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1.
Eur Geriatr Med ; 2022 Nov 23.
Article in English | MEDLINE | ID: covidwho-2129598

ABSTRACT

PURPOSE: Fall prevention is a safety goal in many hospitals. The performance of the Johns Hopkins Fall Risk Assessment Tool (JHFRAT) in older inpatients is largely unknown. We aimed to assess the JHFRAT performance in a large sample of Dutch older inpatients, including its trend over time. METHODS: We used an Electronic Health Records (EHR) dataset with hospitalized patients (≥ 70), admitted for ≥ 24 h between 2016 and 2021. Inpatient falls were extracted from structured and free-text data. We assessed the association between JHFRAT and falls using logistic regression. For test accuracy, we calculated sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Discrimination was measured by the AUC. For calibration, we plotted the predicted fall probability with the actual probability of falls. For time-related effects, we calculated the AUC per 6 months (using data of patients admitted during the 6 months' time interval) and plotted these different AUC values over time. Furthermore, we compared the model (JHFRAT and falls) with and without adjusting for seasonal influenza, COVID-19, spring, summer, fall or winter periods. RESULTS: Data included 17,263 admissions with at least 1 JHFRAT measurement, a median age of 76 and a percentage female of 47%. The in-hospital fall prevalence was 2.5%. JHFRAT [OR = 1.11 (1.03-1.20)] and its subcategories were significantly associated with falls. For medium/high risk of falls (JHFRAT > 5), sensitivity was 73%, specificity 51%, PPV 4% and NPV 99%. The overall AUC was 0.67, varying over time between 0.62 and 0.71 (for 6 months' time intervals). Seasonal influenza did affect the association between JHFRAT and falls. COVID-19, spring, summer, fall or winter did not affect the association. CONCLUSIONS: Our results show an association between JHFRAT and falls, a low discrimination by JHFRAT for older inpatients and over-prediction in the calibration. Improvements in the fall-risk assessment are warranted to improve efficiency.

2.
Multiple Sclerosis Journal ; 28(3 Supplement):918-919, 2022.
Article in English | EMBASE | ID: covidwho-2138825

ABSTRACT

Introduction: During the Covid-19 pandemic, the provision of rehabilitation care to people with MS was significantly reduced (in addition, many patients were afraid to visit medical and sports facilities). An alternative (in these cases) could be telerehabilitation (ie the provision of rehabilitation services at a distance). The aim of our pilot study was to evaluate the feasibility of this form of rehabilitation in people with MS with balance disorders. Method(s): Our pilot study included 20 patients with MS with balance disorders. The intervention lasted 12 weeks. The experimental group underwent individual telerehabilitation (twice a week, 45 individual telerehabilitation), which consisted of balance and strength exercises with a physiotherapist, using the Homebalance system and other simple tools). The control group received regular rehabilitation care (outpatient individual physiotherapy). Functional tests were selected to assess the gait and balance disorders: Timed Up and Go (TUG), TUG with dual cognitive task and Berg Balance Scale (BBS). Subjective perceptions of gait, balance and fatigue disorders were evaluated with standardized questionnaires: Modified Fatigue Impact Scale (MFIS), Multiple Sclerosis Walking Scale-12 (MSWS-12), Falls Efficacy Scale International (FES-I), Activity Balance Confidence Scale (ABC Scale ). Result(s): The mean age of participants was 51 years (34-65 years), with the mean disease duration was 17 years (4-29 years) with a median neurological disability EDSS 5 (3-6.5). There was a significant improvement in the experimental group in the functional mobility test-TUG (p=0.048), balance-BBS (p=0.002) and in the standardized ABC Scale questionnaire (p=0.041). Conclusion(s): The results of the pilot study suggest that individual telerehabilitation could be an alternative to routine rehabilitation care for the treatment of balance and mobility disorders in patients with MS (suitable, for example, for people with a more distant place of residence or in case of new pandemic restrictions).

