Effects of clear visual input and change in standing sequence on standing sway related to falls during night toilet use

sada k., uchiyama j., ohnishi t., ninomiya i. & masino y. (2009)   Effects of clear visual input and change in standing sequence on standing sway related to falls during night toilet use. International Journal of Older People Nursing   5 , 34–40
doi: 10.1111/j.1748-3743.2009.00187.x
Aim.  The aim of this study is to provide objective evidence that clear visual input and change in standing sequence can reduce fall risk related to night toilet use among hospitalized older patients.
Background.  In hospitalized older patients, falls are likely to occur during night toileting needs.
Method.  Using a stabilometer, we measured and compared maximal standing sway for 10 seconds immediately after standing with three visual input modes in two standing patterns, comparing healthy younger adults ( n  = 22) and older patients ( n  = 19). The three modes are no visual input (mode 1), vague (mode 2), and clear visual input (mode 3). Standing sequences A and B are defined as supine-to-standing and supine-to-sitting-to-standing, respectively.
Results.  For a given visual mode, maximal moved distance was significantly greater for older patients than for younger adults with both standing patterns ( P  < 0.0001). Both standing pattern B and clear visual input decreased maximal moved distance in younger adults and older patients. A greater maximal moved distance score indicated a greater fall risk.
Relevance to clinical practice.  It is important for nurses to train older patients to turn on the light and perform standing pattern B, when going to the bathroom at night. In addition, it is advisable to confirm the placement of distinct visual markers on the way to the bathroom.