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Volume 4, Issue 1, March 2019

Original Article JFSF, Vol 4, No 1, March 2019, p.1-10
Developing the React to Falls resources to support care home staff in managing falls
Katie Ruth Robinson, Katherine Jones, Jane Balmbra, Kate Robertson, Jane Horne, Philippa Anne Logan
Keywords: Falls, Falls Prevention, Care Homes, Training, Online Training
Objectives: Care home residents are falling three times more often than elderly frail people living in their own homes and as such, the management of falls is an important area for care home staff to consider. This paper outlines the development of the ‘React to Falls’ training resources to support care home staff in the management of falls. Methods: The ‘React to Falls’ resources were developed in collaboration with falls prevention researchers, expert clinicians working in the field of falls management in care homes and care home staff and residents. Results: A freely accessible online and paper based resource was developed to meet the needs of different care home settings. Expert clinicians and care homes emphasised the importance of promoting activity and quality life and ensuring the resources were a learning tool that supported positive risk taking. Expert clinicians highlighted the need to convey the importance of continually reacting to reducing risk in the management of falls. Conclusions: This study has developed a set of training resources on falls management to support care home staff to continually react and consider the risks and management of falls. An evaluation of the impact of the resource on care staff behaviour and organisational changes is recommended.
Original Article JFSF, Vol 4, No 1, March 2019, p.11-19
Effects of a falls exercise intervention on strength, power, functional ability and bone in older frequent fallers: FaME (Falls Management Exercise) RCT secondary analysis
Dawn A. Skelton, Olga M. Rutherford, Susie Dinan-Young, Marlene Sandlund
Keywords: Exercise, Falls, Strength, Power, Bone Health, Physical Function
Objectives: Falls Management Exercise (FaME) has been shown to reduce falls in frequent fallers and in lower risk sedentary older people. The effects of FaME on the strength, power, physical function and bone health of frequently falling older women are yet to be established. Methods: This paper reports secondary analysis of data from the original randomised controlled trial of FaME in 100 community dwelling women aged ≥65 years with a history of ≥3 falls in the previous year. Intervention was group delivered, weekly one hour tailored dynamic balance and strength exercise classes and home exercise for nine months. Outcome measures included: strength (handgrip, quadriceps, hamstrings, hip abductors, ankles), lower limb explosive power and functional tests (timed up and go, functional reach, timed floor rise and balance), analysed using Linear Mixed Model analysis. Bone Mineral Density (BMD) at hip and spine was measured in a smaller sub-group and analysed using t-tests. Results: Significant time*group interactions in all measures of strength, except isometric ankle dorsiflexion, concentric hamstring and eccentric quadriceps strength. These improvements in strength equated to average improvements of 7-45%. There were also significant improvements in explosive power (W/kg) (18%, p=0.000), timed up and go (16%, p=0.000), functional reach (17%, p=0.000), floor rise (10%, p=0.002) and eyes closed static balance (56%, p=0.000). There was a significant loss of hip BMD in the control group (neck of femur p<0.05; ward’s triangle p<0.02). Conclusion: The FaME intervention improves lower limb strength, power and clinically relevant functional outcomes in frequently falling older women.
Original Article JFSF, Vol 4, No 1, March 2019, p.20-25
The benefits to functional ambulation and physical activity of group-based rehabilitation in frail elderly Bulgarians undergoing total knee arthroplasty. Preliminary results
Julian Krumov, Vasil Obretenov, Alexandrina Vodenicharova, Kostantin Kanalev, Vladimir Stavrev, Troycho Troev, Jannis Papathanasiou
Keywords: Knee Osteoarthritis, Group-based Rehabilitation, Frailty, PASE, Total Knee Arthroplasty
Objectives: Frailty is a geriatric syndrome associated with increased vulnerability of older adults. Knee osteoarthritis (OA) is the most prevalent joint disease and one of the leading causes of disability and poor physical activity (PA) of elderly individuals worldwide. Total knee arthroplasty TKA has been recognized as an effective surgical treatment in end-stage of knee OA. There is a lack of consensus regarding the universally accepted rehabilitation protocol for frail elderly subjects after TKA. Aim: to evaluate the potential benefits in functional ambulation (FA) and PA among frail elderly Bulgarian subjects underwent TKA, a novel group-based rehabilitation protocol was performed from the subjects. Materials and methods: A total of 130 frail elderly Bulgarian TKA recipients (67 women and 63 men aged 72, 69 ± 0.44,) were included. FA was assessed by the six-minute walking distance (6MWD). PA was evaluated by the PASE questionnaire. Participants were evaluated one week before TKA, as well as 3 and 6 months after the group-based rehabilitation. Results: Significant increase in FA was observed at the third and sixth month after the group-based intervention (p< 0.001). PASE score, was increased at the third and sixth month after the group-based intervention (p<0.001, r2=0.74). Conclusions: Our results suggest that the applied group-based intervention led to a significant improvement in FA as well as in PA of frail elderly subjects over the first six months after the group-based intervention.
Expert Opinion Article JFSF, Vol 4, No 1, March 2019, p.26-28
Gap in stroke patients’ and carers’ education
Margialena Manola, Konstantina Petropoulou, Foti Calogero
Keywords: Stroke, Carers, Patient satisfaction, Education, Carers’ burden
Stroke is a multidimensional illness as it affects various aspects in a person’s quality of life. The rehabilitation team focuses mainly on complications but there seems to be a gap in the education of the patients and their carers in skills relevant to the competencies required for community, aged care, health, housing and disability support services. Stroke patients’ and carers’ education-training, as well as their satisfaction has not been studied adequately. The current article presents important studies in the field about the association of patients’ and carers’ satisfaction and based on authors’ opinion suggests appropriate interventions in order to improve the health of the patients.