Postural Balance in the Elderly with Mild Cognitive Impairment: Relationship to Accidental Falls

This study analyzed postural balance in the elderly with mild cognitive impairment and its relationship to accidental falls. A quantitative and quasi-experimental method was used in a sample of 43 elderlies between 64 and 88 years old, mostly females. Data collection was performed in two Basic Health Units in the city of Rio de Janeiro in 2014. The instruments used were the Mini-Mental State Examination (MMSE), Tinetti scale, Motor Scale for the Elderly (EMTI) scale, and Elderly Falls Diary. The data were analyzed with the SAS statistical software version 9.3.1. The scales were applied before and after the psychomotor interventions. A significant difference was observed between the evaluating moments. Balance improvements were observed in all age groups, suggesting that all elderlies, regardless of age, showed satisfactory responses to the implemented psychomotor activities. The elderlies who fell more frequently were those between 60 and 69 years old. It is noteworthy that the age group with the lowest incidence of falls was that of elderlies between 70 and 79 years old. It was concluded that psychomotor activities are beneficial, regardless of age, proving their effectiveness when continued stimuli with cognitive and psychomotor activities are carried out.

Discrepancy between Patients’ and Nurses’ Estimates of Patients’ Activities of Daily Living for Fall Risk Assessment: A Quantitative Observational Study

Background: Patient falls are a serious problem in a rehabilitation unit. Although patient falls have been described in the healthcare literature for more 60 years, and many risk assessment tools have been developed, the rate of falls in hospitals in Japan has remained unchanged for the last 8 years. A previous study reported that about 50% of patients in rehabilitation estimated their fall risk lower than that estimated by their nurses. We believe that patients in rehabilitation tend to overestimate their ability to perform ADLs. Aim: To identify discrepancies between patients’ and nurses’ estimates of patients’ ability to perform activities of daily living (ADL) and clarify any relationship between the discrepancies and patient falls. Methods: Participants comprised 82 patients (42 men) admitted to a rehabilitation unit in Osaka, Japan from July to December of 2017. Patients and their nurses answered the same questionnaire about patients’ ability to perform ADL. The questionnaire was developed based on the Functional Independence Measure (FIM) and administered at admission, at 1 month after admission, and at discharge. Participants were classified into the overestimating group and the accurately estimating/underestimating group, and groups were compared using Wilcoxon rank-sum tests. Results: The mean age of participants was 76.4 years. At admission, approximately 72% of participants estimated their own ability to perform ADL higher than did the nurses. The percentage of overestimating participants dropped to 30% at discharge. Fifteen of the participants experienced a fall;all were in the overestimating group. The ADL Discrepancy and fall-assessment scores for these 15 participants were significantly higher than those of other participants. Conclusions: There are discrepancies between patients’ and nurses’ estimates of patients’ ability to perform ADL and had important significance for assessing their risk of fall. And minimizing the discrepancy may support the prevention of falls.

Syncope in older adults

Syncope, defined as a self-limited transient loss of con- sciousness and postural tone due to global cerebral hypoperfusion, is a common reason for emergency room visits, with a third of these visits leading to an inpatient admission.

Risk factors for falls among children aged 0-18 years:a systematic review

Background Accidental falls are the most common cause of injury in children.These falls not only result in pain and injury to children but also can pose a significant financial burden to their families and society.The aim of this study is to identify risk factors for falls in children.Methods We conducted a systematic review of the literature describing falls in children aged 0–18 years.Studies of falls from a height of 1 m or more were excluded from the analysis.We analyzed the included studies to identify risk factors for falls.Results A total of 1496 articles were initially retrieved,leading to an included set of nine articles,which were published from 1995 to 2021.Risk factors related to fall injury in children aged 0–18 years included age,sex,extroversion,rural areas,history of falls,family factors,caregiver factors,medication use,intravenous therapy,tests requiring movement,disease factors and long hospital stay.Conclusion We identified 12 risk factors affecting falls in children,including individual characteristics and family and social factors.