3.
Injury Prevention ; 28(Suppl 2):A89, 2022.
Article in English | ProQuest Central | ID: covidwho-2137915

ABSTRACT

BackgroundYoga may reduce fall risk in older age. The Successful AGEing (SAGE) yoga trial investigates the effect of yoga on falls among community-dweller people aged 60+. We conducted a process evaluation to gauge participants’ impressions of the supervised 40-week yoga program delivered face-to-face and/or online (due to COVID-19).MethodsParticipants completed a survey assessing: a) perceived program benefit for physical health, wellbeing, and balance/risk of falls, b) satisfaction with program features;c) physical ability to participate in the program. They self-rated these aspects using a 0 to 10 scale, where higher scores indicated more benefit, greater satisfaction/ability. We also measured the proportion of participants who would recommend the program and continue participation in yoga.ResultsWe included 179 participants (mean age of 68 (SD 5);80% female). The mean rating of program benefit was 9/10 (SD 1.8) for physical health and 8/10 (SD 2.0) for wellbeing and balance/risk of fall. Overall, participants expressed greater satisfaction associated with program content (mean 9/10 [SD 1.4]) and yoga instructors (9/10 [SD 1.2]). Participants viewed the yoga program as enjoyable but challenging and reported that yoga instructors were supportive, professional and tailored poses to individual needs. Participants rated their physical ability to participate in the program as excellent (9/10 [SD 1.7]). The majority (n=157, 94%) would recommend the program and intended to continue practising yoga after trial completion (n=100;58%).ConclusionOverall, the SAGE yoga was well-received, perceived to benefit health, wellbeing and balance/falls risk and would be recommended to others.

4.
Injury Prevention ; 28(Suppl 2):A62, 2022.
Article in English | ProQuest Central | ID: covidwho-2137907

ABSTRACT

BackgroundTailored balance and strengthening exercise programs delivered by physiotherapists have been shown to improve mobility and prevent falls in older people. Telehealth physiotherapy is emerging as an innovative method of service delivery for older people during the COVID-19 pandemic. This trial aims to establish the effect on mobility and falls of a telehealth physiotherapy program compared to usual care in older people aged 65+ years receiving aged care services.MethodsThis hybrid Level 1 effectiveness and implementation randomised controlled trial aims to recruit 240 older people receiving aged care services aged 65+ years. Participants will be randomised to either: (1) the Telehealth Physiotherapy (TOP UP) Program or (2) a waitlist control group. The primary outcome is the change in mobility as measured by the change in the Short Performance Physical Battery (SPPB) test score from baseline to 6 months after randomisation. Secondary outcomes include rates of falls, 5 times sit-to-stand, quality of life, and goal attainment. A process evaluation that includes an economic analysis, acceptability, and other qualitative measures will be conducted. Trial registration: ACTRN 12621000734864.ResultsThree aged care partners (2 metro and one rural) have signed the clinical trial agreement with the first participant randomised in September 2021. To date, we have randomised 26 participants in RACF and 25 participants in home care.Learning OutcomesIncreasing the understanding of the effectiveness, cost-effectiveness, and implementation strategies is required to support telehealth physiotherapy uptake and sustainability for mobility and fall prevention programs in aged care.

