Glucksman, E; Jackson, Stephen; Swift, Cameron

doi:10.1016/s0140-6736(98)06119-4

Cited by 841 publications

(623 citation statements)

References 27 publications

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“…70 At 12 months the risk of falling was significantly reduced in the intervention group (odds ratio 0.39 (95% CI 0.23-0.66)) as was the risk of recurrent falls (OR 0.33 (95% CI 0.16-0.68)) This study did not, however, include any direct intervention to improve vision.…”

Section: Preventive Work To Reduce Fallsmentioning

confidence: 85%

Visual loss and falls: a review

Dhital

Pey

Stanford

2010

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150

116

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Section: Preventive Work To Reduce Fallsmentioning

confidence: 85%

Visual loss and falls: a review

Dhital

Pey

Stanford

2010

Eye

150

116

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“…An OT program including a home visit for planning of home adaptation is a rather simple and inexpensive measure, and may also be of help in preventing new falls at home (Close et al 1999, Hagsten et al 2004). We thus recommend that elderly hip fracture patients should be offered OT training and a home visit, to get an individualized training and psychological support, as this seems to improve the ability to perform ADL and IADL and to speed up both mental and social recovery postoperatively.…”

Section: Discussionmentioning

confidence: 99%

Health-related quality of life and self-reported ability concerning ADL and IADL after hip fracture: A randomized trial

2006

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BackgroundIt is not known whether postoperative occupational therapy is of value for hip fracture patients. In this randomized trial we evaluated the effects of an individualized, postoperative, occupational training (OT) program on the patient's self-reported health-related quality of life (HRQL) and self-reported abilities to perform activities of daily living (ADL) and instrumental activities of daily living (IADL).Patients and methods 100 eligible patients (aged ≥ 65 years) were randomized 50:50 to an OT or control group (termed the C group: conventional care). The OT group received individualized OT from day 3 or 4 after surgery and until discharge, and also a home visit. The patients answered the Swedish Health-Related Quality of Life questionnaire (SWED-QUAL) and the modified Disability Rating Index (DRI) three times: 3-4 days after surgery, at discharge, and at follow-up after 2 months.Results We found no statistically significant differences between the groups at discharge and at follow-up regarding mean SWED-QUAL scores. However, on comparing each group over time, 2 months after the fracture the OT group had regained their self-reported pre-fracture HRQL status in 10 of 12 SWED-QUAL subscales, and the C group in 6 subscales. Statistically significant differences (p < 0.05) were found between the groups after 2 months regarding self-reported IADL (moving around indoors, performance of light housework, and getting in and out of a car).Interpretation Our findings indicate that the individualized occupational training improved the ability to

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“…The psychological support from the occupational therapist during the training may therefore be important in encouraging the patients and showing them that it is possible and harmless to perform ADL shortly after surgery. Since the patientʼs ability to perform ADL/IADL is limited to a large extent by psychological factors (Close et al 1999), patient education and motivation are key issues. The home visit turned out to be important in more than one way.…”

Section: Discussionmentioning

confidence: 99%

Early individualized postoperative occupational therapy training in 100 patients improves ADL after hip fractureA randomized trial

Hagsten

Svensson

Gardulf

2004

Acta Orthopaedica Scandinavica

126

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BackgroundIt is not clear whether occupational therapy is of value for hip fracture patients.Patients and methods In a randomized trial we studied the effects of an early, individualized, postoperative occupational training (OT) program on the ability of hip fracture patients to perform ADL and IADL. Secondary endpoints were self-reported fear of pain and pain when performing ADL and IADL. The need for technical aids and/or home adaptations was also investigated. 100 eligible patients (aged ≥ 65 years, with independent residence) were randomized 50:50 to an OT or control group (conventional care). During their hospital stay, members of the OT group received individual daily training which included the use of technical aids. Before discharge, the occupational therapist paid a home visit together with the patient. All patients were assessed 2-4 days after surgery, at discharge and after 2 months, using the Klein-Bell ADL scale and a modified version of the Disability Rating Index.Results At discharge, the OT group had better ability to dress, to take care of personal hygiene and bathing activities independently, and to make toilet visits. Age, sex, type of fracture or length of stay at the hospital made no significant contribution to explaining the better ADL ability on discharge. After 2 months, all patients had regained their ADL and IADL abilities. Half of the patients required technical aids and adaptations in their homes.Interpretation Individualized OT-training speed up the ability of patients to perform ADL, thus enhancing the likelihood of patients returning to independent living and reducing the need for postoperative care at home. Hip fracture is a major healthcare problem in terms of cost and suffering (Zethraeus et al. 1997, Haentjens et al. 2001, Tidermark et al. 2002. Most patients are octogenarians and have many other social and medical problems.Intensive, physiotherapy training during the postoperative period improves the functional capacity of the patient (Barnes and Dunovan 1987, Guccione et al. 1996), as this training focuses mainly on the function of various muscle groups that are important for the mobility of the patient. Occupational therapy (OT) training focuses on the activities that are necessary for independent living, i.e., the patientʼs ability to perform the activities of daily living (ADL) and the instrumental activities of daily living (IADL). It has been suggested that hip fracture patients should receive OT training soon after surgery (Kumar and Redford 1984, Thorngren 1991, Byers and Parker 1992, Stewart and McMillan 1998, but there have been no controlled trials of whether this training improves the ADL and IADL abilities of patients faster. We carried out a randomized, controlled trial to study the effects of an early, individualized, post-operative OT training program. Participants and methods PatientsThe hip fracture patients included in the study were treated at the Orthopedic Department of Huddinge University Hospital and were aged ≥ 65 years of age, proficient in Swedish,...

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Prevention of falls in the elderly trial (PROFET): a randomised controlled trial

Cited by 841 publications

References 27 publications

Visual loss and falls: a review

Visual loss and falls: a review

Health-related quality of life and self-reported ability concerning ADL and IADL after hip fracture: A randomized trial

Early individualized postoperative occupational therapy training in 100 patients improves ADL after hip fractureA randomized trial

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