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1.
Marion L. Mitchell David H.K. Shum Gabor Mihala Jenny E. Murfield Leanne M. Aitken 《Australian critical care》2018,31(4):204-211
Background
Whilst there is a growing body of research exploring the effect of delirium in intensive care unit (ICU) patients, the relationship between patient delirium and long-term cognitive impairment has not been investigated in settings where low rates of delirium have been reported.Objectives
To assess the association between the incidence of delirium, duration of mechanical ventilation and long term cognitive impairment in general ICU patients.Methods
Prospective cohort study conducted in a tertiary level ICU in Queensland, Australia. Adult medical and surgical ICU patients receiving ≥12 h mechanical ventilation were assessed for delirium on at least one day. Cognitive impairment was assessed at three and/or six-months using the: Repeatable Battery for the Assessment of Neuropsychological Status (RBANS); Trail Making Test (TMT) Part A and B; and Mini-Mental State Examination (MMSE).Results
Of 148 enrollees, 91 (61%) completed assessment at three and/or six months. Incidence of delirium was 19%, with 41% cognitively impaired at three months and 24% remaining impaired at six months. Delirium was associated with impaired cognition at six-months: mean TMT Part A scores (information processing speed) were 7.86 s longer than those with no delirium (p = 0.03), and mean TMT Part B scores (executive functioning) 24.0 s longer (p = 0.04).Conclusions
ICU delirium was positively associated with impaired information processing speed and executive functioning at six-months post-discharge for this cohort. Testing for cognitive impairment with RBANS and TMT should be considered due to its greater sensitivity in comparison to the MMSE. 相似文献2.
Gabriele Finco Mario Musu Giovanni Landoni Marcello Campagna Alberto Lai Luca Cabrini Salvatore Sardo Paolo Mura Maura Galletta 《Australian critical care》2018,31(6):340-346
Purpose
Healthcare-associated respiratory tract infections are common and markedly affect the quality of life and mortality, as well as increasing costs for health systems due to prolonged hospitalisation. This study aimed to assess the change in both level and trend of respiratory tract infections after a specific hand hygiene program for intensive care unit (ICU) staff.Materials and methods
The infection data collection was carried out from January 2013 to August 2014. The hand hygiene program started in December 2013. To analyse the change in level and trend of infections after the intervention, the Interrupted Time Series method was used. Chi-square test was used to compare the incidence of respiratory tract infections before and after the intervention.Results
A total of 825 patients were hospitalised in three Italian ICUs. The infection level was significantly decreased by 36.3 infections per 1000 device-days after the intervention. The infection trend was also decreased of about 1 infection per month.Conclusions
After the hand hygiene program a decreased level of infection was found. Continuous performance feedback should be provided to promote a long-term adherence to the guidelines. Organisational and individual risk factors must be individuated and correctly managed to increase quality of practice. 相似文献3.
Objective
To estimate the effectiveness of a 10-week combined exercise training and home-based walking programme on daily physical activity (PA) compared with standard medical care in patients with moderate chronic obstructive pulmonary disease (COPD).Design
Randomised controlled trial.Setting
Primary care physiotherapy.Participants
Consecutive patients with stable COPD at Gold Stage II with a score of two or more on the Medical Research Council Dyspnoea Scale.Intervention
Ten-week combined exercise training and home-based walking programme compared with standard medical care.Main outcomes
At baseline and after 10 weeks, daily PA was evaluated by accelerometry using three levels of intensity and expressed as metabolic equivalent of task. In addition, daily activities (Physical Activity Scale for the Elderly), functional exercise capacity (6-minute Walk Test), health-related quality of life (Chronic Respiratory Questionnaire) and exercise self-efficacy (Exercise Self-Regulatory Efficacy Scale) were measured.Results
Fifty-two patients {34 females; mean age 70.2 [standard deviation (SD) 9.5] years; mean forced expiratory volume in 1 second 67% (SD 9.2) of predicted} were randomised. PA, adjusted for baseline differences, increased significantly in the intervention group compared with the control group, by 26.1 minutes/day [95% confidence interval (CI) 7.3 to 44.9]. The increase in functional capacity between groups was clinically relevant (34.0 m, 95% CI 2.3 to 65.6) in favour of the intervention group.Conclusions
A combined exercise training and home-based walking programme in primary care physiotherapy improved PA in patients with moderate COPD.Clinical trial registration number NL24766.018.08. 相似文献4.
