An Occupational Therapy Fall Reduction Home Visit Program for Community-Dwelling Older Adults in Hong Kong After an Emergency Department Visit for a Fall.

OBJECTIVES: To investigate the effects of an occupational therapy fall reduction home visit program for older adults admitted to the emergency department (ED) for a fall and discharged directly home. DESIGN: Single-blind, multicenter, randomized, controlled trial. SETTINGS: EDs in three acute care hospitals in Hong Kong. PARTICIPANTS: Individuals aged 65 and older who had fallen (N = 311). INTERVENTIONS: After screening for eligibility, 204 consenting individuals were randomly assigned to an intervention group (IG) and received a single home visit from an occupational therapist (OT) within 2 weeks after discharge from the hospital or a control group (CG) and received a well-wishing visit from a research assistant not trained in fall prevention. MEASUREMENTS: Both groups were followed for 12 months through telephone calls made every 2 weeks by blinded assessors with a focus on the frequency of falls. Another blinded assessor followed up on their status with telephone calls 4, 8, and 12 months after ED discharge. Prospective fall records on hospital admissions were retrieved from electronic databases; 198 individuals were followed for 1 year on an intention-to-treat basis. RESULTS: The percentage of fallers over 1 year was 13.7% in the IG (n = 95) and 20.4% in the CG (n = 103). There were significant differences in the number of fallers (P = .03) and the number of falls (P = .02) between the two groups over 6 months. Significant differences were found in survival analysis for first fall at 6 months (log-rank test 5.052, P = .02) but not 9 or 12 months. CONCLUSION: One OT visit after a fall was more effective than a well-wishing visit at reducing future falls at 6 months. A booster OT visit at 6 months is suggested.

The predictive validity of job-specific functional capacity evaluation on the employment status of patients with nonspecific low back pain.

OBJECTIVES: To examine the predictive validity of a job-specific functional capacity evaluation (FCE) on the employment status of patients with nonspecific low back pain (LBP). METHODS: Seven hundred and thirteen patients with nonspecific LBP received job-specific FCE. Based on their performance, return-to-work recommendations were given. Three months after evaluation, all patients were contacted by telephone to find out their employment status to examine the predictive validity of each FCE-based rating. RESULTS: The correct prediction of employment status from an FCE pass rating was 79.8%; fail rating because of not meeting all the criteria of FCE tasks was 61.7%; and fail rating because of failing all FCE tasks was 68.4%. CONCLUSIONS: Job-specific FCE shows a high level of predictive validity that could be used to evaluate the employment status of patients with nonspecific chronic LBP.