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Syftet med studien var att undersöka konsekvenserna avseende fallolyckor bland äldre, samt att undersöka vilka preventiva metoder som presenteras i internationell vetenskaplig litteratur. Metod: Studien genomfördes som en systematisk litteraturstudie. Databassökningen gjordes i Blackwell Synergy och ELIN@Dalarna. De vetenskapliga artiklarna som ingick i studien var skrivna på svenska eller engelska samt publicerade mellan åren 1999 och 2007. Artiklarnas vetenskapliga kvalitet bedömdes utifrån granskningsmallar. I resultatet som grundar sig på 20 artiklar framkom det att hos dem som fallit under studieperioden och som föll igen inom en tremånadersperiod var risken att avlida i samband med det andra fallet 95 procent. Vanliga konsekvenser efter ett fall var höftfrakturer och andra kroppsliga skador samt även fysiska funktionsnedsättningar och imobilitet. Resultatet visade även att socialpsykologiska konsekvenser var vanligt förekommande där dominerande känslor var rädsla, ångest, kraft- och orkeslöshet, förlorad eller minskad självständighet, depression samt förlorad självkontroll. Kvinnor föll oftare, var oftare rädda och hade mer ångest, dessutom fick de oftare höftfrakturer och komplikationer i samband med fallet jämfört med männen. Multidisciplinära preventionsprogram minskade fallolyckorna signifikant. Tidig prevention hos riskgrupper var viktigt. Balansträningsprogram som exempelvis Tai Chi Chuan visade sig ha positiv effekt på balansen och minskade risken att falla. Slutsats: Fallolyckor bland äldre är ett växande problem inte bara i Sverige utan i stora delar av världen. Eftersom fallförebyggande åtgärder är ett komplext område med många faktorer som har betydelse för utfallet krävs det ett samarbete mellan många aktörer men framförallt mellan kommun och landsting. Prevention måste struktureras för bästa resultat lämpligen genom att använda en färdigställd lokal preventionsplan. De samhällsekonomiska vinsterna lokalt, regionalt och nationellt skulle bli stora om det preventiva arbetet prioriterades och effektiviserades.

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Class of 2012 Abstract / Specific Aims: The purpose of this study was to test an interactive educational program for older adults on preventing accidental falls. Methods: This was a prospective, descriptive study evaluating the helpfulness of an interactive educational program. English speaking residents were recruited from five independent senior living communities in Arizona. The intervention consisted of a 30-minute interactive PowerPoint presentation followed by a 10-minute question and answer session. Information provided during the presentation focused on information from the CDC and the Fall Prevention Center of Excellence. Participants completed an anonymous questionnaire to rate the helpfulness of the program. The primary dependent variable was overall helpfulness of the educational session. Other variables included: intention of changing future behavior related to preventing falls, whether participants would recommend the program to others, participant perception of gained knowledge, change in fear of falling, and interest in meeting with pharmacist to discuss medications. Categorical data was analyzed by calculating frequencies and percentages and continuous data by calculating means and SDs. A t-test for independent groups was used to compare men and women. Main Results: A total of 93 individuals attended the presentations. Out of 81 completed surveys, 5 did not indicate gender, 7 additional did not indicate age, and 6 were over 89 years of age. Demographic data for the men and women was similar. 90% of participants indicated that the program was either "very helpful" or "moderately helpful". 92% of participants responded “absolutely yes” or “likely” that they would recommend the program. No participants strongly disagreed that they had a better understanding of fall risks or medications that increase fall risk. 87% of participants responded “absolutely yes” or “likely” that they plan to increase daily exercise . 42% of participants said it was “not likely” that they plan to make changes in their living environment. Conclusions: An interactive educational program on fall safety and prevention is helpful for older adults. As one of the most widely accessible health care providers, pharmacists and pharmacy students are well suited to provide patient education and improve outcomes. The results of this study provide preliminary data supporting the usefulness of a patient education program on fall safety prevention administered by pharmacy students.

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Chronic obstructive pulmonary disease (COPD) is a progressive lung disease comprising of respiratory-related and systemic effects, including impairments in balance. Balance impairments are especially problematic as they increase the risk of falling, potentially leading to negative outcomes such as hospitalization, disability, and death. The main objectives of this thesis were to 1. determine underlying balance impairments that distinguish between individuals with COPD with and without a history of falls and 2. explore facilitators and barriers of a home-based fall prevention program for people with COPD. The first study of this thesis was a secondary analysis of cross-sectional data that showed that the stability limits/verticality and postural responses subcomponents of the Balance Evaluation Systems Test (BESTest) distinguished between those with and without a fall history among 72 patients with moderate to severe COPD. The stability limits/verticality subcomponent also showed acceptable accuracy in identifying individuals with COPD at high risk of falls (cut-off score of 73.8%). In the second study, a qualitative analysis of interviews with 15 patients who completed a home-based fall prevention program, participants indicated that programs that are personalized and focus on providing support for older adults with COPD may help to improve adherence and reduce participants’ risk of falling. The findings from the two studies included in this thesis provide new knowledge for informing fall risk assessment and prevention for people with COPD. / Thesis / Master of Science (MSc)

