Article

PURPOSE: To critically appraise the research literature on the nature of falls
and fallers in traumatic brain injury (TBI) rehabilitation settings. METHOD: An integrative review of the literature using thematic analysis was undertaken.
Papers identified via a systematic search strategy were independently appraised
by two reviewers. A data extraction instrument was developed to record results
and to aid identification of themes in the literature.
Critical Appraisal Skills
Programme instruments were utilised to conduct a methodological critique of the
papers included. RESULTS: Thirteen studies were identified as having between 4%
and 100% TBI patients in their study cohorts. From these papers, up to 71% of
falls took place in a patient's bedroom occurring in peaks and troughs over a
24-h period. With some divergent results, nine themes were identified describing
faller characteristics including: (1) functional mobility impairments; (2)
dizziness; (3) bladder and bowel dysfunction; (4) certain medications and number
of medications prescribed; (5) executive functioning; (6) patient age; (7) fear
of falling; (8) coma length following TBI; and (9) Functional Independence
Measure (FIM) total score, subscale scores and particular individual items.
CONCLUSIONS: Being a multifactorial phenomenon, falls are a complex clinical
issue. Despite the heterogeneity of diagnosis related groups (DRGs) in the
included studies, TBI patients were identified as a high falls risk patient
population in several studies. Implications for Rehabilitation Due to multisystem
impairments, falls in the traumatic brain injury (TBI) rehabilitation context are
a multifactorial and significant clinical issue. When interpreting and
generalising results from research into falls, clinicians need to be mindful that
falls and faller characteristics may be dependent on study setting and patient
population. There is need for context specific research into faller
characteristics following a TBI; particularly in relation to post-traumatic amnesia.
- Chute

Langue : ANGLAIS