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The English and Welsh National Audit of Inpatient Falls – Six Years Using Data to Drive Improvement

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J Whitney1; F Asadi2; S Howie3; M Murden4; J O’ Flaherty5; S Pryor6; J Windsor7; Y Ang 2.
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Introduction Falls are common in inpatient settings and are associated with poor outcomes. Evidence demonstrates multifactorial interventions to address fall risk factors are effective, and as such, have been incorporated into national and international guidelines. However, these complex interventions are difficult to implement at scale in hospitals. Continuous audit with embedded quality improvement is one method for implementation and scaling up complex interventions. Methods The National Audit of Inpatient Falls (NAIF), funded by the Healthcare Quality Improvement Partnership and run by the

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Community-based adaptation of the Otago Exercise Programme delivered by Physiotherapy students for older adults at risk of falls

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G Alvarez1; A Martins1,2,3,4
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Introduction Falls among community-dwelling older adults remain a major cause of morbidity and place a substantial burden on individuals and healthcare systems. Evidence-based exercise programmes, such as the Otago Exercise Programme (OEP), are effective in reducing fall risk. However, access to these interventions remains limited in current practice, which reduces engagement and contributes to low adherence among older adults. This project aimed to address access barriers by adapting the delivery of the OEP to better meet community needs. Method An intervention plan was developed to improve
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A Fall in the Night: High-fidelity simulation exploring comprehensive geriatric assessment (CGA) principles ‘out-of-hours’

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Christopher Stenning1, Luke Murphy2, Charles Horner3
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Introduction: High-fidelity simulation provides a safe scaffold for developing clinical skills within an out-of-hours context. Night-shifts introduce compounding human and system factors that disproportionately affect care of frail older patients. Delirium and inpatient falls are common high-risk overnight presentations, yet recognition of frailty syndromes and the need for comprehensive geriatric assessment (CGA) is frequently missed1,2. System-wide approaches to frailty education include multimedia resources and clinical champions; however simulation-based training for is often poorly
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Community-based dance classes for healthy ageing and fall prevention: pilot trial outcomes and recommendations

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Heidi Gilchrist1, Abby Haynes1, Cathie Sherrington1, Leanne Hassett1, Marina Pinheiro1, Kat Owen2, Dafna Merom3, Anne Tiedemann1
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Introduction Evidence-based exercise programs that improve balance and strength can reduce fall risk in older adults but are often unpopular. Our previous evaluation of community-based, tailored dance classes showed high participation and sustained attendance, but their effectiveness for fall prevention remains untested. This pilot trial examined the acceptability and feasibility of a tailored dance intervention and identified program and implementation features to guide future trials. Method We conducted a randomised waitlist-controlled pilot delivering a 10‑week, twice‑weekly dance program

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Falls Prevention: A UK Mapping Review of Patient-Facing Resources

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Helen Nicholson1, Emily Phillpotts1, Sarah Voss1, Sarah Wiltshire2, Alice Berry1, Jonathan Benger1,3
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Introduction Around a third of people aged 65 and over fall every year and falls are the leading cause of injury-related hospital admission among older adults in the UK. Despite evidence that physical activity reduces falls risk, public awareness of falls prevention information is low. Improving access to this information and leveraging the unique clinical contacts of paramedics to support early signposting, may enhance the reach of falls prevention resources empowering older people to help reduce their falls risk. Method We conducted a systematic mapping review to identify UK-based, community

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Effects of 8-Week Wearable Ultrasound Visual Feedback Training on Walking Performance and Joint Coordination of Older Adults with Chronic Stroke: A Randomized Controlled Trial

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Y Y Luo1; M Pang1; L Y Jia1; F Y Wang1,4; H B Liang1; Z Song1; W T He1,3; C Z H Ma1,2
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Introduction Stroke frequently causes paretic ankle dorsiflexor weakness, impairing gait coordination and increasing fall risks. While a single session of wearable ultrasound visual feedback (UVF) training has been shown to improve isometric ankle dorsiflexion strength in chronic stroke survivors, the transfer of these effects to overground walking is unknown. This study investigated effects of an 8-week UVF training program on walking performance and inter-joint coordination in community-dwelling older adults with stroke. Method Thirty-four older adults with chronic stroke were randomized (17
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A Single Session of Community-Delivered Perturbation-Based Balance Training Is Associated With Reduced Falls in Older Adults

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DK Ravi1; C Awai Easthope2; FA Schulte3
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Introduction: Perturbation-based balance training is a promising approach for reducing fall risk in older adults, yet evidence is largely based on laboratory or clinical interventions. To facilitate translation to community settings, we studied the effectiveness of a single-session, low-cost, accessible perturbation training by examining pre-post differences in falls over a year in older adults. Methods: One hundred community-dwelling older adults (age 75.3 ± 7.5 years; 67% female) participated. Perturbations (n=32) were delivered via a waist-mounted, cable-driven system that pulled
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Presenting to health services after falls and fall injuries in very old age: a population-based study of over-90-year-olds