5.
On - Line Journal of Nursing Informatics ; 26(2), 2022.
Article in English | ProQuest Central | ID: covidwho-2112136

ABSTRACT

Background: Older adults face an increased risk for falling and resulting injury due to age-related physiological changes (Sharif et al., 2018). Effective fall risk screening programs in the primary care setting may be a promising approach to reduce the incidence of falls within this population (Siegrist et al., 2016). The use of technology can be beneficial in supporting care delivery and further reducing the risk. Purpose: This article discusses the implementation of a fall risk screening and reduction program in a primary care setting. The program uses resources of the Centers for Disease Control and Prevention’s (CDC) Stopping Elderly Accidents, Deaths & Injuries (STEADI) Initiative and the development of an Audio Computer-Assisted Self-Interview (ACASI). This study aimed to increase community-dwelling older adult safety by identifying and reducing fall risk. Clinical Relevance: ACASI is an effective alternative to traditional interview methods due to its speed in data capture and the potential for increased accuracy of self-reported data. Introducing ACASI technology in nursing practice is an innovative approach to collecting patient data in a manner that limits physical interaction, reduces bias, and promotes safe social practices, especially when considering the current COVID-19 pandemic. Approach: Participants were recruited from an outpatient facility and consented to participate in the study. Chart reviews were conducted to identify eligible participants. To determine the baseline fall risk scores, questionnaires were presented to participants in the form of an ACASI. This technology was used to communicate the assessment questions and facilitate data collection. Evidence-based informational materials were administered to participants to provide education on fall prevention safety and limiting fall risk. Eight weeks after receiving education on fall risk reduction behavioral and environmental modifications, a follow-up, ACASI- formatted questionnaire was administered to assess for a change in fall risk scores. Results: The research findings demonstrated a significant reduction in fall risk scores (t (40) = -2.220, p =.032) from pre- to post-assessment. Overall fall risk scores among the participants decreased by 43% within a 12-week timeframe. One in four adults age 65+ report falling, resulting in over 50% of all injury-related deaths (Haddad et al., 2018). Individuals who suffer from falls are not only predisposed to injury and untimely death, but also decreased mobility, decreased independence, hospitalization, and nursing home placement (Phelan et al., 2016). The cost to medically treat a fall is approximately $10,000 in direct fees (Dellinger, 2017). Costs associated with caring for fall-related injuries exceed $30 billion each year (Phelan et al., 2016).  The National Patient Safety Goals, established by The Joint Commission (TJC) in 2003, is a safety and quality improvement program to help healthcare organizations target concerning areas of need (The Joint Commission, 2022a). Sentinel Event Alerts, which warn healthcare organizations about risks to patient safety, are included with the safety goal reports. Injurious patient falls have regularly ranked in the top 10 among the TJC’s list of Sentinel Events (The Joint Commission, 2022b). Most falls among older adults result from a combination of risk factors. Approaches to assess and manage modifiable risk factors have been identified as effective interventions for individuals at risk of falling (Phelan et al., 2016). Primary care practitioners can play a key role in identifying and reducing fall risk among patients by identifying and discussing risk factors during regular office visits. The physiologic changes and high incidence of falls in the elderly make it necessary to conduct regular fall risk assessments and interventions among this population (Siegrist et al., 2016). Among the leading fall risk assessment resources that have recently been developed is the Centers for Disease Control and Prevention’s (CDC) STEADI (Stopping Elderly Accide ts, Deaths & Injuries) Initiative (Centers for Disease Control and Prevention, 2017c). STEADI offers healthcare providers a standardized approach to conduct fall risk screenings, assessments, and interventions for older adults (Howland et al., 2018). Technology can assist in screening patients for fall risk in the form of an Audio Computer-Assisted Self-Interview (ACASI). An ACASI-administered survey is a method of data collection that allows participants to complete interviews on their own without the presence of a human interviewer. Questions and response options are displayed as digital text on a personal electronic device and read aloud to participants. The participants listen to the pre-recorded questions and respond by selecting their answers directly on the screen. ACASI is believed to improve the quality of data collection by minimizing data entry errors. Additional benefits of using ACASI, as opposed to traditional survey questionnaires, include increased privacy for participants, accessibility for illiterate participants, reduced staff time for interviewing, and increased data validity for sensitive questions (Kane et al., 2016). In this study, an ACASI was developed and administered to participants in tandem with CDC STEADI (2017c) resources, as part of a fall risk screening and reduction program to identify and reduce the risk of falling among community-dwelling older adults.