Magdalena Kwiatosz-Muc Anna Fijałkowska-Nestorowicz Magdalena Fijałkowska Anna Aftyka Michał Kowalczyk 《Australian critical care》2018,31(6):391-395
Background
High stress levels have been commonly reported among ICU workers. Currently, anaesthesiology is safer for the patient but more stressful for the staff working in this branch of medicine. ICU and anaesthesiology personnel are prone to stress because of the specific character of their work.Objectives
Our objectives were to assess stress prevalence among anaesthesiology and ICU workers to compare this stress prevalence in relation to professional groups, sex, job seniority, and type of hospital and describe the importance of major stressors at work.Methods
The ICU and anaesthesiology workers of 15 randomly selected Polish hospitals were surveyed. To assess stress prevalence, the Perceived Stress Scale (PSS-10) was used. The analysis included 544 surveys.Results
The examined population was divided into two groups. Group N consisted of 406 nurses (74.60%) and group P of 138 physicians (25.40%). The mean result in the PSS-10 scale for the N group was 19.00 and for the P group 17.00. Both group results were related to a 6 sten score, which implied a medium level of stress. In the N group, the PSS-10 results were significantly higher than in the P group. Women showed higher levels of stress than men.Conclusions
Stress levels among ICU and anaesthesiology personnel were of a medium range. Nurses showed significantly higher levels of stress than physicians. Female personnel showed higher levels of stress than male personnel. Age, job seniority and type of hospital did not have an influence on stress levels. The most stressful circumstances for anaesthesiology and ICU personnel included night shifts and duty overload. 相似文献5.
6.
Objective
To conduct a narrative review on the evolution of intensive care and the cost of intensive care services in Australia.Review method
A narrative review using a search of online medical databases and grey literature with keyword verification via Delphi-technique.Data sources
Using Medical Subject Headings and keywords (intensive care, critical care, mechanical ventilation, renal replacement therapy, extracorporeal membrane oxygenation, monitoring, staffing, cost, cost analysis) we searched MEDLINE, PubMed, CINAHL, Embase, Google and Google Scholar.Results
The search yielded 30 articles from which we provide a narrative synthesis on the evolving intensive care practice in relation to key service elements and therapies. For the review of costs, we found five relevant publications and noted significant variation in methods used to cost ICU. Notwithstanding the limitations of the methods used to cost all publications reported staffing as the primary cost driver, representing up to 71% of costs.Conclusion
Intensive care is a highly specialised medical field, which has developed rapidly and plays an increasingly important role in the provision of hospital care. Despite the increasing importance of the specialty and the known resource intensity there is a paucity of data on the cost of providing this service. In Australia, staffing costs consistently represent the majority of costs associated with operating an ICU. This finding should be interpreted cautiously given the variation of methods used to cost ICU services and the limited number of available studies. Developing standardised methods to consistently estimate ICU costs which can be incorporated in research into the cost-effectiveness of alternate practice is an important step to ensuring cost-effective care. 相似文献7.
Objectives
Family satisfaction in intensive care units (ICU) is of increasing relevance for family-centred cared. The objective of this review was to explore the characteristics of studies that have used questionnaires to measure the satisfaction of family members of ICU patients.Review methods
A literature review was performed for studies evaluating family satisfaction in the ICU, independent of design. The following data were obtained for each selected article: publication year, country of origin, design, number of family members, instrument for family satisfaction, instrument score range, response rate, moment at which satisfaction was evaluated, and average level of reported satisfaction.Data sources
The following databases were systematically searched: PubMed, CINAHL, ProQuest Nursing, ProQuest Social Science, ProQuest Psychology, Science Direct, PsycINFO, LILACS, and Scielo.Results
Thirty-seven articles met inclusion criteria, showing high levels of family satisfaction. Among these, nine different questionnaires were identified. In 31.6% of the studies, family satisfaction was evaluated during the ICU stay, whereas 36.9% did not report the evaluation moment. The mean response rate was 65.5%, and response rates greater than 70% were found only in 28.2% of the studies.Conclusions
High satisfaction levels among family members of ICU patients must be contextualised in light of questionnaire heterogeneity, low response rates, and variability in the moment at which family satisfaction is evaluated. The creation of methodological standards for evaluating and reporting family satisfaction could facilitate comparing results between investigations in this field. 相似文献8.
