Association Of Fall-Related Injuries And Different Diagnoses In Older Adults Of Ontario: A Machine Learning Approach, Sorour Rostampour

Electronic Thesis and Dissertation Repository

Falls are the leading cause of injury-related hospitalizations among older adults in Canada. This study aimed to identify the most informative diagnostic categories associated with fall-related injuries (FRIs) using three machine learning algorithms: decision tree, random forest, and extreme gradient boosting tree (XGBoost). Secondary data from two Ontario health administrative databases (NACRS, DAD) covering the period 2006-2015 were analyzed. Older adults (aged ≥ 65 years) who sought treatment for FRIs in emergency departments (ED) or hospitals, as indicated by Canadian version of the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10-CA) codes for falls …

The Psychometric Properties Of The Modified Fear Of Falling Avoidance Behavior Questionnaire In Parkinson’S Disease And Older Adults, Billy La, Arturo Aldaco, Ashley Haller

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background/purpose: The Fear of Falling Avoidance Behavior Questionnaire (FFABQ), developed in 2011 to measure fear of falling avoidance behavior, has good evidence for reliability and validity. However, a recently modified version (mFFABQ) is theorized to be easier to understand for those completing the questionnaire because the Likert responses are more logical in completing the item stem. The purpose of this study was to examine the test-retest reliability and construct validity of the mFFABQ in adults with Parkinson’s Disease (PD) and older adults aged 60-90 years. Methods: Thirty-nine participants (age 72.21 ± 9.5; 29 men, 10 women) diagnosed with PD (diagnosis …

Development Of A Multifactorial Virtual Fall Prevention Tool For Community Dwelling Older Women, Eduardo Gutierrez, Jacob James Nogra, Carol Sparks, Bradley Voels

UNLV Theses, Dissertations, Professional Papers, and Capstones

Falls are the leading causes of injury-related death in adults over the age of 65, with women sustaining more than twice the rate of fall-related fractures as men. Reduced access to in-person falls prevention programs during the COVID-19 pandemic created a need for a user-friendly guide to existing online fall prevention resources targeted at this vulnerable population. The first aim of this study was to create and make widely available a website with evidence-based resources that address a range of modifiable fall risk factors, and the second was to test its feasibility in a convenience sample of older women. The …

Multifactorial Fall Prevention Program Development And Implementation Within An Assisted Living Facility, Makenzie King

Department of Occupational Therapy Entry-Level Capstone Projects

No abstract provided.

The Development Of An Exercise-Based Fall Prevention Program Tailored To Incorporate Caregivers Caring For Older Adults At Risk For Falls, Emma Heldt

OT Student Capstones

Older adults are living longer than ever. The global proportion of individuals 65 years or older was 526 million in 2010 and is estimated to reach 1.5 billion in 2050 (Duarte et al., 2020). The growing aging population comes with various challenges, such as chronic health conditions, which are the leading cause of mortality and disability worldwide. Chronic health conditions can lead to other difficulties, such as declines in physical function or mobility. Duarte et al. (2020) found that around 10 million American older adults have serious difficulty walking or climbing stairs, presenting a risk for falls.

Falling in older …

Purposeful Interventions For Older Adults Post-Joint Replacement Surgery: An Evidence-Based Project, Julia Christianson, Mallorie Corey, Erin Crouch, Juliann Felter, Ellen Gross, Mariah Hedner Beckius, Aimee Lutz, Monique Touchet

Graduate Occupational Therapy Research and Projects

The overall focus of each of case scenarios are related to assessment or interventions that are related to Choosing Wisely Campaign items 1, 2, 3, 5, 8, 10. Case scenarios were developed related to each initiative with clientele and conditions across the lifespan in various practice settings. Practice settings included school district, outpatient pediatric, primary care, skilled nursing facility, work rehabilitation, and acute care.