Previous studies have shown that obesity negatively affects balance during quiet standing, yet little is known about its effect on the ability to recover after a postural perturbation. The purpose of this thesis was to investigate the effects of obesity on single-step balance recovery from an incipient forward fall. Eight obese (BMI = 33.2 ± 2.4) and eight non-obese (BMI = 24.8 ± 1.8) participants were released from a static forward lean and asked to recover their balance with a single step. Lean angle was progressively increased until they could no longer recover balance with a single step. Peak joint torques and relative effort during balance recovery were calculated and compared across the groups. Obese participants achieved a smaller maximum lean angle compared to non-obese participants. During balance recovery, obese participants exhibited higher ankle plantar flexor torques and relative effort. Trends also suggested higher relative hip extensor effort in the obese. Obese adults exhibited a poorer ability to recover from a forward fall with a single step. In addition, obese adults used a higher percentage of their total hip and ankle strength compared to non-obese adults during balance recovery. This suggests that the poorer ability of recovering from a forward fall in the obese may be related to increased exertion levels during balance recovery. / Master of Science

Slips are a leading cause of injury among older adults. Specific slip recovery measures, including slip distance and peak slip speed, have been shown to increase significantly among fallers as compared to non-fallers. Often, slipping kinematics are measured using optoelectronic motion capture (OMC), requiring a laboratory setting and limiting data collection to experimentally-controlled conditions. Inertial measurement units (IMUs) show promise as a portable and wearable form of motion capture. This study had two objectives. First, we investigated whether foot and ankle IMU-derived slip recovery measures could be considered equivalent to the same OMC-derived measures. Second, we investigated if both participant-placed and researcher-placed IMU-derived slip recovery measures could be considered equivalent to the same OMC-derived measures. 30 older adults (ages 65-80) were exposed to a slip while wearing both IMUs and OMC markers. Slip distance and peak slip speed were measured by both systems and compared. Equivalence testing (α = 0.05) showed that IMUs placed on the foot and the ankle were equivalent to OMC in measuring these slip recovery measures. Furthermore, it was shown that researcher and participant-placed IMUs were equivalent (α = 0.05) to OMC in measuring these slip recovery measures. These results confirm that IMUs can be a viable substitute for OMC and have the potential to expand data capture to a real-world environment. / Master of Science / Falls are a major cause of injury among older adults. Slips are a large contributor to falls, so it is important to better understand how slips occur to develop more efficient fall-prevention programs. To understand slips, previous research often utilized optoelectronic motion capture (OMC) to measure slip recovery measures. However, OMC relies on multiple cameras, limiting slip measurement to a laboratory. As we want to understand slips in the real-world, we must use a different form of motion capture. Inertial measurement units (IMUs) are sensors that can afford real-world biomechanical measurement. In this thesis research, 30 older adults (ages 65-80) were exposed to one over-ground slip. Slip recovery measures are compared between OMC and IMUs placed on the foot and ankle. Furthermore, IMU placement is compared between researchers and participants. Equivalence testing showed that IMUs placed on the foot and the ankle were equivalent to OMC in measuring these slip recovery measures. Furthermore, it was shown that researcher and participant-placed IMUs were equivalent to OMC in measuring these slip recovery measures. These results confirm that IMUs can be a viable substitute for OMC and have the potential to expand data capture to a real-world environment.

In America, a person has a 1 in 3 chance of falling each year once they reach the age of 65. When someone falls, they risk bodily injury. There are products available to help people when they fall, but they are only effective once a person reaches a point where they are at risk of falling. In order to reduce an individual's chance of falling as they age, preventive measures must be taken before the problems develop. With the use of digital technology, adults can be properly instructed on how to keep they bodies strong and balanced for there golden years. This thesis documents the research, conceptualization, and development of the Xcel Sleeve. / Master of Science

Falls are nurse-sensitive outcome which reflect the quality of nursing care. Nurses, therefore, have a major role to play in efforts to decrease fall rates. The objective of this project is to increase nurses' knowledge on the proper use of the CVVM as an attempt to effectively decrease fall rates. Pretest, post test, and course evaluation data were collected from 30 nurses. A descriptive analysis of the data was performed. Overall, the pretest evaluation showed that nurses had an average score of 43% in the combined assessment of their knowledge on fall prevention strategies, their use of the CVVM, and their knowledge about the hospital's policy on patient monitoring. The nurses' post test average score in the combined assessment of these measures increased to 89% after the educational training which included presentations, hands-on-training, and provision of reference materials and cheat cards on fall prevention strategies and the use of the CVVM surveillance system. Inadequate training, lack of knowledge on the utilization of CVVM surveillance, inadequate use of system resources, and noncompliance with hospital policies were the primary drivers of fall rates in this hospital. Main recommendations include training and periodic retraining of staff on fall prevention strategies; leadership involvement to ensure nurses' compliance with the use of CVVM technology and hospital policy on patient monitoring; provision of CVVM reference materials; and nursing responsibilities in patient monitoring. Social change implications of this project include that nurses are better equipped through training to prevent falls, therefore, lowering patient morbidity and mortality rates.