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Head Over Heels: Impact of a Health Promotion Program to Reduce Falls in the Elderly

Published online by Cambridge University Press:  29 November 2010

Elaine M. Gallagher  and
Howard Brunt
Elaine M. Gallagher
Affiliation:
University of Victoria
Howard Brunt
Affiliation:
University of Victoria
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Abstract

The Fit (Falls Intervention Trials) Project was a randomized clinical trial of a program designed to reduce falls and their sequela among older people. The sample consisted of 100 persons who were age 60 and over, who lived in the Capital Region District (Victoria, B.C.) and who had experienced a fall in the preceding three months. The intervention consisted of a comprehensive risk assessment, individualized feedback about identified risks and a motivational video and booklet entitled “Head Over Heels”. Outcome measures included fall incidence, falls self-efficacy, fear of falling, social functioning, health service utilization and quality of life. While there were no statistically significant differences between the intervention and control groups on the key study variables, there were improvements in both groups between the beginning of the study and the six-month follow-up assessment. The paper discusses possible reasons for these findings and their implications for further research.

Résumé

Le projet FIT – Falls Intervention Trials (étude sur les essais d'intervention après les chutes) – consistait en une étude clinique avec répartition aléatoire des effets d'un programme visant à réduire l'incidence de chutes et leurs séquelles chez les personnes âgées. L'échantillon se composait de 100 personnes de 60 ans et plus, vivant dans la région de la capitale provinciale (Victoria, C.-B.) et ayant fait une chute au cours des trois mois précédant l'étude. L'intervention prenait la forme d'une évaluation détaillée des risques, de commentaires individuels quant aux risques déterminés, ainsi qu'une bande vidéo accompagnée d'une brochure d'information intitulées Head over Heels. La mesure des résultats comprenait l'incidence des chutes, l'auto-efficacité en cas de chutes, la crainte de chuter, le fonctionnement social, l'utilisation des services de santé et la qualité de vie. Bien que les principales variables de l'étude n'aient révélé aucune différence statistique importante entre le groupe expérimental et le groupe témoin, on a pu constater une amélioration au sein des deux groupes entre le début de l'étude et l'évaluation de suivi, six mois après sa conclusion. L'article traite des différentes raisons possibles expliquant ces résultats et leurs conséquences en fonction de recherches plus approfondies.

Keywords

AgingAccidental InjuryFallsHealth PromotionRisk Reduction.Vieillissementaccident avec blessurechûtepromotions de la santéréduction des risques.
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 15 , Issue 1 , Spring/printemps 1996 , pp. 84 - 96
Copyright
Copyright © Canadian Association on Gerontology 1996