6.
Int J Environ Res Public Health ; 19(22)2022 Nov 17.
Article in English | MEDLINE | ID: covidwho-2115954

ABSTRACT

This study investigated whether strength, balance, body mass index, falls self-efficacy, activity levels, self-rated health, and participation in a multicomponent exercise intervention could predict physical activity levels after 5 months of self-quarantine due to the COVID-19 pandemic. This study included baseline data of 200 community-dwelling older adults (79% women, 21% men) with a mean age of 72 years who participated in a randomized controlled trial investigating a multicomponent exercise program, with 7-month follow-up survey data of their physical activity levels. The results showed significant associations with the activity levels at the 7-month follow-up. The activity levels (odds ratio (OR): 2.83, 95% CI: 1.20-6.71), the self-rated health score (2.80, 1.42-5.53), and being allocated to a specific multicomponent group-based exercise program (2.04, 1.04-4.00) showed a significant association with the activity habits at the 7-month follow-up. As this study suggests, besides the physical activity levels and the self-rated health score, participation in a high challenge multicomponent exercise program was significantly associated with physical activity levels at the 7-month follow-up. This study indicates that a relatively short multicomponent group exercise program (6-9 weeks) can motivate individuals to sustain their own training and activity levels even several months after the program has been paused or terminated. Identifying older adults' physical activity levels and self-rated health scores and prescribing multicomponent group-based exercise programs to promote sustained physical activity habits may be a successful alternative to provide for older adults in the future.


Subject(s)
COVID-19 , Independent Living , Male , Humans , Female , Aged , COVID-19/epidemiology , Cohort Studies , Pandemics , Accidental Falls , Exercise Therapy/methods , Exercise , Habits
7.
Aust Occup Ther J ; 2022 Nov 11.
Article in English | MEDLINE | ID: covidwho-2121852

ABSTRACT

BACKGROUND: Occupational therapist-led environmental assessment and modification (EAM) is effective in reducing falls for populations at high risk. Two regional and rural public health services in Queensland devised an implementation strategy to embed best practice occupational therapist-led EAM. METHODS: A qualitative study was conducted to compare the determinants of implementation success across the different health services, using the COM-B model of behaviour change. Six semi-structured interviews were completed with occupational therapists involved at each site, following 12 months of implementation. Interview data were triangulated with minutes from three combined site steering committee meetings, eight local steering committee meetings, and field notes. Thematic analysis was completed to compare barriers and facilitators to best practice uptake of EAM and differences in outcomes between the two sites. RESULTS: Both sites commenced implementation with similar states of capability and motivation. After 12 months, one site considered that practice change had been embedded as noted in steering committee minutes and comments; however, the other site observed limited progress. According to the COM-B analysis, opportunity (the factors that lie outside the individual's control) had a significant influence on how both sites were able to respond to the practice change and navigate some of the unexpected challenges that emerged, including the COVID-19 pandemic. Existing team structure, multiple responsibilities of key stakeholders, differences in access to resources, and lack of connection between complementary services meant that COVID-19 disruptions were only a catalyst for unveiling other systemic issues. CONCLUSION: This study highlights the power of external factors on influencing behaviour change for best practice implementation. Learnings from the study will provide deeper understanding of completing implementation projects in regional and rural contexts and support the future implementation of EAM in occupational therapy clinical settings.

8.
Emergency Medicine Journal : EMJ ; 39(10):723, 2022.
Article in English | ProQuest Central | ID: covidwho-2064196

ABSTRACT

Byrne et al have explored this in more depth, completing a systematic review into the willingness and preparation of medical students in relation to disaster medicine. Tolhurst-Cleaver et al have reviewed UK guidelines on the management of this condition and found a significant degree of variability, often with variation between written and verbal accounts of practice. [...]we have another paper from Vassallo et al on a comparative analysis of major incident tools in children, an area that I’ve been interested in for many years.