9.
Introduction
Community acquired pneumonia (CAP) is a common reason for admission to an intensive care unit for intubation and mechanical ventilation, and results in high morbidity and mortality. The primary aim of the study was to investigate availability and provision of respiratory physiotherapy, outside of normal business hours, for intubated and mechanically ventilated adults with CAP in Australian hospitals.Materials and methods
A cross-sectional, mixed methods online survey was conducted. Participants were senior intensive care unit physiotherapists from 88 public and private hospitals. Main outcome measures included presence and nature of an after-hours physiotherapy service and factors perceived to influence the need for after-hours respiratory physiotherapy intervention, when the service was available, for intubated adult patients with CAP. Data were also collected regarding respiratory intervention provided after-hours by other ICU professionals.Results
Response rate was 72% (n = 75). An after-hours physiotherapy service was provided by n = 31 (46%) hospitals and onsite after-hours physiotherapy presence was limited (22%), with a combination of onsite and on-call service reported by 19%. Treatment response (83%) was the most frequent factor for referring patients with CAP for after-hours physiotherapy intervention by the treating day-time physiotherapist. Nurses performing respiratory intervention (77%) was significantly associated with no available after-hours physiotherapy service (p = 0.04).Discussion
Physiotherapy after-hours service in Australia is limited, therefore it is common for intubated patients with CAP not to receive any respiratory physiotherapy intervention outside of normal business hours. In the absence of an after-hours physiotherapist, nurses were most likely to perform after-hours respiratory intervention to intubated patients with CAP.Conclusion
Further research is required to determine whether the frequency of respiratory physiotherapy intervention, including after-hours provision of treatment, influences outcomes for ICU patients intubated with pneumonia. 相似文献10.
Objective
The purpose of the study was to identify the impact of family empowerment model intervention on family satisfaction and children’s length of stay in the hospital due to pneumonia.Method
The design of the study was that of a quasi-experiment. About 83 family-child groups were divided into 42 pair in the intervention group and 41 pair in the control group; which were recruited using consecutive sampling using certain inclusion criteria. Three district hospitals in Jakarta were used in this study. A questionnaire and family empowerment instrument were developed and used to collect the data. An analysis of the data used independent and paired t-test.Results
The results of the study showed a significant difference between the intervention and control groups in empowerment and satisfaction aspects after the intervention (p= 0.000; p= 0.000). An analysis of length of stay using the t-test indicates a significant difference between the intervention and control groups (p= 0.000).Conclusions
The family empowerment model (FEM) intervention has a positive impact on families, as it can increase both the satisfaction and the empowerment of the family. Another important indicator of the FEM’s success is its ability to decrease the length of stay of patients. 相似文献11.
Takuya Umehara Ryo Tanaka 《Revista brasileira de fisioterapia (S?o Carlos (S?o Paulo, Brazil))》2018,22(4):265-275
Background
Various systematic reviews and/or meta-analyses examining the effects of pre- or postoperative exercise on body function or activity in patients undergoing total knee arthroplasty (TKA) have been published. However, the interventional period needed to at least improve outcomes is unknown.Objective
The aim of this systematic review and meta-analysis was to investigate the exercise intervention period needed to effectively improve body function or activity before and after TKA in patients with knee osteoarthritis (OA).Methods
Studies published until July 2017 were included in the review. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was applied to each meta-analysis to determine the quality of the evidence.Results
Twenty-seven randomized controlled trials were identified. A meta-analysis indicated that exercises performed for 8 weeks after discharge in addition to standard postoperative intervention effectively improved body function as assessed using pain level; physical function, and stiffness on the Western Ontario and McMaster Universities Arthritis Index; extension strength; active knee flexion range of motion; timed up and go test; and gait speed.Conclusion
Overall, we found low- to moderate-quality evidence that an 8-week exercise period was needed after discharge to improve body function and activity in patients with knee OA undergoing TKA. 相似文献12.