Post-traumatic osteolysis of the distal clavicle,pubis and ischium in 7 patients

Post-traumatic osteolysis (PTOL) is a very rare disease occurring after acute trauma or repetitive micro-trauma, which is characterized by persistent pain in the injured site. In this study, we reported 7 patients, in whom osteolysis developed in the distal clavicle, pubis and ischium.

Effects of short-term active video game play on community adults： under International Classification of Functioning, Disability and Health consideration

Background The effects of active video game play on healthy individuals remain uncertain.A person＇s functional health status constitutes a dynamic interaction between components identified in the International Classification of Functioning,Disability,and Health （ICF）.The aim of this study was to investigate the short-term effects of active video game play on community adults using the ICF.Methods Sixty community adults with an average age of 59.3 years and without physical disabilities were recruited.Over 2 weeks,each adult participated in six sessions of active video game play lasting 20 minutes each.Participants were assessed before and af^er the intervention.Variables were collected using sources related to the ICF components,including the Hospital Anxiety and Depression Scale,Multidimensional Fatigue Inventory,Biodex Stability System,chairrising time,Frenchay Activity Index,Rivermead Mobility Index,Chronic Pain Grade Questionnaire,Work Ability Index,and World Health Organization Quality of Life-Brief Version.Results Compared to baseline data,significantly reduced risk of a fall measured by Biodex Stability System and improvements in disability scores measured by the Chronic Pain Grade Questionnaire were noted.There was no significant change in the other variables measured.Conclusion Short-term,active video game play reduces fall risks and ameliorates disabilities in community adults.

Epidemiological characteristics and preventive strategies for fall injury

To elucidate the epidemiological characteristics and to define some preventive strategies for fall injury (FI). Methods: The medical records of patients admitted following a fall from a certain height between August 1996 and July 1997 were analyzed retrospectively. Results: A total of 138 patients were assessed, with a mortality of 31.2 %. The male to female ratio was 3.5 :1. The persons between 20 and 59 years old were the main victims ( 81.8 %), of which 52.2 % were related with their work altitude. The remaining adults fall because of, accidents in daily life, suicide attempts, drug abuse, alcohol, or criminal behavior. There were significant differences between the death group and the survival group in the Revised Trauma Score (RTS) and the Injury Severity Score (ISS) value (P< 0.05 and P< 0.01 , respectively). Six children fall from balconies, open windows or roofs. There were significant differences for the height of fall and RTS value in aged group than those in children, adolescents, and adults (P< 0.001 , 0.005 , 0.05 ; and P< 0.05 , 0.01 , 0.05 , respectively). The mortality of FI was significantly correlated to the height of fall (r= 0.897 , P< 0.005 ). Conclusions: Male adults are the main victims, especially the workers at high altitudes. The mortality of FI is significantly correlated to the height of fall. The preventive strategies developed through analyzing the risk factors of fall in different age groups might reduce the injuries and deaths following fall.

Frequency of fall-related injuries of female patients referred to the trauma center in the city of Kashan from years 2005 to 2008

Objective： Falls are one of the life events leading to injury and in serious cases cause high morbidity and mortality. This research was conducted to determine the fall incidence among female population of Kashan city from the years 2005 to 2008. Methods： This was a retrospective research using existing data from the data bank of trauma center of Kashan University of Medical Sciences. Records of all the female patients treated at local hospitals with complete hospitalisation kept at the center were examined for 4 con- secutive years from 2005 to 2008. Results： A total of 2 094 female patients＇ records were examined. A significantly higher incidence of injuy occurred in 2008 compared to 2005 （P〈0.0001）. In addition, the highest frequency of injury occurred in age group above 65 years （31.9%） and in group with elementary education level （42.8%）. Conclusion： The results showed that fall incidences occurred in the old age group above 65 years. Fall injuries at this age may cause disability. Therefore, preventive measures should be taken, such as increasing the awareness of the aging population about the seriousness of fall incidence and encouraging the aged individuals to get involved in fitness program to remain physical fit and healthy.