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dc.contributor.authorNiedermann Schneider, Karin-
dc.contributor.authorZindel, Barbara-
dc.contributor.authorMeichtry, André-
dc.contributor.authorKrafft, Valerie-
dc.contributor.authorNast, Irina-
dc.contributor.authorErnst, Markus-
dc.contributor.authorWirz, Markus-
dc.date.accessioned2020-03-12T15:29:04Z-
dc.date.available2020-03-12T15:29:04Z-
dc.date.issued2019-05-11-
dc.identifier.urihttps://digitalcollection.zhaw.ch/handle/11475/19734-
dc.description.abstractBackground. Falls in the elderly are an important public health issue, given the often severe medical consequences and persistent mobility impairments, together with the demographic development. Falls are often due to a combination of internal and external, e.g. environmental, risk factors. The Swiss League Against Rheumatism (SLAR) developed a multidimensional home-based fall prevention programme (FPP), where a trained physiotherapist (PT) or occupational therapist (OT) provides a 60 to 90-minutes visit to the senior at her/his home. The therapist performs a detailed assessment of the senior’s individual risk of falling and subsequently recommends eliminating the identified environmental risk factors and provides tailored exercises. Four weeks later, the PT/OT calls the senior to check if a follow-up visit is required. Purpose. The purpose of this study was to evaluate the effects of the FPP over one year. Primary outcome was the rate of falls; secondary outcomes were fear of falling, as well as PTs’ recommendations and seniors’ satisfaction and adherence. Methods. A prospective observational study was carried out. Participants’ demographic characteristics and fall risk were assessed at baseline, using the ‘Timed Up&Go’ (TUG) with additional motor (TUGmot) and cognitive tasks (TUGcog). Data on falls were assessed at baseline and during one year by fall diaries and bi-monthly telephone calls. The post-intervention fall-rate was compared with the pre-intervention fall-rate; fear of falling was assessed at the same time points using the Fall Efficacy Scale (FESI, 7 items on a 1-4 point scale). A PoissonGEE model for fall counts and a Linear Mixed model for Fall Efficacy Scale were fitted to the data. Additionally the main PTs’ recommendations and seniors’ satisfaction with the intervention and adherence to the exercises after one year were assessed. Results. The analysis was carried out over 335.5 person-years. The participants were mainly female (58%), with a mean age of 82.04 years (SD=5.2, range 57-97 years); 81% and 83% of the participants were able to perform the TUG and the TUGmot respectively, compared to 57% able to perform the TUGcog. The fall rate decreased from 1.34 falls (corresponding to 724 falls) before the intervention to 1.06 falls (corresponding to 577.8 falls) after the intervention, i.e. a relative rate reduction (RRR) of -0.21 (95% CI: -0.37, 0.00). Fear of falling decreased after one year by FESI -1.39 points (95% CI: -1, -1.79). Main recommendations made by PTs/OTs was “fixing down carpets” (69%) and ‘instruction of up to 5 exercises’ (strength, balance, multi-task capability) (83.9%). Almost all seniors (98.2%) were satisfied with the programme, a follow-up visit was provided to 1% of the seniors. After one year, 64% of the participants reported to exercise ‘always’, ‘most of time’ or ‘sometimes’. Conclusions.This low-threshold, multidimensional home-based FPP achieved a 21% fall rate reduction, indicating a potential causal effect of the FPP. The FPP was feasible, and a substantial number of participants was adherent after one year. Implications. Provided that the planned cost-effectiveness study is positive, the FPP developed by the SLAR and provided by PTs and OTs should be established in the national health system and reimbursed to participants. Funding and acknowledgements. This work is funded by the Age Foundation, Zurich, Switzerland and the Foundation for Health Promotion, Lausanne, Switzerland. Ethics approval BASEC 2016-00516de_CH
dc.language.isoende_CH
dc.rightsNot specifiedde_CH
dc.subjectFall preventionde_CH
dc.subjectGeriatricde_CH
dc.subjectElderlyde_CH
dc.subjectPhysiotherapyde_CH
dc.subject.ddc610: Medizin und Gesundheitde_CH
dc.subject.ddc615.82: Physiotherapiede_CH
dc.titleA single home-based fall prevention intervention reduces falls in seniorsde_CH
dc.typeKonferenz: Paperde_CH
dcterms.typeTextde_CH
zhaw.departementGesundheitde_CH
zhaw.organisationalunitInstitut für Physiotherapie (IPT)de_CH
zhaw.conference.detailsWorld Confederation for Physical Therapy (WCPT) Congress 2019, Geneva, 10-13 May 2019de_CH
zhaw.funding.euNode_CH
zhaw.originated.zhawYesde_CH
zhaw.publication.statuspublishedVersionde_CH
zhaw.publication.reviewPeer review (Abstract)de_CH
zhaw.webfeedAngewandte Gerontologiede_CH
zhaw.webfeedFachkommunikation und Wissenstransferde_CH
zhaw.funding.zhawEvaluation RLS Sturzpräventionsprojektde_CH
zhaw.author.additionalYesde_CH
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Niedermann Schneider, K., Zindel, B., Meichtry, A., Krafft, V., Nast, I., Ernst, M., & Wirz, M. (2019, May 11). A single home-based fall prevention intervention reduces falls in seniors. World Confederation for Physical Therapy (WCPT) Congress 2019, Geneva, 10-13 May 2019.
Niedermann Schneider, K. et al. (2019) ‘A single home-based fall prevention intervention reduces falls in seniors’, in World Confederation for Physical Therapy (WCPT) Congress 2019, Geneva, 10-13 May 2019.
K. Niedermann Schneider et al., “A single home-based fall prevention intervention reduces falls in seniors,” in World Confederation for Physical Therapy (WCPT) Congress 2019, Geneva, 10-13 May 2019, May 2019.
NIEDERMANN SCHNEIDER, Karin, Barbara ZINDEL, André MEICHTRY, Valerie KRAFFT, Irina NAST, Markus ERNST und Markus WIRZ, 2019. A single home-based fall prevention intervention reduces falls in seniors. In: World Confederation for Physical Therapy (WCPT) Congress 2019, Geneva, 10-13 May 2019. Conference paper. 11 Mai 2019
Niedermann Schneider, Karin, Barbara Zindel, André Meichtry, Valerie Krafft, Irina Nast, Markus Ernst, and Markus Wirz. 2019. “A Single Home-Based Fall Prevention Intervention Reduces Falls in Seniors.” Conference paper. In World Confederation for Physical Therapy (WCPT) Congress 2019, Geneva, 10-13 May 2019.
Niedermann Schneider, Karin, et al. “A Single Home-Based Fall Prevention Intervention Reduces Falls in Seniors.” World Confederation for Physical Therapy (WCPT) Congress 2019, Geneva, 10-13 May 2019, 2019.


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