Accidental Falls, Fall Risk, Fall Risk, Fall Prevention
Conditions
Keywords
accidental falls, sarcopenia, elderly
Brief summary
Proximal femoral fractures are associated with increased mortality in older adults and may contribute to loss of functional independence, resulting in a higher risk of long-term institutionalization. The SIOT 2021 guidelines emphasize that management of older patients with proximal femoral fracture (FPF) requires a multidisciplinary approach, ideally integrated across all phases of care, including rehabilitation and secondary prevention at the community level, according to a continuity-of-care model that incorporates the implementation of Fracture Liaison Services. Multiple clinical, social, and environmental factors influence fall risk. Falls are also associated with psychological consequences. Age-related reductions in muscle strength contribute to progressive functional decline, increased morbidity and mortality related to falls, reduced quality of life, depression, and hospitalization. Sarcopenia is characterized by both quantitative and qualitative reductions in muscle tissue, including progressive replacement of contractile tissue with fibrous and adipose tissue. The European Working Group on Sarcopenia in Older People (EWGSOP), in its updated consensus (EWGSOP2), identifies low muscle strength as the primary parameter of sarcopenia, accompanied by a significant and generalized reduction in muscle mass. A use-case model dedicated to patients with sarcopenia describes typical demographic and social characteristics, associated comorbidities, and specific care needs, with the aim of identifying the most appropriate management pathways. This study adopts a person-centered approach to design, validate, and implement an integrated strategy for fall prevention, taking into account the multiple determinants of fall risk and related adverse health outcomes.
Interventions
DEVICEKhymeia
All patients will undergo specific rehabilitation training for fall risk prevention and will be assessed twice at To and T1.
Sponsors
Federico II University
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
65 Years to 99 Years
Healthy volunteers
No
Inclusion criteria
Age ≥ 65 years at the time of enrollment Radiographically confirmed knee osteoarthritis or hip osteoarthritis classified as Kellgren-Lawrence grade 2 or 3 Clinical indication for structured rehabilitation therapy Diagnosis of sarcopenia according to European Working Group on Sarcopenia in Older People 2 (EWGSOP2) criteria, defined as: Low muscle strength (handgrip strength \< 27 kg in men or \< 16 kg in women, or chair stand test \> 15 seconds for 5 rises), and Reduced muscle mass confirmed by a validated assessment method (e.g., dual-energy X-ray absorptiometry \[DXA\] or bioelectrical impedance analysis \[BIA\]) according to established cut-off values
Exclusion criteria
Absolute contraindication to rehabilitation therapy as determined by the treating physician Hemodynamic instability, including uncontrolled arrhythmias, symptomatic hypotension, or acute coronary syndrome within the previous 3 months Unstable fractures Severe open wounds or lacerated-contused injuries requiring surgical management Severe cognitive impairment preventing participation in rehabilitation activities (e.g., Mini-Mental State Examination score \< 18)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Balance Measurement | 2 months | Participant balance assessed using standardized clinical tests. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Joint Range of Motion (Degrees) | two months | Measured in degrees using goniometry |
| SARC-F Score for Sarcopenia Screening | two months | Total score 0-10; score \>4 indicates probable sarcopenia. |
| Romberg Test Balance Time (Seconds) | two months | Time in seconds maintaining balance. |
| Pain Intensity Measured by Numeric Rating Scale (0-10) | two months | Scale 0-10; 0 = no pain, 10 = worst pain. |
| Short Physical Performance Battery (SPPB) Total Score | two months | Total score 0-12; lower scores indicate poorer physical performance. |
| Quality of Life Scale (QOLS) Total Score | two months | 17-item questionnaire; higher scores indicate better quality of life. |
Countries
Italy
Contacts
CONTACTRossana Gnasso, Researcher
CONTACTAntonio Picone, PhD
Outcome results
None listed