Lower Extremity Power And Movement Velocity In Competitive Older Athletes, Becca D. Jordre

Dissertations and Theses

Older adults are a rapidly growing population which house a subset of older athletes who regularly engage in sport competition. The physical health and risk factors of this competitive older athlete population have been largely overlooked by healthcare providers and researchers and are poorly understood. Older athletes exhibit distinctly different measures of physical performance which require unique thresholds to identify health-related risk factors. While lower extremity power and movement velocity have been identified as valuable measures of physical performance and fall risk in community-dwelling older adults this relationship has not been explored in competitive older athletes. One method for analyzing …

No Evidence Of Stochastic Resonance In Postural Sway Response To Noisy Galvanic Vestibular Stimulation In Healthy Young Adults, Dominique Rice

All Graduate Plan B and other Reports, Spring 1920 to Spring 2023

The transcutaneous application of a sub-sensory electrical stimulation to the vestibular afferents, known as noisy galvanic vestibular stimulation (nGVS), is thought to cause a reduction in postural sway at optimal amplitude intensities due to a mechanism known as stochastic resonance (SR). SR is a phenomenon whereby the addition of low amplitude noise to a non-linear system can be beneficial rather than detrimental. In humans, behavioral markers of SR in postural sway have been inconsistent, potentially due to insufficient power or false positives. Therefore, the main purpose of this study was to determine whether the frequency of observing SR-like effects improves …

A Vicious Cycle Of Fear Of Falling Avoidance Behavior In Parkinson’S Disease: A Path Analysis, Kameron Jacobson, Nicole Matsunami, Hannah Mccarl, Michelle Regis

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Postural instability (PI) in Parkinson’s disease (PD) is associated with several negative down- stream consequences. Objective: The purpose was to explore the validity of a theoretical model of these downstream consequences arranged in a vicious cycle wherein PI leads to decreased balance con!dence, which in turn leads to increased fear of falling (FOF) avoidance behavior, which in turn leads to decreased physical conditioning, which then feeds back and negatively affects PI. Methods: A path analysis of cross!sectional data from 55 participants with PD was conducted. The four con- structs in the model connected in succession were: 1. PI (principal …

Reducing Fall Among Acute Rehabilitation Patients Through Implementation Of A Video Monitoring System, Priscila Alfonso

Student Scholarly Projects

Practice Problem: Falls are a significant healthcare issue that leads to substantial patient suffering and exorbitant health care expense. The Centers for Medicare and Medicaid Services (CMS) identify falls as preventable and not eligible for reimbursement.

PICOT: The PICOT question that guided this project was: for acute rehabilitation inpatients (P), will the continuous use of video monitoring (VM) (I) compared to using bed alarms (C), decrease the fall rate by 10% (O) within six weeks of implementation (T)?

Evidence: The practice recommendation for using a VM system as a primary intervention or part of a multifactorial comprehensive fall prevention strategy …

Association Between Patient Ability In Activities Of Daily Living At Hospital Admission And Key Indicators, Stephanie Rosen, Amber Steele

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Illness and inactivity in the hospital frequently leads to disability that can reduce quality of life and increase costs. Early identification of people with limitations in activities of daily living (ADL) who are at risk for poor outcomes such as increased length of stay (LOS), hospital acquired conditions (i.e., falls and pressure injuries (PIs)), and discharge away from home can facilitate appropriate intervention. The Activity Measure for Post-Acute Care Inpatient Activity Short Form (AM-PAC IASF), a reliable and valid tool to measure ADL limitations, is scored at admission for all patients in our hospital. The purpose of this study …

Hospital To Home: Fall Prevention Interventions For The Discharging Patient, Joy Bridewell

Nursing Masters Papers

Falls is a major public health problem globally, with an estimated 646,000 fatal falls per year. This makes falls the second leading cause of unintentional injury death. Falls are very costly with non-fatal fall injuries costing about $50 billion per year and fatal falls with an estimated $754 million. Many risk factors contribute to a person’s risk of falling. Risk factors include age, gender, muscle strength, underlying medical or disabling conditions, and unsafe environments. Patients who have been hospitalized are also among those at risk. Most hospitalized patients are assessed frequently to determine their risk of falling so that care …

Demonstrating The Role Of Occupational Therapy In Hospice Care Through Fall Prevention Intervention Program Development, Lauren Schar

OTD Capstone Projects

Demonstrating the Role of Occupational Therapy in Hospice Care through Fall Prevention Intervention Program Development

