title: The impact of falls prevention on participation in daily occupations of older adults following discharge: a systematic review and meta-analysis.
abstract: OBJECTIVE
  To investigate the impact of falls intervention programmes on participation of older adults returning home to live, following discharge from hospital.
  
  
  METHODS
  A systematic review of peer-reviewed articles and grey literature was completed. Limits were set for articles published in English, dated 1990-2012. Inclusion criteria included randomised control trials with older adults (≥65 years) that used an effective falls intervention and a participation measure, following discharge from hospital or emergency department. Two independent researchers assessed the studies for eligibility. Research risk of bias was evaluated using the PEDro scale (range 1-10). A meta-analysis of the selected articles was completed.
  
  
  RESULTS
  Five studies fulfilled the inclusion criteria and measured participation outcomes short-term (<six months post-discharge, n = 488) and long-term (6-12 months post-discharge, n = 571). The results indicated that falls interventions provided a positive improvement in patients' participation level (p = 0.042, p = 0.026). However, the effect size was small at 0.20 and 0.21.
  
  
  CONCLUSIONS
  The meta-analysis findings indicate that there is a causal association between falls interventions and participation in daily occupations with older adults post-discharge. Although the effect size was small, practice implications of this study suggest that participation needs to be considered in future falls prevention research. Implications for Rehabilitation Falls interventions for older adults following discharge home from hospital, increase participation in life situations to a small extent. Health professionals can include a focus on falls prevention programmes with older adults to promote participation.
authors.affiliation: Department of Physiotherapy and.
authors.forename: E
authors.initials: E
authors.lastname: Pritchard
authors.forename: T
authors.initials: T
authors.lastname: Brown
authors.forename: A
authors.initials: A
authors.lastname: Lalor
authors.forename: T
authors.initials: T
authors.lastname: Haines
mesh_terms: D000056:Accident Prevention / Q000379:methods*; D000058:Accidental Falls / Q000517:prevention & control*; D000061:Accidents, Home / Q000517:prevention & control*; D000203:Activities of Daily Living; D000368:Aged; D015577:Geriatric Assessment; D006801:Humans; D010351:Patient Discharge
keywords: Activities of daily living; elderly; fall; participation; post-discharge