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: FALL PREVENTION IN THE HOSPITAL SETTING

Y.G. Yi et al. / Annals of Physical and Rehabilitation Medicine 61S (2018) e309–e433 e335

functional BOS i.e. the real stability boundary and the factors that can affect this ability. Aim The new index of anterior stability limit (IASL) explaining the functional base of support (BOS) in sagittal plane (while par- ticipants voluntarily displace their COP in the front direction) that can assess fear and risk of falling. Material and method Twenty five students of the University of the Third Age voluntarily participated in the study. The force plate measurements allowed to investigate functional limit of stability in addition to clinical tests (BBS, Duncan, TUG). The FES-I ques- tionnaire was used to evaluate fear of falling. Additionally, the anthropometric parameters of the foot were measured. The IALS is proportion between range of COP displacement during maximum forward lean and distance from the ankle joint to the head of first metatarsal bone. The Pearson’s linear correlation between FES-I, BBS, Duncan test, TUG test and IASL was conducted. Results High negative correlation was observed between IASL and main scores of FES-I (r = −0.64, P < 0.05) and also between IASL and TUG test (r = −0.76, P < 0.05). Positive correlation was noticed between IASL and Duncan test (r = 0.66, P < 0.05), as well as BBS (r = 0.6, P < 0.05). Conclusion The use of IASL indicate that elderly people used on average 70% of their functional BOS. Use of smaller functional BOS determines increase the fear of falling. Lower values of IASL corre- late with clinical test, which assess risk of falling. IASL has potential as screening tools for fear and risk of falls. Keywords Postural control; Fear and risk of falling; Index of anterior stability limit Disclosure of interest The authors declare that they have no com- peting interest.

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The added value of combined functional tests on predicting future falls in Chinese community-dwelling elderly L. Wang 1,∗, Q. Guo 2 1 TEDA International Cardiovascular Hospital, Rehabilitation Medicine, Tianjin, China 2 Tianjin Medical University, Department of Rehabilitation Medicine, Tianjin, China ∗ Corresponding author. E-mail address: [email protected] (L. Wang)

Introduction/Background Falls are one of the major causes of mor- tality and morbidity in older adults, which needs a practical fall risk assessment tool to predict future falls. Recent researches sug- gested various functional tests produce more power than a single test in many aspects. So we aimed to determine whether combined functional tests could increase predictive ability of future falls, especially recurrent-falls, which may result in stronger adverse impacts. Material and method This was a prospective cohort study (N = 875) among residents of Hangu area of Tianjin, China, who were ≥ 60 years old. Falls were ascertained after one year. Mean- while, sociodemographic information, medical history and physical performance data were also collected. The Timed Up and Go Test (TUGT), walking speed (WS) and grip strength (GS) are more recommended as tests targeting on bal- ance, mobility and muscle strength by many studies. Therefore, we selected these three tests to clarity our hypothesis. Results The mean age was 67.1 years; 58.6% were women. According to ROC area, the cutoff point of TUGT, GS and WS of falls is 10.31 s, 0.3742 kg/kg and 0.9467 m/s, respectively. There- fore we defined good performance on the tests as “ + ”, and poor performance as “ − ” with the cutoff point. Towards any-falls, com- bination of “TUGT−, GS−, WS + ” was most correlated with its

occurrence, with odds ratio (OR) 2.197, 95% CI: 1.204–4.009. Mean- while, combined “TUGT−, WS + ” (OR: 2.103, 1.367–3.235) and combined “TUGT−, GS+, WS − ” (OR2.071, 1.124-3.814) were also more related to any-falls than a single test, like TUGT− (OR: 1.676, 1.170–2.401). However, compared with a single test (TUGT−, OR: 2.192, 1.225–3.922), only the combination of “TUGT−, GS−,WS + ” (OR: 2.536, 1.025–6.272) was a more stronger predictor. Conclusion A simple tool using TUGT, GS and WS has better pre- dictive power on future falls. Based on this result, individuals who show poor ability in TUGT and WS but have good grip strength ought to be more concerned about the high-risk of future falls, especially the likelihood of recurrent-falls. Keywords Combined functional tests; Falls; Elderly Disclosure of interest The authors declare that they have no com- peting interest.

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Factors associated with the risk of fall in stroke inpatients T. Enishi 1,∗, N. Yamasaki 1, A. Matsumoto 1, T. Higuchi 2, M. Takeuchi 2, M. Kashima 2, S. Yoshioka 2, M. Nakamura 2, S. Nakano 2 1 Tokushima Municipal Hospital, Rehabilitation Medicine, Tokushima, Japan 2 Tokushima Municipal Hospital, Orthopedics, Tokushima, Japan ∗ Corresponding author. E-mail address: [email protected] (T. Enishi)

Introduction/Background Falls are popular and major problem for stroke patient during their hospital stay. The aim of this study is to reveal the factors associated with the risk of fall in stroke inpatients. Material and method Retrospective study carried out with stroke hospitalized patients. Thirty-four stroke patients who fell and 34 stroke patients who did not fall during their hospital stay underwent structured medical examinations to identify factors associated with fall. The control subjects were matched for age, height, body weight, body mass index (BMI), and primary diagnosis. Potential variables related to fall risk factors were collected from medical records. A conditional logistic regression was performed to calculate odds ratios using SPSS. Clinical data were collected from January to December 2016. “An unexpected displacement of the body to a lower level than the initial position without loss of consciousness” was regarded as fall. Results Nutrition status, evaluated with modified CONUT score at admission, was significantly associated with fall risk (odds ratio = 3.11, 95% CI: 1.18–9.94). There were no statistically signif- icant differences in the other candidate factors (e.g. sarcopenia, activities of daily living, and rehabilitation intervention) between the two groups. Conclusion Our findings demonstrated that nutrition status was associated with fall risk in stroke hospitalized patients. Further studies are needed to reveal that nutritional intervention can con- tribute to falls prevention in stroke patients. Keywords Fall prevention; Nutrition; Stroke Disclosure of interest The authors declare that they have no com- peting interest.

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