Effect of Physiotherapy in Patients Presenting to the Emergency Department After a Fall

University Hospital, Basel, Switzerland104 enrolled

Overview

The aim of this monocentric, block-randomized, controlled, open-label, parallel-group study is to assess whether patients presenting to the emergency department (ED) with a fall within the past 7 days would benefit from a physiotherapy intervention, as compared to patients without physiotherapy intervention at the time of ED presentation. Primary objective of this study is to assess "fear of falling" 7 days after ED presentation with versus without a physiotherapy intervention.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

OTHER

Masking

SINGLE

Enrollment

104

Conditions

Fear of Falling

Interventions

physiotherapeutic interventionOTHER

The intervention consists of a brief physiotherapeutic assessment, the short physical performance battery, a brief information on the expected course of the condition, a check of fall hazards at home using the "Bundesamt für Unfallverhütung" (bfu) checklist, and instructions on self-management (eg. staying active, adaptation of behavior and surrounding at home). Additionally, two exercises for daily self-guided therapy will be instructed, namely, sit-to-stand and balance performance exercises.

Eligibility

Sex: ALLMin age: 65 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Written informed consent * Age ≥65 * History of falls within the last 7 days * Presentation to the ED of the University Hospital Basel Exclusion Criteria: * Inpatient disposition after ED work-up * Immobilizing fractures of the lower extremities * Inability or contraindications to undergo the investigated intervention or follow the study procedures, e.g. due to certain neurological disorders (such as parkinsonism, hemiplegia, severe multiple sclerosis), language problems, psychological disorders, cognitive impairment * Prior enrolment in this trial

Locations (1)

Department of Emergency Medicine, University Hospital Basel

Basel, Switzerland

Outcomes

Primary Outcomes

Change in short International Falls efficacy scale (sFES-I)

Change in the fear of falling between groups at day 7, measured by the short International Falls efficacy scale (sFES-I). It is a 7-item questionnaire where individuals are instructed to score their concern of falling during an activity on a 4 point Likert scale with 1 as not concerned at all and 4 as very concerned. The item scores are summed up to obtain a total, with a higher score indicating a higher fear of falling.

Time frame: At Day 0 and Day 7 ± 7 days

Secondary Outcomes

Feasibility of the intervention

Feasibility of the intervention assessed by a questionnaire filled out by the physiotherapist

Time frame: At Day 0

Objective functional levels in the intervention group

Functional levels measured by SPPB in the intervention group

Time frame: At Day 0 and Day 7 ± 7 days

Satisfaction with ED work-up

Patients' satisfaction with ED work-up assessed by questionnaire

Time frame: Day 7 ± 7 days

Change in short International Falls efficacy scale (sFES-I)

Change in the fear of falling, measured by the short International Falls efficacy scale (sFES-I). It is a 16-item questionnaire where individuals are instructed to score their concern of falling during an activity on a 4 point Likert scale with 1 as not concerned at all and 4 as very concerned. The item scores are summed up to obtain a total, with higher the score, higher being the concern for falling.

Time frame: At Day 0, Day 7 ± 7 days, Day 21 ± 3 days, Day 42 ± 3 days

Utilization of medical resources

Comparison of the use of medical resources between both groups (ED visits, GP visits, hospitalization, physiotherapy, imaging; all since inclusion)

Data from ClinicalTrials.gov

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