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Jane Fleming, Carol Brayne
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Introduction Older people who fall often do not present to health services, even if injured, but this is difficult to quantify. Methods When all participants in the Cambridge City over-75s Cohort, a representative population-based study of ageing, were aged over 90 prospective falls data collection successfully followed-up 96% of survivors for one year (20 men and 90 women aged 91-105, 18% in care). Participants or proxy informants returned weekly falls calendars and were re-interviewed after all reported falls regarding circumstances, consequences and whether they told anyone about that fall

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Beyond the Hip: Comparing the Burden of Injury between Cervical Spine Fractures and Neck of Femur Fractures in the Elderly

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Dominic Luttrell1, Karen Ward2, Shreya Srinivas2, Suvira Madan2
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Introduction Fractures of the cervical spine and neck of femur (NOF) represent a high burden of injury and mortality in the elderly population. Disability adjusted life years lost (DALY) is a measure of how many years of full health are lost across a population due to an injury. Methods Retrospectively 51 patients aged 65 or over that had sustained a cervical spine fracture were identified through ED coding between January 2023 and December 2023. Outcome data on 551 patients aged 65 or over that had sustained a NOF fracture was collected via the National Hip Fracture database for 2023. Local
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Algorithm to detect gait perturbations: Generalization regarding participant group and perturbation protocol

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Lea Feld1,2,3, Jessica Koschate-Storm1, Tim Stuckenschneider1, Nina Marie Schmidt1, Andreas Hein2, Birger Kollmeier3, Tania Zieschang1
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Introduction Many falls in older adults occur during walking, particularly when responding to sudden gait perturbations such as slips or trips. Although automatic gait perturbation detection with wearable devices has been demonstrated in controlled datasets, it often remains uncertain whether such models generalize to unseen data. This study examines whether a pre-trained deep convolutional long short-term memory (DeepConvLSTM) algorithm, can generalize to an older participant group with a history of falls and to a different perturbation protocol. Method This sub-analysis used data from an
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Effects of ReacStep training program on balance recovery and fall risk factors in older people: An assessor-blinded randomised control trial

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Shivam Sharma 1,2, Chaplin C2, Hicks C1,2, Treacy D1, Farlie M3, Phu S2, Smith N2, Gibson H2, Ho C2, Coleman E4, Huang T1, Canning C4, Allen N4, Close J1,2, Lord S1,2, Okubo Y1,2
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Background: Reactive balance training using repeated perturbations may reduce falls, however, training methods are not easily replicated or translatable to clinical settings. This study aimed to examine the effects of a novel reactive balance training program on balance recovery from laboratory induced trips and slips and fall risk factors in older people using simple and low-cost equipment. Methods: We conducted a randomised controlled trial involving 88 older people. An intervention group (n = 43) received the ReacStep program which involved tether-release reactive stepping and intentional
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Oral Bisphosphonate Administration on a Hip Fracture Unit : Knowledge, Practice & Patient Experience Audit

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C Byrne; Z Brown; A Monro
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INTRODUCTION Oral bisphosphonates are widely prescribed for fracture prevention. Their efficacy is dependent on adherence to administration guidance. A British Geriatrics Society (BGS) review highlighted that incorrect administration provides minimal or no fracture protection, particularly in frail or hospitalised patients (1,2). Despite this, oral bisphosphonates are frequently prescribed or continued during inpatient admissions where correct administration may be challenging. Our aim was to assess multidisciplinary knowledge, local administration practice, and patient recall of
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Why do older adults fall on stairs at home? Insights from a nationwide survey of 194 older adults

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R Foster1; A Akpan2; M Hodges3; L Corner4; M Hollands1; M Scott1; L Alcock4
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Introduction Stair falls cause major morbidity and mortality in older adults. Despite this, stair-focused recommendations are lacking from the 2022 World Falls Guidelines. We aimed to characterise environmental risk factors and consequences of home stair falls and near-falls, and demographics of older adults reporting them. Method Co-designed online survey of adults ≥60 years in England (N=194). Respondents provided demographics, indices of multiple deprivation (IMD), concern about falling, and injury outcomes for home falls/near-falls over two years. This analysis focuses on the stair/step
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'Get it on Time' Parkinson's Medication QIP

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L Miller1, A Ward1
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Introduction Parkinson’s medications are time critical and delays of over 30 minutes can increase the risk of harm to patients. Complications range from physical deconditioning, with associated risk of prolonged hospital stay or aspiration pneumonia to neuroleptic malignant syndrome. Inspired by Parkinson’s UK ‘Get it on Time’ campaign, we sought to improve administration of Parkinson’s medications to within 30 minutes of prescription time in at least 80% of patients at York Hospital. Method Parkinson’s patients on medical wards in York Hospital were continuously audited across May, June and
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Wearable Low-cost Motion Trackers for Dynamic Stability Parameters – Calibration based on Artificial Intelligence

