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  • Title: Falls in a rehabilitation setting: functional independence and fall risk.
    Author: Saverino A, Benevolo E, Ottonello M, Zsirai E, Sessarego P.
    Journal: Eura Medicophys; 2006 Sep; 42(3):179-84. PubMed ID: 17039213.
    Abstract:
    AIM: With this study we wanted to determine the incidence, characteristics and consequences of falls in our rehabilitation setting. METHODS: An observational study was carried out in a rehabilitation setting for postacute orthopedic and neurological inpatients. Three-hundred and twenty patients were enrolled. Falls risk factors (Downton index [DI] and other known parameters), disability (functional independence measure [FIM]) and balance (Berg balance scale [BBS]) were assessed at admission. Falls that occurred during the rehabilitation stay were prospectively classified (St. Louis Older Adult Service and Information System [OASIS] system) and analyzed. RESULTS: Forty patients experienced a fall (12.5%). The faller group was characterized by a major clinical complexity; 70% of fallers were neurological patients and 30% presented cognitive impairment (mini mental state examination [MMSE] <24). They presented a statistically significant worse score on FIM (motor and cognitive), BBS and DI at admission, with 74% predictability of falls as measured by total FIM score and age. Falls recorded with the OASIS classification showed a prevalence (52.5%) for not bipedal (wheelchair transfer) and self-generated falls; 35% were intrinsic falls (caused by subject-specific factors) and 12.5% extrinsic falls (caused by environmental factors). Falls resulted in only minor clinical consequences, except for one rib fracture, but led to a significant increase in length of stay. CONCLUSIONS: In a rehabilitation centre, for good management of resources and safe prescriptions of a patient's independence in activities of daily living, fall risk is better evaluated with appropriate scales.
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