9.
Professional Safety ; 67(10):34, 2022.
Article in English | ProQuest Central | ID: covidwho-2046852

ABSTRACT

[...]FY22 proved to be a strong year financially, as revenue, operating profit and net assets all improved. [...]consolidated net assets increased $2.8 million as of March 31, 2022. During the year, ASSP: *continued to lead on standards focusing on the top 10 causes of occupational injuries, illnesses and fatalities including confined spaces and lockout/tagout concerns;fall protection and fall arrest;and construction and demolition topics such as the use of drones, heat exposure, excavation and roofing *continued efforts to move training forward with a revised standard addressing hydrogen sulfide and new training techniques *distributed more than 20,000 standards through sales, distributors, special events, and educational offerings and engaged more than 1,300 volunteers representing some 500 organizations, resulting in 17 new or revised industry consensus standards, technical reports and guidance documents The ASSP Foundation helps build a strong pipeline of OSH professionals to make all industries safer and continues to strengthen programs and leverage resources to better serve the safety community.

11.
Clin Interv Aging ; 17: 1393-1404, 2022.
Article in English | MEDLINE | ID: covidwho-2043233

ABSTRACT

Purpose: We aimed to investigate the prevalence and factors associated with falls in older adult outpatients during the coronavirus disease (COVID-19) pandemic in Vietnam. Patients and Methods: From February 2022 to June 2022, this cross-sectional study included 814 patients (aged ≥60 years; mean age 71.8 ± 7.3 years; women, 65.2%) attending three geriatric clinics for a comprehensive geriatric assessment. Self-reported fall events in the past 12 months and post-COVID-19 falls were assessed. Factors associated with falls were determined using logistic regression analysis. Results: In total, 188 patients (23.1%) had falls (single fall, 75.5%; recurrent falls, 24.5%). The most frequent location, time, and circumstance of falls were the bedroom (43.1%), morning (54.3%), and dizziness (34.6%), respectively. Most patients experienced health issues after falls (bruise/grazes, 53.7%; fracture, 12.8%; immobility, 9.6%; hospital admission, 14.9%). In the adjusted model, factors associated with falls were being underweight (odds ratio [OR] 2.50, 95% confidence interval [CI] 1.37-4.56, P = 0.003), limitations in instrumental activities of daily living (OR 2.03, 95% CI 1.05-3.95, P = 0.036), poor sleep quality (OR 1.83, 95% CI 1.10-3.05, P = 0.020), and fear of falling (OR 3.45, 95% CI 2.23-5.33, P <0.001). Among 357 COVID-19 infected patients, post-COVID-19 falls occurred in 35 patients (9.8%) and were associated with fear of falling (OR 3.14, 95% CI 1.18-8.40, P = 0.023) and post-COVID-19 lower limb weakness (OR 2.55, 95% CI 1.07-6.10, P = 0.035). Conclusion: Our study found a substantial prevalence of falls among older outpatients during the COVID-19 pandemic in Vietnam. Management of factors associated with falls may be needed to reduce the burden of falls in the older population.


Subject(s)
Accidental Falls , COVID-19 , Accidental Falls/prevention & control , Activities of Daily Living , Aged , COVID-19/epidemiology , Cross-Sectional Studies , Fear , Female , Humans , Pandemics , Risk Factors , Vietnam/epidemiology
12.
Int J Environ Res Public Health ; 19(17)2022 Aug 26.
Article in English | MEDLINE | ID: covidwho-2006009

ABSTRACT

Recent studies suggest that also the non-critical form of COVID-19 infection may be associated with executive function impairments. However, it is not clear if they result from cognitive impairments or by COVID-19 infection per se. We aimed to investigate if patients in the post-acute stage of severe COVID-19 (PwCOVID), without manifest cognitive deficits, reveal impairments in performing dual-task (DT) activities compared to healthy controls (HS). We assessed balance in 31 PwCOVID vs. 30 age-matched HS by stabilometry and the Timed Up and Go (TUG) test with/without a cognitive DT. The DT cost (DTC), TUG test time and sway oscillations were recorded; correct cognitive responses (CCR) were calculated to evaluate cognitive performance. Results show a significant difference in overall DT performance between PwCOVID and HS in both stabilometry (p < 0.01) and the TUG test (p < 0.0005), although with similar DTCs. The main difference in the DTs between groups emerged in the CCR (effect size > 0.8). Substantially, PwCOVID gave priority to the motor task, leaving out the cognitive one, while HS performed both tasks simultaneously. Our findings suggest that PwCOVID, even without a manifest cognitive impairment, may present a deficit in executive function during DTs. These results encourage the use of DTs and CCR in PwCOVID.


