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Home > Journals > European Journal of Physical and Rehabilitation Medicine (Europa Medicophysica) > Archive > Europa Medicophysica 2006 September;42(3) > Europa Medicophysica 2006 September;42(3):179-84

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EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE (EUROPA MEDICOPHYSICA)

Europa Medicophysica 2006 September;42(3):179-84

 

    ORIGINAL ARTICLES

Falls in a rehabilitation setting: functional independence and fall risk

Saverino A., Benevolo E., Ottonello M., Zsirai E., Sessarego P.

Rehabilitation Institute IRCCS, Salvatore Maugeri Foundation, Genoa-Nervi, Italy

Aim. With this study we wanted to determine the incidence, characteristics and consequences of falls in our rehabilitation setting.
Methods. An observational study was carried out in a rehabilitation setting for postacute orthopedic and neurological inpatients. Three-hundred and twenty patients were enrolled. Falls risk factors (Downton index [DI] and other known parameters), disability (functional independence measure [FIM]) and balance (Berg balance scale [BBS]) were assessed at admission. Falls that occurred during the rehabilitation stay were prospectively classified (St. Louis Older Adult Service and Information System [OASIS] system) and analyzed.
Results. Forty patients experienced a fall (12.5%). The faller group was characterized by a major clinical complexity; 70% of fallers were neurological patients and 30% presented cognitive impairment (mini mental state examination [MMSE] <24). They presented a statistically significant worse score on FIM (motor and cognitive), BBS and DI at admission, with 74% predictability of falls as measured by total FIM score and age. Falls recorded with the OASIS classification showed a prevalence (52.5%) for not bipedal (wheelchair transfer) and self-generated falls; 35% were intrinsic falls (caused by subject-specific factors) and 12.5% extrinsic falls (caused by environmental factors). Falls resulted in only minor clinical consequences, except for one rib fracture, but led to a significant increase in length of stay.
Conclusions. In a rehabilitation centre, for good management of resources and safe prescriptions of a patient’s independence in activities of daily living, fall risk is better evaluated with appropriate scales.

language: English


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