Circumstances of Falls During Sit-to-Stand Transfers in Older People: A Cohort Study of Video-Captured Falls in Long-Term Care |
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| Affiliation: | 1. Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, Canada;2. School of Engineering, University of British Columbia, Kelowna, Canada;3. Neuroscience Research Australia, Sydney, Australia;4. School of Population Health, Faculty of Medicine, University of New South Wales, Sydney, Australia;5. School of Engineering Science, Simon Fraser University, Burnaby, Canada;1. Harvard Medical School, Boston, MA;2. Massachusetts General Hospital, Boston, MA;3. MGH Institute of Health Professions, Charlestown, MA;4. University of Nottingham, Nottingham, England;5. The Ohio State University, Columbus, OH;6. Moss Rehabilitation Research Institute, Elkins Park, PA;7. University of Texas Southwestern, Dallas, TX;8. Spaulding Rehabilitation Hospital, Charlestown, MA;9. Boston University, Boston, MA;1. Department of Epidemiology and Biostatistics, Michigan State University – College of Human Medicine, Grand Rapids, MI;2. John F. Butzer Center for Research and Innovation, Mary Free Bed Rehabilitation Hospital, Grand Rapids, MI;3. Division of Rehabilitation, Michigan State University – College of Human Medicine, Grand Rapids, MI;4. Department of Biostatistics, Grand Valley State University, Grand Rapids, MI;1. Department of Physical Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil;2. Department of Physical Therapy, Faculdade Ciências Médicas de Minas Gerais (FCM-MG), Belo Horizonte, Minas Gerais, Brazil;1. Department of Epidemiology and Biostatistics, Michigan State University – College of Human Medicine, Grand Rapids, MI;2. John F. Butzer Center for Research and Innovation, Mary Free Bed Rehabilitation Hospital, Grand Rapids, MI;3. Division of Rehabilitation, Michigan State University – College of Human Medicine, Grand Rapids, MI;4. Department of Biostatistics, Grand Valley State University, Grand Rapids, MI;1. Department of Physical Medicine and Rehabilitation, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Gyeonggi-do, Republic of Korea;2. Department of Thoracic and Cardiovascular Surgery, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Republic of Korea;1. Massachusetts Veterans Epidemiology and Research Information Center (MAVERIC), VA Boston Healthcare System, Boston, MA;2. Department of Gerontology, University of Massachusetts Boston, Boston, MA;3. Medical Practice Evaluation Center and Center for Aging and Serious Illness, Mongan Institute, Department of Medicine, Massachusetts General Hospital, Boston, MA;4. Department of Clinical Research, Copenhagen University Hospital, Hvidovre, Denmark;5. Department of Clinical Medicine, University of Copenhagen, Denmark;6. New England Geriatric Research Education and Clinical Center, VA Boston Healthcare System, Boston, MA;7. Harvard Medical School, Boston, MA;8. Boston University, Boston, MA;9. Brigham and Women''s Hospital, Boston, MA;10. Geriatrics and Extended Care, VA Boston Healthcare System, Boston, MA;11. Spaulding Rehabilitation Hospital, Boston, MA |
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| Abstract: | ObjectiveTo characterize the circumstances of falls during sit-to-stand transfers in long-term care (LTC), including the frequency, direction, stepping and grasping responses, and injury risk, based on video analysis of real-life falls.DesignCohort study.SettingLTC.ParticipantsWe analyzed video footage of 306 real-life falls by 183 LTC residents that occurred during sit-to-stand transfers, collected from 2007 to 2020. The mean age was 83.7 years (SD=9.0 years), and 93 were female (50.8%).InterventionNot applicable.Main Outcome MeasuresWe used Generalized Estimating Equations to test for differences in the odds that a resident would fall at least once during the rising vs stabilization phases of sit-to-stand and to test the association between the phase of the transfer when the fall occurred (rising vs stabilization) and the following outcomes: (1) the initial fall direction; (2) the occurrence, number, and direction of stepping responses; (3) grasping of environmental supports; and (4) documented injury.ResultsFalls occurred twice as often in the rising phase than in the stabilization phase of the transfer (64.0% and 36.0%, respectively). Falls during rising were more often directed backward, while falls during stabilization were more likely to be sideways (odds ratio [OR]=1.95; 95% confidence interval [CI]=1.07-3.55). Falls during rising were more often accompanied by grasping responses, while falls during stabilization were more likely to elicit stepping responses (grasping: OR=0.30; 95% CI=0.14-0.64; stepping: OR=8.29; 95% CI=4.54-15.11). Injuries were more likely for falls during the stabilization phase than the rising phase of the transfer (OR=1.73; 95% CI=1.04-2.87).ConclusionMost falls during sit-to-stand transfers occurred from imbalance during the rising phase of the transfer. However, falls during the subsequent stabilization phase were more likely to cause injury. |
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| Keywords: | Accidental falls Activities of daily living Aging Biomechanical phenomena Locomotion |
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