Subject(s)
COVID-19 , Cognitive Dysfunction , Cognition/physiology , Humans , Physical Therapy Modalities , Task Performance and Analysis
13.
Emergency Medicine Journal : EMJ ; 39(8):645-646, 2022.
Article in English | ProQuest Central | ID: covidwho-1986381

ABSTRACT

Editor’s note: EMJ has partnered with the journals of multiple international emergency medicine societies to share from each a highlighted research study, as selected by their editors. This edition will feature an from each publication.

14.
Health Soc Care Community ; 30(5): e2590-e2603, 2022 09.
Article in English | MEDLINE | ID: covidwho-1985876

ABSTRACT

Guillain-Barré syndrome (GBS) has several enduring effects that can lead to further harm and/or lower quality of life. These effects include falling and body pain, neither of which have been fully explored. This study aims to examine the risk factors associated with falling and potential causes of body pain in a post-GBS population. A cross-sectional survey of 216 participants was conducted using an electronic questionnaire that included. Self-report measures for: overall health, balance, anxiety and depression levels, body pain and demographics related to GBS experience and falls. A large proportion of individuals post-GBS experience ongoing problems beyond those expected with ageing. Comparative tests indicated that people reporting falls in the previous 12 months had: poorer levels of mobility, poorer F-scores, higher levels of body pain, poorer balance, poorer anxiety and depression scores and higher levels of fatigue. Gender did not appear to contribute to falls. Injuries following falls were associated with a lack of physiotherapy postdischarge and time since GBS. In a regression analysis of the identified and expected key variables, age and body pain statistically predicted falls. In over a quarter of cases reported here, respondents did not receive community physiotherapy following hospital discharge. In the midst and aftermath of COVID-19, provision of rehabilitation needs to be recalibrated, not just for COVID patients, but the wider community with ongoing needs. Issues around well-being and quality of life in the post-GBS community also need further consideration.


Subject(s)
COVID-19 , Guillain-Barre Syndrome , Adult , Aftercare , Cross-Sectional Studies , Guillain-Barre Syndrome/complications , Guillain-Barre Syndrome/epidemiology , Humans , Pain/epidemiology , Patient Discharge , Quality of Life
15.
Age Ageing ; 51(8)2022 Aug 02.
Article in English | MEDLINE | ID: covidwho-1985029

ABSTRACT

BACKGROUND: falls are common in older people, but associations between falls, dementia and frailty are relatively unknown. The impact of the COVID-19 pandemic on falls admissions has not been studied. AIM: to investigate the impact of dementia, frailty, deprivation, previous falls and the differences between years for falls resulting in an emergency department (ED) or hospital admission. STUDY DESIGN: longitudinal cross-sectional observational study. SETTING: older people (aged 65+) resident in Wales between 1 January 2010 and 31 December 2020. METHODS: we created a binary (yes/no) indicator for a fall resulting in an attendance to an ED, hospital or both, per person, per year. We analysed the outcomes using multilevel logistic and multinomial models. RESULTS: we analysed a total of 5,141,244 person years of data from 781,081 individuals. Fall admission rates were highest in 2012 (4.27%) and lowest in 2020 (4.27%). We found an increased odds ratio (OR [95% confidence interval]) of a fall admission for age (1.05 [1.05, 1.05] per year of age), people with dementia (2.03 [2.00, 2.06]) and people who had a previous fall (2.55 [2.51, 2.60]). Compared with fit individuals, those with frailty had ORs of 1.60 [1.58, 1.62], 2.24 [2.21, 2.28] and 2.94 [2.89, 3.00] for mild, moderate and severe frailty respectively. Reduced odds were observed for males (0.73 [0.73, 0.74]) and less deprived areas; most deprived compared with least OR 0.75 [0.74, 0.76]. CONCLUSIONS: falls prevention should be targeted to those at highest risk, and investigations into the reduction in admissions in 2020 is warranted.


