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European Journal of Physical and Rehabilitation Medicine 2012 March;48(1):9-15

Copyright © 2012 EDIZIONI MINERVA MEDICA

language: English

Adherence to recommendations for fall prevention significantly affects the risk of falling after hip fracture: post-hoc analyses of a quasi-randomized controlled trial

Di Monaco M. 1, Vallero F. 1, De Toma E. 2, Castiglioni C. 1, Gardin L. 2, Giordano S. 2, Tappero R. 3

1 Osteoporosis Research Center, Presidio Sanitario San Camillo, Turin, Italy; 2 Service of Occupational Therapy, Presidio Sanitario San Camillo, Turin, Italy; 3 Division of Physical Medicine and Rehabilitation, Presidio Sanitario San Camillo, Turin, Italy


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BACKGROUND: Few studies focused on fall prevention in hip-fracture survivors.
AIM: To investigate the role of adherence to targeted recommendations on both home environment and behaviors in affecting the hazard of falling after a fall-related hip fracture.
DESIGN: Post-hoc analysis of a quasi-randomized controlled trial.
SETTING: Post-acute rehabilitation hospital.
POPULATION: Ninety-five of 119 women living in the community with a fall-related fracture of the hip.
METHODS: We assessed home hazard of falling and suggested targeted modifications of home environment and behaviors in activities of daily living to prevent falls during inpatient rehabilitation. Falls were recorded at a six-month follow-up during a pre-planned home visit.
RESULTS: Nineteen of the 95 women sustained at least one fall during the six-month follow-up. Women with > 2 uncorrected risk factors had a significantly higher risk of falling than those with 0-2 risk factors; the odds ratio adjusted for four confounders was 4.58 (95%CI 1.472-4.250; P=0.009). Adherence to recommendations for fall prevention was negatively associated with fall risk. The adjusted odds ratio for a ten percent increase in adherence rate was 0.749 (95%CI 0.594-0.945; P=0.015).
CONCLUSION: Uncorrected environmental and behavioral risk factors and poor adherence to targeted recommendations for fall prevention significantly predicted the risk of falling in community-dwelling women who sustained a fall-related hip fracture.
CLINICAL REHABILITATION IMPACT: Fall-risk assessment should be performed during inpatient rehabilitation following a fall-related hip fracture. Improving adherence to targeted recommendations emerges as a major goal to prevent falls in hip-fracture survivors.

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