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Displaying 1 - 20 of 2012

Predicting Dosage of Balance Training Interventions

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M Lyon1; G Brusola2; R Pontiff2; A Benner1; M Farlie3
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Introduction: Balance training is an evidence-based fall prevention intervention, and optimal dosage parameters (frequency, intensity, type, time) are essential for effectiveness in adults with balance impairments and fall risk. Evidence is limited on the dosage parameters clinicians use in practice. This study’s purpose was to determine the time spent in active exercise and balance-specific activities during routine physical therapy and examine if any patient characteristics predict time spent exercising. Methods: Trained researchers conducted real-time naturalistic observations of 135
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Older patients presenting with a fall and long lie; is there an opportunity to reduce unnecessary hospital admissions?

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Jayne Walters1, Mark Baxter1
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Introduction Older people who suffer a fall and long lie present a significant challenge to the pre-hospital and front door services. The guidance and definition are controversial with little evidence on the incidence and complications of long lie. There is limited data on reliable lie times which are usually unrecorded and hard to collate. To address this, we did a study on assessment and management of falls, long lie and rhabdomyolysis in a single tertiary centre. Methods A retrospective case note review of patients aged over 80 who attended the emergency department acutely with a fall and
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Developing falls KPIs for Physiotherapy Team based on World Guidelines’ recommendations

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Chandini Gadhvi1
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Introduction: There are over 80 physiotherapists at Auckland City hospital working across several in-patient areas including acute medical, surgical, stroke/ neurology, orthopaedics, and geriatric rehabilitation. The physiotherapy team plays a huge role in the assessment, treatment, and management of vulnerable fall’s risk patients. Since 2018 the physiotherapy team had not reviewed key performance indicators (KPIs) in relation to best practice in falls assessment and management. With the release of the World Guidelines (1) for fall prevention, it was timely and important to review our KPIs

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Improving delays in Geriatric Medicine referral for Older surgical inpatients admitted following orthostatic hypotension & falls

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S Koushik1, C Bitsara1, A Parbhoo1
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Introduction Orthostatic hypotension (OH) is a common, under-recognised, and potentially reversible cause of falls in older adults. Older patients admitted under surgical specialties following falls frequently have frailty, polypharmacy, and high anticholinergic burden (ACB), predisposing them to OH and recurrent falls. National Institute for Health and Care Excellence (NICE) guidance, Royal College of Physicians (RCP) recommendations, and the National Audit of Inpatient Falls advocate routine lying and standing blood pressure (LSBP) measurement as part of comprehensive falls assessment

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Sustainability Of Fall Prevention Exercise Programmes For Community-Dwelling Older Adults: A Scoping Review

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I Abel-Adegbite1, N Shishov2, M Gonzalez Lara1, K Sibley3, D Bouchard2, DS Kehler1.
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Introduction Exercise-based fall-prevention programmes effectively reduce falls among community-dwelling older adults; however, sustaining these initiatives remains a persistent challenge. Programme sustainability is critical for optimizing resources, maintaining community trust, and achieving lasting population-level benefits. This scoping review examined factors influencing the sustainability of community-based fall-prevention exercise programmes using the Program Sustainability Assessment Tool (PSAT). Methods A scoping review was conducted following Joanna Briggs Institute methodology and
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Adaptation of the Action Falls programme for stroke survivors and telehealth delivery: Stroke Action Falls (SAF)

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V Booth1,2; E Doig3; PA Logan1,3; M Golding-Day1; F Allen1; M Lear3; A J Hill4; J Watterson1,2; S Burgess1
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Background Action Falls is a falls prevention programme identifying falls risks and actions which has been shown to significantly reduce fall rates in care home residents. Falls after stroke are a leading cause of hospitalisation resulting in high healthcare costs. Falls negatively impact stroke survivors’ confidence and independence. Action Falls could be effective for stroke survivors. Therefore, the collaborative team across the UK and Australia partnered with stroke survivors and experienced multidisciplinary stroke healthcare professionals across Australia and the UK, to produce the
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Towards Establishing Ecological Validity of Robust Gait Variability Metrics for Walking in Real-World and Fall Risk Assessment

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Kai Zhe Tan1,3, Krešimir Friganović2, Yong Kuk Kim1,3, Angela Frautschi3, Michelle Gwerder3, Kok Yang Tan1,5, Vanessa J.W. Koh1,4,5, Rahul Malhotra1,4,5, Angelique W.M. Chan1,4,5, David B. Matchar1,4, Navrag B. Singh1,2
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Introduction: Gait variability is a crucial indicator for dynamic stability and fall risk. However, inherent sensitivity to outliers can compromise measurement reliability of standard variability metrics like the Coefficient of Variation (CV), especially when applied to the "messy," non-normal data in free-living environments. The objective of the study is to validate a robust, non-parametric alternative — the Robust Coefficient of Variation using Median Absolute Deviation (RCV-MAD) — to ensure clinically reliable remote monitoring. Methods: We analysed datasets collected in controlled lab

