The efficacy of a multidisciplinary falls prevention clinic with an extended step-down community program.
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.
Sze
Pan-Ching
PC
Department of Orthopaedics and Traumatology, Chinese University of Hong Kong, Hong Kong, China.
Cheung
Wing-Hoi
WH
Lam
Pui-Sze
PS
Lo
Hip-Shing Dominic
HS
Leung
Kwok-Sui
KS
Chan
Tan
T
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