Falls among top reasons for transfers from continuing care to acute care hospitals in Canada

The effects of proprioceptive neuromuscular facilitation integration pattern exercise program on the fall efficacy and gait ability of the elders with experienced fall

The purpose of this study is to investigate the effect of exercising program utilizing proprioceptive neuromuscular facilitation integration pattern (PIP), which is effective in improvement of the physical function, on the fall efficacy and gait ability of the elders who experienced injuries from falls. Also, this study aims to investigate he applicability of exercise program as methods for fall reoccurrence prevention and physical functions enhancement. The subjects of the study were 30 elders in the local community with experience of injuries from falls. The period of the study was 4 weeks with 12 exercise sessions. The subjects were randomly allocated to 2 groups where 15 elders were allocated to PIP and the rest 15 elders were allocated to general exercise (GE) group. Fall efficacy scale (FES) and GAITRite were used for the measurements in this study. Paired t-test was used to analyze the differences within the group while independent t-test was used to analyze the difference between two groups. In the comparison of measurements before and after exercise program, FES, velocity, cadence, and stride length were shown to be significantly increased in both PIP group and GE group. Also, in the comparison between two groups after the exercise program, the measurements of FES, cadence, stride length, and step length in PIP group were shown to be significantly increased compared to the GE group. Therefore, the PNF combined pattern is judged to be applicable to as methods for fall reoccurrence prevention and physical functions enhancement of the elders with experience of being fallen.

Interventions for improving mealtime experiences in long-term care

Poor food intake in residents living in long-term care (LTC) homes is a common problem. The mealtime experience is known to be important in the multifactorial causes of food intake. Diverse interventions have been developed, implemented, and/or evaluated to improve the mealtime experience in LTC; it is possible that multicomponent interventions will have a greater benefit than single activities. To identify the range of feasible and potentially useful interventions for including in a multicomponent intervention, this scoping review identified and summarized 58 studies that described and/or evaluated mealtime experience interventions. There were several randomized controlled trials, although most studies used less rigorous methods. Interventions that are multicomponent (e.g., food service, dining environment, staff education) and target multilevel factors (e.g., residents, staff) in LTC appear to be feasible, with a variety of outcomes measured. Further research is still needed with more rigorously designed studies, confirming effectiveness, feasible implementation, and scaling up of efficacious interventions.

Knowledge translation for falls prevention: the view from Canada

Researchers have now conclusively demonstrated that many falls in older adults can be prevented, and that the interventions can produce cost-savings. Because most falls are multifactorial, falls prevention interventions can involve several approaches delivered by numerous health care professions in multiple settings. These complexities may make knowledge translation (KT) more challenging than with simpler interventions for specific diseases. After describing these complexities and reviewing the evidence base for falls prevention, this paper examines the few published demonstrations of KT in falls prevention. It continues with a description of the visibility and accessibility of falls prevention Clinical Practice Guidelines (CPGs) on the websites of four key Canadian health professional associations: nurses, occupational therapists, physical therapists, and physicians. The paper concludes with a review of published studies of KT in falls prevention in Canadian health care settings, including research on care or treatment gaps in falls prevention and the uptake of CPGs.

IMPACT ON INDUSTRY

Those in the long term care and hospital industries may use the findings when considering fall prevention programs. This paper does not cover occupational falls, and participants in the referenced studies will be past conventional retirement age.