Person-Environment Interactions: The Psychological Implications Of Behaviors, Confidence, And Self-Efficacy In Falls Management., Lisa S. Roberson

Occupational Therapy Doctorate Capstone Projects

Background: Strong evidence supports medication review and management, health and safety education, and home modifications as a holistic approach to falls prevention. Current research demonstrates that individual interventions reduce the risk of falls yet do not statistically reduce the number of falls (Gallo, Stelmach, Frigeri, & Ahn, 2018). The problem this Capstone project addressed was the limited psychological considerations, awareness of behaviors, confidence, and self-efficacy, as they relate to falls prevention. These psychological factors have not been previously studied in a single study.

Purpose: To determine the relationship or significance of psychological considerations as they relate to fall prevention. Increase …

Assessing The Risk Of Falling In Adults One-Year After Total Hip Arthroplasty, William Janes

Electronic Thesis and Dissertation Repository

The purpose of this study was to examine falls prevalence, falls risk factors and knowledge of falls in individuals who have undergone a total hip arthroplasty. There were 135 patients examined at their one-year follow-up appointment for total hip arthroplasty. Our primary outcome, falls prevalence and falls circumstances, found a falls prevalence of 21.5% with identical circumstances to that of average community-dwelling older adults. Female sex, number of prescription medications and multiple joint replacements were found to be significantly associated with the occurrence of falls in the previous year. The Falls Risk for Older People in a Community Setting Questionnaire …

Exploring The Use Of The Timed Up And Go Test To Identify Patient Fall Risk In An Inpatient Geriatric Psychiatry Unit, Danielle Struble-Fitzsimmons

Seton Hall University Dissertations and Theses (ETDs)

Background: Patient falls during hospitalization influence healthcare costs and quality, and hospitals are mandated to complete fall risk assessments on all patients. Inpatient geriatric psychiatry units have the highest fall rates in the acute care setting, and most falls in this population occur during the mobility tasks of transfers and ambulation. The Timed Up and Go (TUG) test includes these two specific functional tasks, and has been used to predict falls in other geriatric populations, but has never been tested in an inpatient geriatric psychiatry unit. The purpose of this study was to determine if the TUG is a predictive …

Effect Of Individual Height And Testing Methods On Outcome Of The Forward Functional Reach Test, Jill Elaine Heitzman

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background: With falls a leading cause of injuries among those over age 65, early recognition of risk is imperative to reduce rising rates. The Forward Functional Reach test (FFRT) (Duncan et al., 1990) is frequently used to identify fall risk, however, the variability in cut values found in the research may be related to height and reach strategies.

Purpose: The purpose of this study was to determine if FFRT is affected by an individual’s height and if bilateral reach to height ratio could more accurately identify fall risk.

Methods: Sixty-six participants (60 and older) were recruited from a senior center …

Gait And Balance In Alzheimer's Disease: A Retrospective Analysis Across Varying Levels Of Cognitive Impairment, Diana Contreras, Jessica Heim, Jun Nelson

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: It was once thought that Alzheimer’s disease (AD) affected mostly cognition with minor motor impairment; however, it is becoming apparent that motor impairment may also be a prominent feature. Determining the extent of motor impairments throughout the continuum of cognitive impairment is critical in developing timely interventions for this population. Purpose/Hypothesis: The aim of this study was to gain a greater understanding of motor impairment in AD by exploring the relationships among gait, balance, and falls. Specifically, we explored the association of fall history to measures of cognition and performance-based balance measures in individuals with AD. We hypothesized that …

Disposition And Success Of Patients Following Discharge In The Acute Setting, Ciera Cortney, Kathryn Lutjens, Kristopher Raines

UNLV Theses, Dissertations, Professional Papers, and Capstones

Abstract: Background & Purpose: Many patients are seen in the hospital by physical therapists who also help decide where the patient will go after discharge (e.g., home, rehab hospital, skilled nursing facility) with the goal being the safest and best quality of life. Therapists may use different tests and measures along with their own professional judgment to help make a recommendation for a discharge location. The purpose of this study was to examine how PT’s recommendation for discharge location, POMA score, “6-clicks” score, age, diagnosis, and gender determine patient’s fall/readmission status after being discharged by hospital. Subjects: There were 113 …

