Article

PURPOSE: To compare falls event rates and risk factors for falls across three
rehabilitation settings. METHODS: A multi-centre prospective longitudinal cohort
study was conducted of 1682 participants referred for rehabilitation from 18
sites (across two Australian states) and receiving physiotherapy treatment. Falls
risk factors across multiple domains (rehabilitation settings, medical diagnoses,
age, gender, standing balance, functional capacity, cognition, prior living
arrangements, pre-admission use of gait aid and past history of falls) were
collected by treating physiotherapists on admission to rehabilitation. Falls were
measured by incident reporting and review of medical histories in the inpatient
settings and by weekly interviews in the outpatient and domiciliary settings.
RESULTS: Overall, outpatient and domiciliary settings demonstrated lower falls
event rates compared to inpatient [IRR (95% CI): 0.58 (0.36-0.93) and 0.35
(0.24-0.51)], respectively. Cognitive status, functional ability and past history
of falls were consistent risk factors across settings. However medical diagnoses
of stroke, other neurological conditions, elective orthopaedic and other
orthopaedic together with standing balance were inconsistent as risk factors or
protective factors across settings. CONCLUSIONS: Risk factors for falls,
including medical diagnosis, are not necessarily universal across settings.
Balance performance was a significant risk factor for outpatient and domiciliary
settings but was not a risk factor for inpatients. Cognitive status and a
previous history of falls were, however, consistent risk factors across all
settings. This suggests that different approaches for the prevention of falls may
be required for the same diagnostic group of patients depending on the location
of the rehabilitation setting.

Langue : ANGLAIS