Subject(s)
COVID-19 , Dementia , Frailty , Aged , COVID-19/epidemiology , Cross-Sectional Studies , Dementia/diagnosis , Dementia/epidemiology , Emergency Service, Hospital , Frailty/diagnosis , Frailty/epidemiology , Hospitals , Humans , Male , Pandemics , United Kingdom/epidemiology , Wales/epidemiology
16.
J Manipulative Physiol Ther ; 2022 Aug 12.
Article in English | MEDLINE | ID: covidwho-1983505

ABSTRACT

OBJECTIVE: The aim of this study was to assess the effects of aquatic training on motor risk factors for falls in older people during the COVID-19 pandemic. METHODS: A randomized controlled trial was carried out with older people, divided into an aquatic training group (ATG) (n = 24) and a control group (CG) (n = 25). Muscle strength was assessed by the 5-Times Sit-to-Stand Test, mobility by the simple and dual-task Timed Up and Go Test, and postural stability through stabilometric data (force platform). The CG received monthly calls to monitor general health. The ATG carried out training lasting 16 weeks, with two 1-hour sessions per week. RESULTS: Both groups improved muscular strength and cognitive-motor tasks, and they performed a dual task with fewer errors in the secondary task after 16 weeks regardless of the pandemic and COVID-19 diagnosis. There was a significant decrease in the area of center of pressure displacement in the tandem posture with eyes closed in the CG. When analyzing participants who adhered at least 50% to the intervention, the ATG significantly reduced the number of steps on the Timed Up and Go Test performance. Both groups improved muscular strength and cognitive-motor tasks and increased the cognitive task cost. In the CG, there was a significant decrease in the mean amplitude of the anteroposterior center of pressure displacement in the feet together with eyes open. CONCLUSION: We found that aquatic physical exercise presented positive effects on some potentially modifiable motor risk factors for falls (mobility and muscle strength) regardless of the COVID-19 pandemic and COVID-19 diagnosis, especially among people who adhered to the intervention.

17.
The New Zealand Medical Journal (Online) ; 135(1558):103-105, 2022.
Article in English | ProQuest Central | ID: covidwho-1940290

ABSTRACT

[...]there have been reports on the difficulty of wearing masks due to adverse skin reactions,2 and the challenges of communication for those with hearing loss.3 Also of concern is the increased risk of falls and injuries due to obscuration of inferior peripheral vision caused by face masks and mask-related fogging of glasses.4'5 We present two patients admitted with significant injuries due to falls resulting from wearing masks. Strategies to reduce the risks of falls with face masks include: advising older people of the poten- tial risk of falls and injuries with face masks;ensuring a tight fit of the face mask to reduce any obstruction to vision and to reduce the likelihood of glasses fogging up;4 if wearing glasses, washing the lenses in soapy water before using a mask to reduce mask-related fogging;9 advising people to take their time before starting their walk, and to walk more slowly to allow more time to detect upcoming trip hazards and to plan a safe route.4 However, more research is required to explore and determine the risks of falls and ries with face masks, particularly in older people during this pandemic, and to evaluate strategies to reduce such risk during these challenging times. Abey-Nesbit R, Schluter P J, Wilkinson T, Thwaites J H, Berry S D, Jamieson H A. Risk factors for hip fracture in New Zealand older adults seeking home care services: a national population cross-sectional study.