A Systems Approach To The Problem Of Falls In Old Age, Patrick A. Dillon

Theses and Dissertations--Gerontology

The problem of falls in old age is enormously costly and disruptive for the older individual, others, and society, and its severity is likely to intensify as our population ages. This dissertation takes a systems-oriented approach toward the falls problem and is presented in two parts. The first part critically develops a new approach to the problem of falls. The second part describes an empirical study that applies this new approach in a pragmatic manner.

Conventional fall prevention strategies employ a reductionist approach to the problem of falls. This approach is questioned because it corresponds poorly to the holistic nature …

The Effects Of Orthotics And Increased Plantar Sole Mechanoreceptor Activation On Turning Performance In Individuals With Parkinson’S Disease, Kelly A. Robb

Theses and Dissertations (Comprehensive)

Locomotion and turning are complex movement patterns essential to activities of daily living. Individuals with Parkinson’s disease (PD) report difficulties turning, often coupled with impaired balance and increased fear of falling. The purpose of this within-subject study was to determine if orthotics, with and without a textured top cover, can improve gait stability and turning performance within Parkinson’s participants. Seven participants with a diagnosis of idiopathic Parkinson’s disease, aged 55-80 years old, participated in the study. Participants completed three testing sessions; baseline, 4 weeks post-baseline, and 5 weeks post-baseline. The ‘footwear only’ and ‘footwear + non-textured orthotic’ conditions were tested …

The Effects Orthostatic Hypotension Has On Falls: A Study Done In San Francisco With The Patient Population Of The Veterans Affairs Hospital, Sherry A. Ballard Ms.

Master's Projects and Capstones

The Effects Orthostatic Hypotension has on Falls: A Study Done in San Francisco Represented

Population of the Veterans Affairs Hoapital

The global AIM of this project is to Identify patients that are at risk for Orthostatic Hypotension (OH) with in the first 24 hours of addmission. It was identified that 50% of the falls over the last 4 quarters at the VA were OH related. The patients were not identified as a fall risk and over half of them had fallen multiple times. After performing a nursing survey online, a SWOT analysis, and a Root Cause Analysis using a fishbone …

The Role Of Postural Stability And Other Factors In Distal Radius Fracture, Sheena Saju Philip

Electronic Thesis and Dissertation Repository

The objective of the thesis was to describe the factors leading to falls in distal radius fracture (DRF) events, explore patient perceived risk of falls, and postural stability. A mixed method study described the type of fall in DRF patients (n= 1454) and patient perceived contributing factors (n=29). A prospective cohort study examined the postural stability and related fall risk of DRF participants (n=137) in Biodex Balance System (BBS) and compared to normative values. Environmental factors were a major contributor to DRF events. Older adults (44 to 65 years) had the highest rate of DRF (female: male ratio of 2:1). …

The Lifestyle-Integrated Functional Exercise Program For Older Adults, Anna Lee, Courtney Beyer, Jessica Lim, Sienna Anderson

Dissertations, Masters Theses, Capstones, and Culminating Projects

According to the Centers for Disease Control and Prevention, falls are the most common cause of fatal and non-fatal injuries among older adults over the age of 65 (Centers for Disease Control and Prevention [CDC], 2009). Falls can lead to a myriad of traumatic physical and emotional consequences. Integrated exercise programs such as the Lifestyle-integrated Functional Exercise (LiFE) program are effective in preventing falls and increasing fall efficacy in individuals who have previously fallen (Clemson et al., 2012). The purpose of our study was to examine if the LiFE program is as effective in reducing fall risk and increasing fall …

Preventing And Reducing Falls In Assisted Living Facilities: An Educational Intervention, Jennifer A. Borcich, Raquel F. Ramos, Taylor S. Wong