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Yixuan He1 2, Yuxin Dong2, Matthew A. Brodie2, Juno Kim2, Stephen R. Lord1 2, Yoshiro Okubo1 2
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Background: Low-cost inside‑out wearable trackers can be deployed at scale to measure body motion. However, errors in the estimated sensor position and orientation can propagate into coordinate transformations and affect derived metrics such as gait parameters and measures of dynamic stability. Methods: Healthy adults walked on a treadmill at 0.5–2.0 m/s while VIVE Ultimate Tracker (VUT) and Vicon data were recorded. Data-driven calibration models were developed to correct tracker coordinates and estimate the full-body centre of mass (CoM) from a sacrum-only configuration. Agreement with Vicon
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Randomised controlled trials to evaluate clinical and cost effectiveness of the Stroke Action Falls rehabilitation programme

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PA Logan1,2;E Doig1;V Booth2;F Allen2;A Arjunan1;M Chatfield3;T Comans3;L Connell4; E Cox2;R Durairaj4;N Foster1;R Gee6;R Grimley7;H Gullo3;R Haydock2;K Harding8;F Higton6;A Hill8;T Hepburn2;S Isbel9;M James2;N Lannin10;P Leighton2;J Liddle3;N Mahendran1;
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Background Falls are one of the most common secondary complications after stroke. Clinical guidelines do not include a falls prevention programme addressing the specific needs of stroke survivors. A falls prevention intervention called Action Falls has reduced fall rates in care home residents and could be effective for stroke survivors. The FISS trials in Australia and the UK aim to evaluate whether implementing the Stroke Action Falls programme helps in reducing fall rates among stroke survivors at home in the 12 months after discharge from hospital, and if it is more cost-effective compared
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Electrodermal responses to unannounced perturbations during walking on a treadmill in fall-prone older adults – preliminary results

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S Drefs¹, I Melzer², T Zieschang¹, J Koschate-Storm¹
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Introduction: Treadmill-based perturbation training (PBT) simulates gait perturbations and trains reactive dynamic balance responses under safe conditions and can reduce falls in daily life of older adults. Electrodermal activity (EDA) responses, an indicator of emotional arousal, decreases across six perturbations in young, healthy adults, suggesting adaptation. EDA was not yet measured during perturbed walking in older adults or across multiple sessions. Hence, the EDA trajectory during PBT and conventional treadmill training (CTT) in older adults with and without cognitive impairment (CI)
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Data-Driven Secondary Falls Prevention in the Emergency Department: SeFallED and iSeFallED

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Tim Stuckenschneider, Tania Zieschang
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Background: Older adults presenting to the emergency department (ED) after a fall who are discharged home are at increased risk of subsequent falls and functional decline. Although they represent a substantial proportion of ED visits, this population is highly heterogeneous with respect to health status, preferences, and risk profiles. This heterogeneity complicates the allocation of appropriate secondary prevention strategies, particularly under constraints of limited healthcare resources. Data-driven risk stratification followed by targeted secondary prevention may help optimize care
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Fall-related injuries, burden & costs in Luxembourg’s older population: A nationwide analysis of emergency department (ED) visits

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Anne-Marie Hanff1,2, Dritan Bejko3,4, Armin Rauschenberger5, Jessica Pastore6, Marie Louyot6, Valerie Moran7,8 , Sophie Pilleron9, Christopher McCrum4
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Introduction: In 2024, fall-related injuries accounted for +/-10% of all hospital treatments in Luxembourg and fall-related mortality increased sharply after age 70. Beyond mortality, injuries burden individuals and healthcare systems. Aim: Estimate the age- and sex-specific differences of fall-related injuries, fractures and related hospitalisations in Luxembourg. Methods: Using RETRACE injury surveillance data, we analysed all 8,404 fall-related emergency department (ED) visits in 2018 of individuals ≥60 years in Luxembourg. We estimated age- and sex-specific differences of central body
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Perceptual–motor influences on stair walking: The roles of conscious control and environmental context

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L Hill1; R Mills1; R Masters2; N Middlebrook3; N Reeves4; L Uiga1
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Introduction: Stair falls are the leading cause of accidental death among older adults. A psychological factor that may contribute to unsafe stair negotiation is conscious movement processing (CMP), the tendency to consciously monitor and control movement execution. Higher CMP in older adults has been associated with prolonged stance and double-support times and less accurate foot placement during level ground stepping. Its role during stair negotiation and the influence of perceived stair steepness remains unclear. As an initial step, this study examined associations between CMP, perceived
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