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References

1.Morris, EV, Isaacs, B.The prevention of falls in a geriatric hospital. Age and Ageing 1980; 9: 1981–5.CrossRefGoogle Scholar
2.Orlando, T. The meaning of falling for elderly community-dwelling individuals 1988. Unpublished master's thesis, University of British Columbia.Google Scholar
3.Patla, A, Frank, J, Winter, D.Assessment of balance control in the elderly: major issues. Physiotherapy 1990; 2: 89–97.Google Scholar
4.Statistics Canada. Canada Year Book 1988. Ottawa, ON: The Bryant Press Ltd. 1987.Google Scholar
5.Mackus, M, Mullette, J.Supporting Community Elderly. Journal of Gerontological Nursing 1987; 13(12): 26–29.CrossRefGoogle ScholarPubMed
6.Campbell, AJ, Reinken, J, Allan, BC, Martinez, GS. Falls in old age: a study of frequency and related clinical factors. Age and Ageing 1981; 10: 264–70.CrossRefGoogle ScholarPubMed
7.Hogue, C.Injury in late life: prevention. Journal of the American Geriatrics Society 1982; 30: 276–80.CrossRefGoogle Scholar
8.Tinetti, ME, Williams, TF, Mayewski, R. Fall risk index for elderly patient's based on number of chronic disabilities. The American Journal of Medicine 1986; 30: 429–35.CrossRefGoogle Scholar
9.Schulman, BK, Acquaviva, T.Falls in the elderly. Nurse Practitioner 1989; 12(11):30–37.Google Scholar
10.Still, JM.Scientific analysis of falls. Geriatric Consultant 1988; Mar/April, 21: 27–29.Google Scholar
11.Gryfe, CI, Amies, A, Ashley, MJ. A longitudinal study of falls in an elderly population: incidence and morbidity. Age and Ageing 1977; 6: 202–10.CrossRefGoogle Scholar
12.Rousseau, P. Evaluation and treatment of falls. Geriatric Consultant 1987; Sept/Oct, 22–24.Google Scholar
13.Wolf-Klein, FP, Silverstone, FA, Basavaraju, N, Foley, CJ, Pascaru, A, Ma, PH. Prevention of falls in the elderly population. Archives of Physical Medical Rehabilitation 1988; 69(9):689–91.Google ScholarPubMed
14.Walsh, JB. To trip, to slip, perchance to tumble. Irish Medical Journal 1989; 82(2):52–53.Google ScholarPubMed
15.Abernathy, TJ, Wigmore, D, Lentzes, D. Falls in the elderly: evaluation of a community-based prevention program. Unpublished study 1988; Calgary, AB.Google Scholar
16.Tideiksaar, R, Kay, A. What causes falls! A logical diagnostic procedure. Geriatrics 1980; 41(12):42–44, 47–50.Google Scholar
17.Prudham, D, Evans, JG. Factors associated with falls in the elderly: a community study. Age and Ageing 1981; 10: 141–6.CrossRefGoogle ScholarPubMed
18.Cummings, SR, Nevitt, MC, Kidd, S. Forgetting falls: the limited accuracy of recall of falls in the elderly. Journal of the American Geriatrics Society 1988; 36: 613–6.CrossRefGoogle ScholarPubMed
19.Neilson, E. Accidents among seniors: can they be prevented? Presented at the Conference of the Canada Safety Council, June, 1989, Victoria, BC.Google Scholar
20.Fisk, R. Epidemiological Factors. Presented at the Workshop on Falls, Victoria, BC, 1989.Google Scholar
21. Capital Regional District Care Programs — QRT Statistics.Google Scholar
22.Perry, BC. Falls among the elderly living in high-rise apartments. The Journal of Family Practice 1982; 14(6):1069–73.Google ScholarPubMed
23.Hindmarsh, JJ, Estes, EH. Falls in older persons: causes and interventions. Archives of Internal Medicine 1989; 149: 2217–22.CrossRefGoogle ScholarPubMed
24.Tideiksaar, R. Geriatric falls: assessing the cause, prevention, preventing recurrence. Geriatrics 1989; 44(7):57–62.Google ScholarPubMed
25.Patterson, C, Torresin, W. Falls in the frail elderly — keep your patient's feet on the ground. Geriatrics 1989; 4: 15–25.Google Scholar
26.Vellas, B, Cayla, F, Bocquet, HM, dePemille, F, Albarede, JL. Prospective study of restriction of activity in old people after falls. Age and Ageing 1987; 16: 189–93.CrossRefGoogle ScholarPubMed
27.Isaacs, B.Clinical and laboratory studies of falls in old people: prospects on prevention. Clinical Geriatric Medicine 1985; 1, 513–20.CrossRefGoogle ScholarPubMed
28.Tinetti, M.Decreasing the risk of falling. Clinical Report on Aging from The American Geriatrics Society 1987; 1(5):1,15–16.Google Scholar
29.Albarede, JL, Vellas, B. Restriction d'activités après la chute de la personne âgée. Rapport à l'O.M.S., Centre International de Gérontologie Sociale, 1985.Google Scholar
30.Wild, D, Nayak, USL, Isaacs, B. How dangerous are falls in old people at home? British Medical Journal 1981; 282: 266–8.CrossRefGoogle ScholarPubMed