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The Geriatric Rehabilitation And Care Enhancement Pilot (GRACE)

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L Stanton Hughes1, H Pun1, S Swain1, H Payne1 , H Foxley1, C Colby1, P Draper1
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Introduction The GRACE initiative was a pilot designed to enhance inpatient experience of older adults. Proportionate moving and handling techniques were introduced as well as increasing the number of therapy staff on a ward reducing reliance on multiple staff for routine ward care. We aimed to improve patients’ functional independence and prevent deconditioning. Methods A ward of 26 patients was chosen with a control comparison and nursing staff were upskilled in proportionate manual handling. For 4 weeks, therapy staffing was increased from 2 therapists to 4 and patients given additional

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E-learning for Hospital Staff on the Prevention of In-Hospital Falls at the North Estonia Medical Centre

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Evelin Männik 1, Kai Kuuspalu 2
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Introduction. Inpatient falls are the most common patient safety incident. The World Health Organization (WHO) recognises falls as a significant public health issue and highlights the need for coordinated, evidence-based prevention strategies, including staff training. A multifactorial approach—including fall risk assessment, engagement of staff and patients, environmental modifications, and implementation of preventive measures—significantly reduces fall rates when combined with training activities. Studies have shown that e-learning-based training for healthcare professionals improves
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Effectiveness and Generalisability of Fall-resisting Skills Training in Older Adults: Protocol for a Randomised Controlled Trial

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Elisabeth G van der Hulst 1,2; Tamaya van Criekinge 3; Kenneth Meijer 1; Christopher McCrum 1; Pieter Meyns 2;
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Introduction Falls are a major concern in our ageing society. General exercise interventions like strength and balance training show limited community-wide impact due to poor adherence and low dose. Task-specific interventions such as perturbation-based balance training and gait adaptability training have demonstrated great effectiveness, targeting distinct fall-resisting skills: proactive gait adaptability (PGA), gait robustness (GR), and reactive gait recovery (RGR). This study protocol investigates whether task-specific training of one of the three fall-resisting skills leads to
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Older Adults’ Perceptions of Fall-resisting Skills Training and their Stability: a Pilot Study for a Randomised Controlled Trial

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Elisabeth G van der Hulst 1,2; Kenneth Meijer 1; Pieter Meyns 2; Christopher McCrum 1;
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Introduction Training fall-resisting skills can prevent falls in older adults. These skills include proactive gait adaptability, gait robustness, and reactive gait recovery, which allow people to effectively avoid, resist, and recover from balance threats, respectively.This pilot study guided the design of an RCT of fall-resisting skills training by investigating older adults’ perceptions of the training and their own stability. The aims were 1) explore older adults’ perceptions of stability during walking perturbations related to gait researcher observations; 2) investigate how task
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Perturbation Training for Fall Prevention in Parkinson’s Disease (ReSteP): Protocol for a Randomized Controlled Trial

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P Rueß1; E Kwag1; A Becker2; M Kirchner3; R Schüle4; J Conrad5; J Wolf6; S Steib1
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Introduction People with Parkinson’s disease (PwPD) are at significantly increased risk of falling due to gait and balance impairments. Notably, reactive balance, which is essential for adequate motor responses to external perturbations, is particularly affected in this population. Perturbation-based balance training (PBT) specifically addresses this issue and has been shown to reduce fall rates by up to 50% in fall-prone older adults. The objective of this study is to evaluate the feasibility and efficacy of treadmill-based PBT in PwPD. Method In this randomized controlled trial, 90 PwPD (40
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Examining the Association between Recurrent Falls and Comprehensive Parkinson's Disease Subtypes

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Abigail Kehrer-Dunlap 1; Laura Rosok 2; Christina Lessov-Schlaggar 2; Joel Perlmutter 1,2,3,4; Paul Kotzbauer 2; Erin Foster 1,2,5; M Campbell 2,3
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At least 60% of people with Parkinson’s disease (PD) will fall every year and nearly 70% fall recurrently, many as often as several times a day or week. Identifying those most at risk for recurrent falls is key to improving tailored fall prevention interventions for people with PD. This study investigated the relationship between recurrent falls, clinical characteristics, and PD subtypes using a novel PD subtyping scheme. Participants from the WashU Movement Disorders Research Group with idiopathic PD, at least one complete fall report, and a Clinical Dementia Rating < 1 at baseline were
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Barriers And Enablers To Adult Ethnic Minority Patients' Participation In Healthcare Interventions Delivered In The Community In The UK: A Qualitative Systematic Review

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Joy Oghogho Watterson (1, 2), Katie Robinson (1), Fran Allen (1), Caroline Rick (3), Laura Nellums (4)
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INTRODUCTION: The NHS 10-year plan ethos is providing care that is fit for the future. Healthcare interventions delivered in the community offer an opportunity for health equity that can lead to sustainable social change, delivering an outward-facing approach and community-centred care. More work is needed to develop tailored healthcare interventions suitable for ethnic minorities to effectively address their needs. This review is component one of a wider PhD study that aimed to develop and establish principles for delivering health interventions to ethnic minorities in the community using
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Preventing the Next Fall: Risk Factors for Recurrent Falls in Older Adults in Primary Care