18.
Res Sports Med ; : 1-12, 2022 Jul 19.
Article in English | MEDLINE | ID: covidwho-1937591

ABSTRACT

This study aimed to investigate the changes in physical activity levels and the rate of falls during the COVID-19 pandemic in the Korean population. The Korean Community Health Survey (KCHS) conducted in 2019 was compared with that conducted in 2020. Simple or multiple linear regression with complex sampling was conducted to calculate the estimated value (EV) of physical activity in the 2020 group vs. the 2019 group. The odds ratio (OR) of fall histories was calculated using simple or multiple logistic regression with complex sampling for the 2020 group compared to the 2019 group. The time spent on vigorous and moderate physical activity was lower in the 2020 group than in the 2019 group (EV = -10.0, 95% CI = -12.1 to -8.0, P < 0.001 for vigorous exercise and EV = -24.0, 95% CI = -26.7 to -21.4, P < 0.001 for moderate exercise). The rate of falls was lower in the 2020 group than in the 2019 group (OR = 0.66, 95% CI = 0.62 to 0.70, P < 0.001). Vigorous and moderate exercise decreased after the COVID-19 pandemic compared to before the pandemic. The occurrence of falls was lower during the COVID-19 pandemic than in the pre-pandemic period.

19.
Natural Hazards and Earth System Sciences ; 22(7):2289-2316, 2022.
Article in English | ProQuest Central | ID: covidwho-1934500

ABSTRACT

We present a quantitative risk analysis (QRA) case study from the Kā Roimata o Hine Hukatere / Franz Josef Glacier and Te Moeka o Tuawe / Fox Glacier valleys, on the west coast of the South Island, Aotearoa / New Zealand. The glacier valleys are important tourist destinations that are subject to landslide hazards. Both valleys contain actively retreating glaciers;experience high rainfall;and are proximal to the Alpine Fault, which is a major source of seismic hazard on the west coast. We considered the life safety risk from rockfalls, soil/rock avalanches, and flows that either are seismically triggered or occur aseismically. To determine the range in risk values and dominant contributing variables to the risk, we modelled nine different risk scenarios where we incrementally changed the variables used in the risk model to account for the underlying uncertainty. The scenarios represent our central estimate of the risk, e.g. neither optimistic nor conservative, through to our upper estimate of the risk. We include in these estimates the impact time-variable factors, such as a recently reactivated landslide, have had on locally increasing risk and the time-elapsed since the last major earthquake on the nearby Alpine Fault. We disaggregated our risk results to determine the dominant drivers in landslide risk, which highlighted the importance of considering dynamic time-variable risk scenarios and the changing contributions to risk from aseismic versus seismic landslides. A detailed understanding of the drivers of landslide risk in each valley is important to determine the most efficient and appropriate risk management decisions.

20.
J Clin Med ; 11(14)2022 Jul 08.
Article in English | MEDLINE | ID: covidwho-1928590

ABSTRACT

The aim of the study was to explore the effects of Intentional Rounding, a regular-based proactive patient monitoring, on falls and pressure ulcers in internal medicine units. This is a cluster-randomised controlled study, where units were assigned (1:1) to Intentional Rounding (intervention group) or Standard of Care (control group). The primary outcome was the cumulative incidence of falls and new pressure ulcers. These events were considered separately as secondary endpoints, together with the number of bell calls and the evaluation of patient satisfaction. Primary analyses were carried out on the modified intention-to-treat population (hospitalisation of at least 10 days). Recruitment occurred between October 2019 and March 2020, at which time the study was prematurely closed due to the COVID-19 pandemic. Enrolment totalled 1822 patients at 26 sites; 779 patients were included in the modified intention-to-treat analysis. The intervention group had a lower risk of falls (adjusted incidence rate ratio 0.14; 95% confidence interval, 0.02-0.78; p = 0.03). There were no statistical differences in new pressure ulcers or the cumulative incidence of both adverse events. Mean bell calls for each patient were 15.4 ± 24.1 in the intervention group and 13.7 ± 20.5 in the control group (p = 0.38). Additionally, patient satisfaction in the intervention group was almost at the maximum level. Our study supports the usefulness of Intentional Rounding in a complex and vulnerable population such as that hospitalised in internal medicine units.

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