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Biomedical subjects

T Finnegan

Publications and source records attributed to T Finnegan.

6 recordsLinked to original sources

A randomised trial of hip protector use by frail older women living in their own homes.

OBJECTIVES: To investigate the efficacy and effectiveness of hip protectors in frail community living older women. DESIGN: Randomised controlled trial. SETTING: Aged care health services in New South Wales, Australia. PATIENTS: 600 women 74 years of age or more (mean age 83 years), who had two or more falls or one fall requiring hospital admission in the previous year, and who lived in their own homes. INTERVENTION: Use of hip protectors. MAIN OUTCOME MEASURES: Adherence with use of hip protectors, falls, incidence of hip fracture, and adverse effects of use of hip protectors. RESULTS: Adherence was approximately 53% over the duration of the study and hip protectors were worn at the time of 51% of falls in the intervention group. The risk of hip fracture when falling while wearing hip protectors, compared with a fall with no hip protectors in place, was significantly reduced (relative risk (RR) 0.23, 95% confidence interval (CI) 0.08 to 0.67). On an intention to treat analysis, 21 and 22 hip fractures occurred in the intervention and control groups respectively (adjusted RR 0.92, 95% CI 0.51 to 1.68). Three users of hip protectors sustained a hip fracture while wearing properly applied protectors, while 16 hip protector users (5%) developed minor local complications. CONCLUSIONS: Hip protectors prevent hip fractures in community dwelling older women if worn at the time of a fall. The overall effectiveness of hip protectors was not established in this study, because of incomplete adherence with use of the protectors, and limited statistical power.

Accidental Falls↗

Hip protectors improve falls self-efficacy.

OBJECTIVES: To investigate the effect of use of external hip protectors on subjects' fear of falling and falls self-efficacy (belief in their own ability to avoid falling). DESIGN: Randomized controlled trial. SETTING: Aged-care health services in Sydney, Australia. PARTICIPANTS: 131 women aged 75 years or older, who had two or more falls or one fall requiring hospital admission in the previous year and who live at home. Sixty-one subjects were in the intervention group and 70 in the control group. INTERVENTION: Use of external hip protectors and encouragement to use the protectors by an adherence nurse. MEASUREMENTS: At the time of enrolment into a wider study examining the effect of hip protectors on hip fractures, participants recruited at home completed an assessment of fear of falling and falls efficacy as measured by the Falls Efficacy Scale and the Modified Falls Efficacy Scale. At 4-month follow-up, these scales were readministered by an observer who was not aware of the allocation of the participant to intervention or control groups. RESULTS: Fear of falling and falls self-efficacy, as measured by the Falls Efficacy and Modified Falls Efficacy Scales, were similar at baseline in both groups. Fear of falling was present at follow-up in 43% of subjects using hip protectors and 57% of the control group (chi2 = 2.58, P = 0.11). Hip protector users had greater improvement in falls self-efficacy at follow-up as measured by the Falls Efficacy Scale (t = 2.44, P = 0.016) and the Modified Falls Efficacy Scale (t = 2.08, P = 0.039). CONCLUSION: Hip protectors improve falls self-efficacy. As users of hip protectors feel more confident that they can complete tasks safely, they may become more physically active and require less assistance with activities of daily living.

Accidental Falls↗

Musculoskeletal disability among elderly people in the community.

OBJECTIVES: To determine the prevalence and determinants of disability among elderly people living in the community. DESIGN: A cross-sectional postal questionnaire survey. SETTING: Northern Sydney Area Health Service. PARTICIPANTS: 1527 residents (622 men and 905 women) aged 65 years and over. MAIN OUTCOME MEASURES: Self-reported chronic illnesses, injuries or conditions; difficulties with activities of daily living assessed by the Health Assessment Questionnaire (HAQ); and home modification and use of functional aids. RESULTS: "Arthritis or rheumatism" was the leading long term condition, reported by 59.5%, 55.8% and 59.7% of women and 40.5%, 47.0% and 43.6% of men in the three age groups (65-74, 75-84 and 85 years and over), respectively. The back, neck and knees were the most common sites of pain and stiffness. Of the respondents, 23.4% of women and 24.3% of men reported regularly taking nonsteroidal anti-inflammatory drugs. Impaired performance of activities of daily living increased with age, with 53.9%, 70.7% and 89.6% of women and 37.6%, 63.6% and 73.2% of men in the respective age groups reporting at least some difficulty (HAQ score > 0). Multivariate analysis found self-reported poor general health, loss of a limb, arthritis or rheumatism, other long term conditions restricting physical activity, impaired vision, female sex, and age to be significant predictors of disability as measured by HAQ scores. Only 13.9% of women and 9.4% of men had made changes to their home. Functional aids were used by 27.7%, 37.3% and 65.9% of women and 15.6%, 33.4% and 59.1% of men in the respective age groups. CONCLUSION: Arthritis and rheumatism were the most prevalent chronic conditions among elderly people in the community, and were significantly associated with difficulty with performing activities of daily living, after controlling for effects of age, sex and other chronic conditions.

Activities of Daily Living↗

Can occupational therapy intervention play a part in maintaining independence and quality of life in older people? A randomised controlled trial.

The main objective of this study was to see if older people could maintain their quality of life and independence after their homes had been modified and they were using community services as recommended by an occupational therapist. There were 167 study participants aged 69 to 94 years from the Northern Sydney Area. After being assessed at home by an occupational therapist, 105 were randomly allocated to one of two groups, to either have or not have the occupational therapist's recommendations carried out. They were assessed again after six months. A third group did not require any intervention. This group was followed up by telephone and postal questionnaire at six months. The main outcome measures used were the Sickness Impact Profile, the Philadelphia Geriatric Center Morale Scale, the Life Satisfaction Index, assessment of Activities of Daily Living, the Health Assessment Questionnaire and change in residence. After six months there were no difference in outcomes among the three groups. Most study participants remained at a satisfactory level on each measure. Three people had died. One had moved to hostel care and one had moved to a nursing home. A further 14 from the group having no intervention had withdrawn from the study. A secondary objective of this study was to indicate the responsiveness of these outcome measures to change in the short term (over six months) in an elderly population. Twelve-month assessments are in progress and may indicate what to expect from these outcome measures in the medium term.

Activities of Daily Living↗