Matthew L. Stevens Chung-Wei C. Lin Mark J. Hancock Trish Wisby-Roth Jane Latimer Chris G. Maher 《Physiotherapy》2018,104(2):217-223
Background
Before beginning a large and complex trial it is considered good practice to run a pilot study to assess the feasibility and acceptability so that quality is maintained and resources are not wasted.Objective
To assesses the feasibility and acceptability of procedures for TOPS: Trial Of Prevention Strategies for low back pain.Design
Randomised controlled pilot trial.Methods
This is a trial of an 8 week, physiotherapist-led group exercise and education program for preventing recurrence of low back pain (LBP) in those recently recovered from LBP. We assessed the feasibility of recruitment and data-collection procedures, acceptability of the trial interventions and loss-to-follow up.Results
The feasibility of recruitment, acceptability of the intervention and feasibility of physical activity data-collection procedures were all below anticipated levels. We enrolled 12 participants over 44 weeks, the adherence rate for the intervention group was 63% and valid physical activity data were obtained for 67% of the measurements. Follow-up methods for collection of LBP recurrence were successful with this information able to be collected for 100% of participants.Conclusion
In response to the pilot, modifications were made to the main trial protocol. We will increase recruitment by relaxing inclusion criteria and expanding recruitment sites to include workplaces, community centres and via social media. We will facilitate compliance by expanding treatment sites to provide more options for participants to access the program and we will limit missing data by checking the validity of baseline physical activity measures prior to enrolment.Trial registration: The study was prospectively registered with the Australian and New Zealand Clinical Trials Registry (ref: ACTRN12614000706673). 相似文献
13.
Marie-Ève Bérubé Stéphane Poitras Marc Bastien Lydie-Anne Laliberté Anyck Lacharité Douglas P. Gross 《Physiotherapy》2018,104(1):1-8
Background
Many physiotherapists underuse evidence-based practice guidelines or recommendations when treating patients with musculoskeletal disorders, yet synthesis of knowledge translation interventions used within the field of physiotherapy fails to offer clear conclusions to guide the implementation of clinical practice guidelines.Objectives
To evaluate the effectiveness of various knowledge translation interventions used to implement changes in the practice of current physiotherapists treating common musculoskeletal issues.Data sources
A computerized literature search of MEDLINE, CINHAL and ProQuest of systematic reviews (from inception until May 2016) and primary research studies (from January 2010 until June 2016).Study selection and eligibility criteria
Eligibility criteria specified articles evaluating interventions for translating knowledge into physiotherapy practice.Data extraction and data synthesis
Two reviewers independently screened the titles and abstracts, reviewed full-text articles, performed data extraction, and performed quality assessment. Of a total of 13 014 articles located and titles and abstracts screened, 34 studies met the inclusion criteria, including three overlapping publications, resulting in 31 individual studies.Results
Knowledge translation interventions appear to have resulted in a positive change in physiotherapist beliefs, attitudes, skills and guideline awareness. However, no consistent improvement in clinical practice, patient and economic outcomes were observed.Limitations
The studies included had small sample sizes and low methodological quality. The heterogeneity of the studies was not conducive to pooling the data.Conclusions and implication of key findings
The intensity and type of knowledge translation intervention seem to have an effect on practice change. More research targeting financial, organizational and regulatory knowledge translation interventions is needed. 相似文献14.
Emine Alp Tuğba Tok Leylagül Kaynar Fatma Cevahir İsmail Hakkı Akbudak Kürşat Gündoğan Mustafa Çetin Jordi Rello 《Australian critical care》2018,31(6):363-368
Background
Haematological cancer (HC) patients are increasingly requiring intensive care (ICUs). The aim of this study was to investigate the outcome of HC patients in our ICU and evaluate 5 days-full support as a breakpoint for patients’ re-assessment for support.Methods
Retrospective study enrolling 112 consecutive HC adults, requiring ICU in January-December 2015. Patients’ data were collected from medical records and Infection Control Committee surveillance reports. Logistic regression analysis was performed to identify independent risk factors for ICU mortality.Results
Sixty-one were neutropenic, and 99 (88%) had infection at ICU admission. Acute myeloid leukaemia was diagnosed in 43%. Thirty-five (31%) were hematopoietic stem cell transplant recipients. Only 17 (15%) were in remission. Eighty-nine underwent mechanical ventilation on admission. Fifty-three patients acquired ICU-infection (35 bacteremia) being gram negative bacteria (Klebsiella pneumoniae and non-fermenters) the top pathogens. However, ICU-acquired infection had no impact on mortality. The overall ICU and 1-year survival rate was 27% (30 patients) and 7% (8 patients), respectively. Moreover, only 2/62 patients survived with APACHE II score ≥25. The median time for death was 4 days. APACHE II score ≥25 [OR:35.20], septic shock [OR:8.71] and respiratory failure on admission [OR:10.55] were independent risk factors for mortality in multivariate analysis. APACHE II score ≥25 was a strong indicator for poor outcome (ROC under curve 0.889).Conclusions
APACHE II score ≥25 and septic shock were criteria of ICU futility. Our findings support the full support of patients for 5 days and the need to implement a therapeutic limitations protocol. 相似文献15.