31.Campbell, AJ, Borrie, MJ, Spears, GF. Risk factors for falls in a community-based prospective study of people 70 years and older. Journal of Gerontology 1989; 44(4):M112–7.CrossRefGoogle Scholar
32.Ross, RT. Prevention of falls in the elderly. New England Journal of Medicine 1989; 23: 1614.Google Scholar
33.Droller, H. Falls among elderly people living at home. Geriatrics 1955; 10: 239–44.Google ScholarPubMed
34.Exton-Smith, AN. Clinical manifestations. In: Exton-Smith AN, Evans G (eds), Care of the Elderly: Meeting the Challenge of Dependency. London, England: Academic Press, 1977.Google Scholar
35.Morse, JM, Morse, RM, Tylko, SJ. Development of a scale to identify the fall-prone patient. Canadian Journal on Aging 1989; 8(4):366–77.CrossRefGoogle Scholar
36.Gross, YT, Shimamoto, Y, Rose, CL, Frank, B. Why do they fall? Monitoring risk factors in nursing homes. Journal of Gerontological Nursing 1990; 6(6):20–25.Google Scholar
37.Overstall, PW, Johnson, AL, Exton-Smith, AN. Instability and falls in the elderly. Age and Ageing 1978; 7: 92–96.CrossRefGoogle Scholar
38.Crosbie, WJ, Nimmo, MA, Banks, MA, Brownlee, MG, Meldrum, F. Standing balance reponses in two populations of elderly women: a pilot study. Archives of Physical Medical Rehabilitation 1989; 70: 751–4.Google Scholar
39.Heitmann, DK, Gossman, MR, Shaddeau, SA, Jackson, JR. Balance performance and step width in noninstitutionalized, elderly, female fallers and non fallers. Physical Therapy 1989; 69(11):923–31.CrossRefGoogle Scholar
40.Overstall, PW. Falls in the elderly — epidemiology, aetiology and management. In: Isaacs, B (ed), Recent Advances in Geriatric Medicine 1978; p. 61–72.Google Scholar
41.Berg, K.Balance and its measure in the elderly: a review. Physiotherapy Canada 1989; 41(5):240–6.CrossRefGoogle Scholar
42.Sullivan, M.Atrophy and exercise. Journal of Gerontological Nursing 1987; 13(7):26–31.CrossRefGoogle ScholarPubMed
43.Craven, R, Bruno, P.Teach the elderly to prevent falls. Journal of Gerontological Nursing 1986; 12(8):27–33.CrossRefGoogle ScholarPubMed
44.Wickham, C, Cooper, C, Margetts, M, Barker, DJP. Muscle strength, activity, housing and risk of falls in elderly people. Age and Ageing 1989; 18: 47–51.CrossRefGoogle ScholarPubMed
45.Shapiro, E.Hospital use by elderly Manitobans resulting from an injury. Canadian Journal on Aging 1988; 7(2):125–33.CrossRefGoogle Scholar
46.Robbins, AS, Rubenstein, LZ, Josephson, MPH, Shulman, BL, Osterweil, D, Fine, G. Predictors of falls among elderly people. Results from two population-based studies. Archives of Internal Medicine 1989; 149: 1628–33.CrossRefGoogle ScholarPubMed
47.Archea, J. Falls in the elderly: environmental factors associated with stair accidents by the elderly. Clinical Geriatric Medicine 1985; 1: 555–69.CrossRefGoogle Scholar
48.Waller, JA. Injury: conceptual shifts and preventive implications. Annual Review of Public Health 1987; 8: 21–49.CrossRefGoogle ScholarPubMed
49.Eriksson, SV, Lindgren, JU. Outcome of falls in women: endogenous factors associated with fractures. Age and Ageing 1989; 18: 303–8.CrossRefGoogle Scholar
50.Gerson, LW, Jarjourna, D, McCord, G. Risk of imbalance in elderly people with impaired hearing or vision. Age and Ageing 1989; 18: 31–34.CrossRefGoogle ScholarPubMed
51.Vandervoort, A, Hill, K, Sandrin, M, Vyse, VM. Mobility impairment and falling in the elderly. Physiotherapy Canada 1990; 42(2):99–107.Google Scholar
52.Speechley, M, Tinetti, M.Assessment of risk and prevention of falls among elderly persons: role of the physiotherapist. Physiotherapy Canada 1990; 42(2):75–79.Google Scholar
53.Tinetti, M. Performance-oriented assessment of mobility problems in elderly patients. The American Geriatrics Society 1986; 34(2): 119–26.CrossRefGoogle ScholarPubMed
54.Girdano, D, Dusek, D. Changing Health Behavior 1988. Gorsuch Scarsbrick Pubs, Arizona.Google Scholar
55.Washington University Division of Biostatistics. FICIT Frailty and Injuries: Cooperative Studies of Intervention Techniques. Procedure Manual. St. Louis, MI: Washington University, 1991.Google Scholar
56.Edwards, N. Ottawa-Carleton Health Unit Study of Falls. (Unpublished Interview Schedule), 1991.Google Scholar
57.Reuben, D, Laliberte, L, Hiris, J, Mor, V. A hierarchical exercise scale to measure function at the advanced activities of daily living (AADL) level. Journal of the American Geriatrics Society 1990; (38):855–61.CrossRefGoogle ScholarPubMed