Fear of Falling
Conditions
Keywords
fall, Ground Level Fall (GLF), physiotherapy intervention, short International Falls efficacy scale (sFES-I)
Brief summary
The aim of this monocentric, block-randomized, controlled, open-label, parallel-group study is to assess whether patients presenting to the emergency department (ED) with a fall within the past 7 days would benefit from a physiotherapy intervention, as compared to patients without physiotherapy intervention at the time of ED presentation. Primary objective of this study is to assess fear of falling 7 days after ED presentation with versus without a physiotherapy intervention.
Interventions
The intervention consists of a brief physiotherapeutic assessment, the short physical performance battery, a brief information on the expected course of the condition, a check of fall hazards at home using the Bundesamt für Unfallverhütung (bfu) checklist, and instructions on self-management (eg. staying active, adaptation of behavior and surrounding at home). Additionally, two exercises for daily self-guided therapy will be instructed, namely, sit-to-stand and balance performance exercises.
Sponsors
University Hospital, Basel, Switzerland
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
65 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Written informed consent * Age ≥65 * History of falls within the last 7 days * Presentation to the ED of the University Hospital Basel
Exclusion criteria
* Inpatient disposition after ED work-up * Immobilizing fractures of the lower extremities * Inability or contraindications to undergo the investigated intervention or follow the study procedures, e.g. due to certain neurological disorders (such as parkinsonism, hemiplegia, severe multiple sclerosis), language problems, psychological disorders, cognitive impairment * Prior enrolment in this trial
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in short International Falls efficacy scale (sFES-I) | At Day 0 and Day 7 ± 7 days | Change in the fear of falling between groups at day 7, measured by the short International Falls efficacy scale (sFES-I). It is a 7-item questionnaire where individuals are instructed to score their concern of falling during an activity on a 4 point Likert scale with 1 as not concerned at all and 4 as very concerned. The item scores are summed up to obtain a total, with a higher score indicating a higher fear of falling. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Objective functional levels in the intervention group | At Day 0 and Day 7 ± 7 days | Functional levels measured by SPPB in the intervention group |
| Satisfaction with ED work-up | Day 7 ± 7 days | Patients' satisfaction with ED work-up assessed by questionnaire |
| Feasibility of the intervention | At Day 0 | Feasibility of the intervention assessed by a questionnaire filled out by the physiotherapist |
| Utilization of medical resources | Day 7 ± 7 days, Day 21 ± 3 days, Day 42 ± 3 days | Comparison of the use of medical resources between both groups (ED visits, GP visits, hospitalization, physiotherapy, imaging; all since inclusion) |
| Occurence of falls | Day 7 ± 7 days, Day 21 ± 3 days, Day 42 ± 3 days | Occurence of falls following randomization from patient recollection |
| Change in short International Falls efficacy scale (sFES-I) | At Day 0, Day 7 ± 7 days, Day 21 ± 3 days, Day 42 ± 3 days | Change in the fear of falling, measured by the short International Falls efficacy scale (sFES-I). It is a 16-item questionnaire where individuals are instructed to score their concern of falling during an activity on a 4 point Likert scale with 1 as not concerned at all and 4 as very concerned. The item scores are summed up to obtain a total, with higher the score, higher being the concern for falling. |
Countries
Switzerland
Outcome results
None listed