C. López-López A. Arranz-Esteban M.V. Martinez-Ureta M.C. Sánchez-Rascón C. Morales-Sánchez M. Chico-Fernández 《Enfermería intensiva / Sociedad Espa?ola de Enfermería Intensiva y Unidades Coronarias》2018,29(2):64-71
Objective
To analyse the influence of psychotropic substance use on the level of pain in patients with severe trauma.Design
Longitudinal analytical study.Scope
Intensive Care Unit (ICU) of Trauma and Emergencies.Patients
severe trauma, non-communicative and mechanical ventilation > 48 hours. Two groups of patients were created: users and non-users of psychotropic substances according to medical records.Interventions
Measurement of pain level at baseline and during mobilization, using the Pain Indicator Behaviour Scale.Variables
demographic characteristics, pain score, sedation level and type and dose of analgesia and sedation.Results
Sample of 84 patients, 42 in each group. The pain level in both groups, during mobilisation, showed significant differences p = 0.011, with a mean of 3.11 (2.40) for the user group and 1.83 (2.14) for the non-user group. A relative risk of 2.5 CI (1,014-6,163) was found to have moderate / severe pain in the user group compared to the non-user group. The mean dose of analgesia and continuous sedation was significantly higher in the user group: P=.032 and P=.004 respectively. There was no difference in bolus dose of analgesia and sedation with P=.624 and P=.690 respectively.Conclusions
Patients with a history of consumption of psychoactive substances show higher levels of pain and experience a higher risk of this being moderate/severe compared to non-users despite receiving higher doses of analgesia and sedation infusion. Key words: pain, multiple trauma, drug users. 相似文献16.
Effects of exercise training in water and on land in patients with COPD: a randomised clinical trial
J.M. Felcar V.S. Probst D.R. de Carvalho M.F. Merli R. Mesquita L.S. Vidotto L.R.G. Ribeiro F. Pitta 《Physiotherapy》2018,104(4):408-416
Objectives
To compare the effects of two similar 6-month protocols of high-intensity exercise training, in water and on land, in patients with chronic obstructive pulmonary disease (COPD).Design
Randomised controlled trial.Setting
University-based outpatient clinic.Participants
Thirty-six patients with predominantly moderate-to-severe COPD completed the study.Intervention
Patients were evaluated at baseline, at 3 months and at the end of the programme (i.e. 6 months). For both groups, the 6-month protocol consisted of high-intensity endurance and strength exercises with gradual increase in time and/or workload, totalling 60 sessions.Main outcomes
Objective monitoring of physical activity in daily life (PADL, primary outcome), lung function, peripheral and respiratory muscle strength, body composition, maximal and submaximal exercise capacity, functional status, quality of life, and symptoms of anxiety and depression.Results
After 6 months of training, a significant improvement in PADL was seen for both groups [mean difference (95% confidence interval): land group 993 (358 to 1628) steps/day; water group 1669 (404 to 2934) steps/day]. Significant improvements were also seen in inspiratory, expiratory and peripheral muscle strength; maximal and submaximal exercise capacity; quality of life and functional status for both groups. There were no significant improvements in lung function, body composition, and symptoms of anxiety and depression for either group. No difference was found in the magnitude of improvement between the two types of training for any outcome.Conclusion
High-intensity exercise training in water generates similar effects compared with training on land in patients with moderate-to-severe COPD, rendering it an equally beneficial therapeutic option for this population.Clinical trial registration number
NCT01691131. 相似文献17.
