baseline (V0) and at the end of intervention (V1) into two groups: high
risk (HR) (two or more falls in the previous year or an index lower
Tinetti 17 points) (n 22) and low risk (LR) (n 15).
The group of HR has a FES-IV0 of 32.14 and the group of BR of
23.8 (p = 0.008). The FES-IV1 is of 30.45 in the group of HR and 20.72 in
the group of BR (P = 0.004). Two other groups are analyzed according
towhether it has reached the goal of preventing falls: is prevent (n 32),
FES-IV0 28.63, versus not prevented (n 5) 29.6 (p = 0.69). After the
intervention the group that was prevented has FES-IV1 of 24.22 and
the group was not prevented has 39.8 (p = 0.048). In the whole study
European helps to reduce the fear of falling into the physical therapy
group, but not in our group. When comparing different groups
compared to placebo found no significant differences in the evolution
of fear of falling.
The fear of falling tends to decrease in all study groups
except those who fail to prevent new episodes of falls. Both the initial
group at highest risk of falling, such as patients in which episodes of
falls are not prevented fear of falling is not reduced, so we believe that
should be the target groups to strengthen and monitor in handling.
Indoor geriatric early rehabilitation; a randomised outcome study
of 2,308 patients
C. Angleitner, P. Heise, P. Golmayer, S. Traussnigg, I. Reiter, U. Ewerth.
Department of Geriatrics and Remobilisation
Introduction and aims of the study:
Stationary geriatric early
rehabilitation is very well implemented and sufficiently standardized
in many countries. But is stationary geriatric early rehabilitation suffi-
ciently in functional outcome for patients from all assigning specialist
departments? Purpose: Is it possible to reach for all stationary geriatric
early rehabilitation patients no matter from which department they
come from a sufficient therapeutic progress in functional outcome?
The retrospective study includes all the patients from 2008
to 2014 which our department of Geriatrics and Remobilisation took
over from the neurologic, traumotologic, orthopaedic and internal/
cardiological departments. The development was measured with the
FIM (functional independence measure). The take over FIM was taken
inside 72 hours after arriving and the discharge FIM was taken inside
the last 48 hours before leaving.
The study contains 2.308 patients, 753 orthopaedic patients
with an average age of 76,59 years, a residence time from 17,43 days
and a FIM development from 98 to 113 points; 637 traumatological
patients with an average age of 81,89 years, a residence time from
18,78 days and a FIM development from 83 to 103 points; 632
neurological patients with an average age of 76,62 years, a residence
time from 19,22 days and a FIM development from 73 to 90 points as
well as 286 cardiological/internal patients with an average age of 80,02
years a residence time from18,23 days and a FIMdevelopment from 77
to 96 points. The IM development of all patient groups is 1,22 (+/
points) per therapeutic day. The recommended aim value of the
American Rehabilitation Counselling Association (ARCA) amounts to1
FIM point per therapeutic day.
It is possible to obtain a sufficient functional progress for
all patients in stationary early geriatric rehabilitation independently
from which specialist department they were overtaken from.
early geriatric rehabilitation; functional outcome; FIM.
Functional decline in hospitalized elderly patients: a prospective
study with 6 months follow-up
, P. Aroso
, D. Oliveira
, P. Dias
, A. Simao
, A. Carvalho
Centro Hospitalar e Universitário de Coimbra
Previous studies demonstrate that 30 to 60% of the
elderly develop new limitations performing activities of daily living
(ADLs) after hospitalization.
To evaluate variability and associated factors of functional
decline after acute care hospitalization (ACH).
We performed an observational, prospective study, of a
sequent sample with patients >65 years with a Katz index (KI) >0
admitted to a hospital ward. Evaluation of functional capacity (FC) was
performed using modified KI and Barthel Scale (BS) in 2 moments. The
first evaluation of FC was carried out up to 24 hours after admission
and the second at time of discharge. Sociodemographics and clinical
data were collected. After discharge patients were evaluated for
hospital readmission and mortality rate at 6 months.
55 patients satisfied the established criteria (median age of
81 years). Previous to admission, 65% (KI) and 84% (BS) presented
some degree of limitation performing ADLs. During hospitalization,
16% of the patients were referred to evaluation by Physical and
Rehabilitation Medicine, a median of 3 days prior to discharge. At
discharge, 44% (KI) and 62% (BS) of the patients presented functional
decline in at least one ADLs relatively to admission (p < 0,001).
Transfers, gait and climbing stairs were the ADLs with greater
functional decline. The age of patients and residence in health care
institutions were associated with functional decline after hospitaliza-
tion (p < 0,05). At 6 months follow-up, 29% rehospitalization rate and
9%mortality ratewas observed. Between thosewith functional decline
during hospitalization, 33% were rehospitalized and 12% mortality rate
was found, however between those without functional decline 24%
rehospitalization rate and 5% mortality rate was noticed.
ACH represents an important risk factor for elderly to
develop new functional limitations. The activities related to mobility
are most affected.
Berg balance scale and timed up and go test as suitable measures
for monitoring rehabilitation in fallers
, M. Carter
, T. Masud
Sheffield Hallam University,
Nottingham University Hospitals NHS Trust, UK
Falls in older people are common and are associated
with significant morbidity. Multifaceted interventions can reduce falls
rates. Berg Balance Scale (BBS) and Timed Up and Go test (TUG) are
commonly used to assess balance and mobility respectively, and
poor performance in both predict falls. This service evaluation
explored if these tests were responsive to change in a falls intervention
Consecutive patient referred to a secondary care falls unit,
who underwent strength and balance exercises as part a multifaceted
falls prevention intervention were evaluated. Patient records were
used to ascertain the patients
age, sex, BBS and TUG scores at the first
and last visits. The mean changes in BBS and TUG were determined.
Seventy patients (58.6% women, mean age = 78.5, range = 55
98 years) were evaluated. Baseline BBS score (/56) and TUG (seconds)
were 36.0 (SD = 11.5) and 27.8 (SD = 16.1) respectively. Mean changes
in BBS and TUG were +9.1 (95%CI = 7.7
7.3 seconds (95%
10.3) respectively. With the BBS, only 5.7% showed either
a negative or no change, whereas with the TUG 25.4% showed no
change or a change in the wrong direction (mainly because the
requirement for walking aids subsided).
Both BBS and TUG showed good responsiveness in the
majority of patients undergoing a rehabilitation intervention in falls
patients. Where patients improve and no longer require walking aids
that were previously used, then the change in TUG scores were less
useful. Both BBS and TUG provided objective evidence for improve-
ment in patients
balance and mobility respectively.
The positive experience of geriatric unit pioneer in Portugal
Arsenio Paula Ribeiro, Silva Iwona Tonzakc, Clara João Gorjão.
Universitária de Geriatria do Hospital Pulido Valente
Portugal is one of two countries in Europe where there
is still a lack in the specialty of geriatrics. The first unit of Geriatrics in
Portugal was created in the Pulido Valente hospital in Lisbon in 2010.
The model of the unit implemented was based on international
Poster presentations / European Geriatric Medicine 7S1 (2016) S29