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N Thiagarajan; S Manuel; D Kler; Huan WS; S Suparman; M Kamaruddin; N Othman; A Mokhtar; F Shariffudin; A Roslan; M Ghaffar; N Sidik; M Padzil
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Background: Malaysia is projected to become an aged nation by 2030, with adults aged ≥60 years comprising approximately 15.3% of the population. As population ageing accelerates, primary care must address age-related conditions, including falls, which are a major cause of morbidity and functional decline among older adults. Recurrent falls represent a key opportunity for prevention, as they reflect underlying, modifiable risk factors. In Kuala Lumpur primary healthcare clinic, we assess the risks of fall and manage it with a multidisciplinary team comprising of staff nurses, medical assistants
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Validating realism of the PaddleTrip treadmill system: Comparisons with a trip walkway and surface perturbation treadmill

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Vinuri Peiris1,2, Stephen Lord1,2, Matthew Brodie2, Juno Kim2, Daniel Treacy3, Peter Humburg2, Liao Wu2, Paulo Silva Pelicioni1,2, Carly Chaplin1, Kirsty McDonald2 , Yoshiro Okubo1,2
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Introduction: We designed the PaddleTrip treadmill, equipped with rotating paddles, to induce trip-like perturbations. This study aimed to determine whether this PaddleTrip treadmill can generate realistic obstacle‑induced trips. Methods: Twenty healthy adults (38.3 ± 16.7 years; range: 21–72) fitted with a fall-arrest harness completed three walking‑perturbation conditions in random order: (A) PaddleTrip treadmill, (B) 8‑m walkway with two concealed trip boards, and (C) surface‑perturbation treadmill (12 m/s²; M‑Gait). The PaddleTrip treadmill and walkway condition included four trips
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Barriers to participation in a community falls prevention program.

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Trinh Vo1; Keith Hill2; Sarah Milne1; Amelia Crabtree 1,2; Liz Dalla Santa 1,2; Natasha Brusco2, Kelly De Santis1, Margaret Thomas3, Natasha Layton2
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Introduction Falls are a major cause to injuries, loss of independence and healthcare costs for older adults globally. An Australian study identified less than 8% of clients eligible for a 12 week education and exercise falls prevention program participate. The aim of this research was to describe the perspectives of clients, carers and staff on the barriers and enablers to participating in the community falls prevention program; to identify changes to the current model of care in order to improve participation rates. Methods A co-design methodology was used which involved consumer chief

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Interventions for preventing falls in people who have presented to emergency departments

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Luiza Pivotto1; Suzanne Dyer2; Wing Kwok1; Charlotte McLennan1; Sallie Lamb3; Ian Cameron1; Cathie Sherrington1; Marina Pinheiro1
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Introduction: The emergency department (ED) is often the first point of contact with the health system following a fall. After an ED visit for a fall, many will experience subsequent falls and revisit the ED. Although guidelines recommend that ED health care professionals assess fall risk and initiate actions to prevent future falls, there remains substantial uncertainty about the effectiveness of interventions for preventing falls among people who present to the ED. Therefore, we aim to assess the effects of interventions designed to reduce falls in adults and older adults who present to the
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Implementation of a Multifactorial Fall Risk Assessment at North Estonia Medical Centre

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H Lehtmets1; R Kaljurand1; K Zirel1
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Background Falls and fall-related injuries are a common healthcare concern, particularly among patients over the age of 65³. It is estimated that nearly one million patients fall during hospitalization worldwide each year. Of those who fall, 25–30% sustain injuries², and 4–10% suffer serious harm²,⁵. Conducting an individualized assessment enables the application of the most appropriate, evidence-based prevention strategies tailored to each patient¹,⁶. An internal review of patient falls at North Estonia Medical Centre in 2023 showed that preventive actions were not systematically tailored to
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Planning implementation of patient falls preventive education in hospitals: gaining the consumer perspective

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AM Hill1; CY Loo1; ME. Morris2, J Francis-Coad1; S Coulter3; H Heng4; RI Shorr5,6; U Phan4; C Watson3; A Semciw2,4; CM Said7,8; B Rasmussen7,9; S Bunting7; C Etherton-Beer1,3; J Wood1
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Introduction: Falls in hospital can be reduced through education of patients and staff. However, limited evidence exists on how staff can systematically implement patient falls prevention education. Planning implementation with hospital staff may enhance their acceptance, engagement, and delivery of falls education to patients. This study aimed to design an implementation plan with hospital staff to guide the successful delivery of patient falls education. Method: Three participatory workshops using a World Café methodology were conducted in hospitals in Western Australia and Victoria. Staff
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