title: Falls in a rehabilitation setting: functional independence and fall risk.
abstract: OBJECTIVE
  With this study we wanted to determine the incidence, characteristics and consequences of falls in our rehabilitation setting.
  
  
  METHODS
  An observational study was carried out in a rehabilitation setting for postacute orthopedic and neurological inpatients. Three-hundred and twenty patients were enrolled. Falls risk factors (Downton index [DI] and other known parameters), disability (functional independence measure [FIM]) and balance (Berg balance scale [BBS]) were assessed at admission. Falls that occurred during the rehabilitation stay were prospectively classified (St. Louis Older Adult Service and Information System [OASIS] system) and analyzed.
  
  
  RESULTS
  Forty patients experienced a fall (12.5%). The faller group was characterized by a major clinical complexity; 70% of fallers were neurological patients and 30% presented cognitive impairment (mini mental state examination [MMSE] <24). They presented a statistically significant worse score on FIM (motor and cognitive), BBS and DI at admission, with 74% predictability of falls as measured by total FIM score and age. Falls recorded with the OASIS classification showed a prevalence (52.5%) for not bipedal (wheelchair transfer) and self-generated falls; 35% were intrinsic falls (caused by subject-specific factors) and 12.5% extrinsic falls (caused by environmental factors). Falls resulted in only minor clinical consequences, except for one rib fracture, but led to a significant increase in length of stay.
  
  
  CONCLUSIONS
  In a rehabilitation centre, for good management of resources and safe prescriptions of a patient's independence in activities of daily living, fall risk is better evaluated with appropriate scales.
authors.affiliation: Rehabilitation Institute, IRCCS, Salvatore Maugeri Foundation, Via Missolungi 14, 16100 Genoa-Nervi, Italy. asaverino@fsm.it
authors.forename: A
authors.initials: A
authors.lastname: Saverino
authors.forename: E
authors.initials: E
authors.lastname: Benevolo
authors.forename: M
authors.initials: M
authors.lastname: Ottonello
authors.forename: E
authors.initials: E
authors.lastname: Zsirai
authors.forename: P
authors.initials: P
authors.lastname: Sessarego
mesh_terms: D000057:Accident Proneness; D000058:Accidental Falls / Q000706:statistics & numerical data*; D000203:Activities of Daily Living; D000368:Aged; D016009:Chi-Square Distribution; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D004856:Postural Balance; D012047:Rehabilitation Centers; D018570:Risk Assessment; D012307:Risk Factors; D018709:Statistics, Nonparametric