Dissertations, Masters Theses, Capstones, and Culminating Projects

As the number of older adults continues to rise, falling in older adults has become a national health care issue. Many older adults who fall reside in assisted living facilities. Every time a fall incident occurs, first responders are called, utilizing a significant amount of first responder’s time and resources. Therefore, the purpose of this project was to implement a fall prevention program for residents of an assisted living facility (ALF) to reduce fall risk and fall-related calls to the local fire department. The project consisted of a four-week course given once weekly for 60 minutes to residents at an …

Balance Confidence And Fear Of Falling Avoidance Behavior Are Most Predictive Of Falling In Older Adults: A Prospective Analysis, Sarrie Oscar, Jessica Sasaoka, Kyle Vaughn

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Evidence suggests that there are several fall predictors in the elderly population, including previous fall history and balance impairment. To date, however, the role of psychological factors has not yet been thoroughly vetted in conjunction with physical factors as predictors of future falls. Objective: The purpose of this study was to determine which measures, physical and psychological, are most predictive of falling in older adults. Design: This was a prospective cohort study. Methods: Sixty-four participants (mean age=72.2 years, SD=7.2; 40 women, 24 men) with and without pathology (25 healthy, 17 with Parkinson disease, 11 with cerebrovascular accident, 6 with …

Effects Of Chemotherapy-Induced-Peripheral-Neuropathy On Spatiotemporal Gait Parameters And Fall Risk In Cancer Patients After The Completion Of Chemotherapy Drug Treatment, Timothy F. Marshall

Seton Hall University Dissertations and Theses (ETDs)

Background: Cancer patients undergoing chemotherapy often experience chemotherapy-induced-peripheral-neuropathy, which reportedly causes gait disturbances that may increase their risk for falls. Falls are a significant event because they have been linked to serious injuries and disabilities, loss of independence, and increased mortality rates. Purpose: The purpose of this study was to assess whether chemotherapy-induced peripheral neuropathy is associated with spatiotemporal gait adaptations in posttreatment adult cancer survivors when compared to healthy, disease-free, age and morphologically matched controls. Methods: In a quasi-experimental design, 16 subjects participated in the present study. There were 8 CIPN subjects between the ages of 50–70 years of …

Brachial Plexus Injury And Benign Paroxysmal Positional Vertigo Following A Fall: A Case Report, Przemyslaw Ilczyk

All Capstone Projects

Background: In the elderly population, research has shown that impairments of balance and strength are common reasons for falls. Falls constitute one of the main reasons for emergency department and hospital admissions, and are the second most common reason for brachial plexus injury. Another common symptom, after a fall and head trauma incident, is Benign Paroxysmal Positional Vertigo (BPPV). Approximately 50% of subjects with traumatic brain injury complain about positional vertigo. Research shows that traumatic BPPV is commonly misdiagnosed in clinical practice.

Purpose: The purpose of this case report is to present interventions that were used to treat a patient …

The Effect Of Training Older Adults In Tai Chi And Compensatory Stepping On Balance Control, Hannah L. Moore Miss

Theses and Dissertations (Comprehensive)

Abstract

Introduction: In Canadian society, there is a growing prevalence of older adults and one of the main problems facing this generation today is the risk of falling. Tai Chi (TC) is a martial art that has demonstrated improvements in balance control. It uses a series of fluid movements that engage head, neck and trunk rotation while simultaneously reducing base of support. In addition, it has been demonstrated that training older adults by administering unpredictable perturbations to challenge balance better equips them to react successfully in response to balance perturbations. This study aims to determine the potential balance specific benefits …

Understanding And Preventing Falls: Perspectives Of First Responders And Older Adults, Monica Fernandez, Anita Diep Hin, Chelsea C. Prado

Dissertations, Masters Theses, Capstones, and Culminating Projects

OBJECTIVE. The objectives of this study were to identify characteristics of older adult fallers in a local community in Marin County, California, examine the perceptions of older adults who contacted a local fire district after a fall, examine the perceptions of first responders from a local fire district regarding falls and fall prevention, explore the degree of depression in older adult fallers, and identify strategies to prevent falls in older adults.

METHODS. This research study was an exploratory and retrospective descriptive study that utilized a mixed-method design. The researchers coded narratives from Patient Care Report (PCRs) provided by the fire …