PubMed · 10496631
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J Schott, R W Force. 1999. Do bedrails decrease falls in hospitalized patients?. https://pubmed.ncbi.nlm.nih.gov/10496631/
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OBJECTIVE: To document the circumstances surrounding falls in patients with Parkinson's disease. DESIGN: Prospective. METHOD: Parkinson patients with a check-up appointment in the period 1 May 1998-31 May 1999 at the Neurology Outpatient's Department of Leiden University Hospital, used standardized forms to record the circumstances surrounding all incidents of falling during the subsequent 6 months. For control purposes, a partner or acquaintance with comparable living conditions was asked to do the same. The researchers judged whether falls were related to physical impairment (personal, intrinsic factors) or environmental factors (extrinsic factors). RESULTS: 59 patients with Parkinson's disease (21 women (36%); mean age: 60.8 years; mean Hoehn and Yahr score: 2.3) and 55 controls (37 women (67%); mean age: 59.6 years) were studied. Patients reported 205 falls and controls 10 falls. Recurrent (> or = 2) falls occurred in 15 patients (25%) and two controls (4%) (relative risk (RR): 9.0: 95% confidence interval (95% CI): 2.0-41.7). Recurrent falls were more common among persons using benzodiazepines (RR: 5.0: 95% CI: 1.6-15.5). Reliable information was obtained for 160 falls in patients. Most falls (79%) had an intrinsic cause, like turning around, standing up, bending and stumbling. Abrupt movements were a particularly frequent cause of falls. Simultaneous performance of multiple tasks contributed to almost 50% of falls in patients. CONCLUSION: Falls are common among Parkinson patients. Most falls are related to intrinsic factors. Prevention of these intrinsic falls requires treatment of the underlying postural instability. Use of benzodiazepines must be avoided whenever possible. Interventions aimed at extrinsic factors, such as reduction of domestic hazards, are possibly less effective.
BACKGROUND: Inability to get up from the floor after an accidental fall is a frightening and potentially dangerous experience. Especially elderly individuals living alone are exposed to this. MATERIAL AND METHODS: In a geriatric five-day ward 206 patients living alone were tested for their ability to rise from the floor. This was carried out under safe conditions in a training room. Those who failed were offered instruction and training given by a physiotherapist, up to five sessions. The training programme is described. RESULTS: 154 patients (75%) were able to get up unaided within two minutes. The time needed varied considerably. Of the 52 who failed 39 accepted training, and 22 finally managed to get up independently. INTERPRETATION: Teaching elderly patients living alone how to get up from the floor is often successful and will probably reduce the risk of being unable to get up for an extended period of time.