title: The efficacy of a multidisciplinary falls prevention clinic with an extended step-down community program.
abstract: OBJECTIVE
  To investigate the efficacy of a falls prevention clinic and a community step-down program in reducing the number of falls among community-dwelling elderly at high risk of fall.
  
  
  METHODS
  Prospective cohort.
  
  
  METHODS
  Community.
  
  
  METHODS
  Community-dwelling elderly (N=200) were screened for risk of fall; 60 were identified as being at high risk and were referred to the intervention program.
  
  
  METHODS
  Twelve sessions of a once-a-week falls prevention clinic, including fall evaluation, balance training, home hazard management program, and medical referrals, were provided in the first 3 months. The community step-down program, including falls prevention education, a weekly exercise class, and 2 home visitations, was provided in the following 9 months.
  
  
  METHODS
  Fall rate, injurious fall, and its associated medical consultation were recorded during the intervention period and the year before intervention. Balance tests included the Berg Balance Scale (BBS), Sensory Organization Test, and limits of stability test; fear of falling, as evaluated using the Activities-specific Balance Confidence (ABC) scale, was measured at baseline and after the training in the falls prevention clinic.
  
  
  RESULTS
  Significant reductions in fall rate (74%), injurious falls (43%), and fall-associated medical consultation (47%) were noted. Significant improvement in balance scores (BBS, P<.001; endpoint excursion in limits of stability test, P=.004) and fear of falling (ABC scale, P=.001) was shown.
  
  
  CONCLUSIONS
  The programs in the falls prevention clinic were effective in reducing the number of falls and injurious falls. The community step-down programs were crucial in maintaining the intervention effects of the falls prevention clinic.
authors.affiliation: Department of Orthopaedics and Traumatology, Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Pan-Ching
authors.initials: PC
authors.lastname: Sze
authors.forename: Wing-Hoi
authors.initials: WH
authors.lastname: Cheung
authors.forename: Pui-Sze
authors.initials: PS
authors.lastname: Lam
authors.forename: Hip-Shing Dominic
authors.initials: HS
authors.lastname: Lo
authors.forename: Kwok-Sui
authors.initials: KS
authors.lastname: Leung
authors.forename: Tan
authors.initials: T
authors.lastname: Chan
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D015519:Bone Density; D003131:Combined Modality Therapy; D003153:Community Health Services; D005260:Female; D015577:Geriatric Assessment; D006723:Hong Kong; D006801:Humans; D008297:Male; D010353:Patient Education as Topic; D026741:Physical Therapy Modalities; D004856:Postural Balance; D011446:Prospective Studies