Objective
To compare clinical pain intensity, exercise performance, pain sensitivity and the effect of aerobic and isometric exercise on local and remote pressure pain thresholds (PPTs) in patients with chronic musculoskeletal pain with high and low levels of kinesiophobia.Design
An experimental pre–post within-subject study.Setting
An exercise laboratory in a multidisciplinary pain clinic.Participants
Fifty-four patients with chronic musculoskeletal pain.Interventions
Acute aerobic and isometric leg exercises.Main outcome measures
Clinical pain intensity (numerical rating scale, range 0 to 10), Tampa Scale of Kinesiophobia, aerobic and isometric exercise performances (intensity and maximal voluntary contraction), and PPTs at local and remote body areas before and after exercise conditions.Results
Patients with a high degree of kinesiophobia demonstrated increased pain intensity compared with patients with a low degree of kinesiophobia [high degree of kinesiophobia: 7.3 (1.6) on NRS; low degree of kinesiophobia: 6.3 (1.6) on NRS; mean difference 1.0 (95% confidence interval 0.08 to 1.9) on NRS]. Aerobic and isometric exercises increased PPTs, but no significant group differences were found in PPTs before and after exercise.Conclusions
Clinical pain intensity was significantly higher in patients with a high degree of kinesiophobia compared with patients with a low degree of kinesiophobia. Despite a difference in isometric exercise performance, the hypoalgesic responses after cycling and isometric knee exercise were comparable between patients with high and low degrees of kinesiophobia. If replicated in larger studies, these findings indicate that although kinesiophobic beliefs influence pain intensity, they do not significantly influence PPTs and exercise-induced hypoalgesia in patients with chronic musculoskeletal pain. 相似文献18.
Kay Cooper Llinos M. Jehu Susan Klein Blair H. Smith Patricia Schofield 《Physiotherapy》2018,104(2):239-247
Objective
To determine the feasibility and acceptability of a training programme for peer volunteers to support older adults with chronic low back pain (CLBP) following discharge from physiotherapy.Design
Feasibility study.Setting
Community-based.Participants
17 adults (4 male, 13 female) with CLBP or experience of supporting someone with CLBP enrolled and 12 (2 male, 10 female) completed the volunteer training.Intervention
Volunteers took part in a face-to-face or blended delivery peer support training programme based on the Mental Health Foundation’s “Principles into Practice” and adapted for CLBP by the study team.Main outcome measures
Recruitment/retention rates; demographics; time & resources used to deliver training; training evaluation (questionnaire); knowledge questionnaire, and self-efficacy questionnaire.Results
17 participants enrolled on the training programme (11 face-to-face, 6 blended delivery). 12 (71%) completed the training (73% face-to-face, 67% blended delivery). The training was positively evaluated. All but two participants passed the knowledge quiz at the end of the training, and the majority of self-efficacy scores (90%) were high.Conclusions
It is feasible to develop, implement and evaluate a peer support training programme for the facilitation of CLBP self-management in older adults following discharge from physiotherapy. Blended delivery of training may facilitate the recruitment of greater numbers of peer support volunteers in future studies. Supported self-management of CLBP pain is widely recommended but can be difficult to achieve. Peer support might be a promising method of facilitating CLBP self-management without additional burden to health services, and should be further evaluated in a larger study. 相似文献19.
Background
The Berg Balance Scale (BBS) is often used in clinical practice to predict falls in the older adults. However, there is no consensus in research regarding its ability to predict falls.Objective
To verify whether the BBS can predict falls risk in older adults.Data source
Manual and electronic searches (Medline, EMBASE, CINAHL, Ageline, Lilacs, Web of Science, Cochrane Library and PEDro) were conducted using blocks of words (older adults, falls, BBS, study design) and their synonyms, with no language restrictions and published since 1989.Study selection criteria
Prognostic studies or clinical trials were used to assess the BBS and falls history.Data extraction and data synthesis
In this narrative synthesis, two independent assessors extracted data from articles and a third reviewer provided consensus, in case of disagreement. The methodological quality was assessed using the Quality In Prognosis Studies tool.Results
1047 studies were found and 8 studies were included in this review. The mean BBS score was high, regardless of the history of falls. Three studies presented cut-off scores for BBS, ranging from 45 to 51 points. Two studies reported a difference in the BBS score between fallers and non-fallers. Studies presented low to moderate risk of bias.Limitations
Unfeasible to conduct a meta-analysis due the heterogeneity of included studies.Conclusion
The evidence to support the use of BBS to predict falls is insufficient, and should not be used alone to determine the risk of falling in older adults.Systematic review registration number
PROSPERO CRD42016032309. 相似文献20.