Can the Healthcare Assistant in General Practice provide Preventative Support for Older People to Reduce Risk of Falls?
DOI:
https://doi.org/10.14738/bjhmr.105.15641Abstract
In 2014, 2,734 people over 65 across the four London boroughs were predicted to have been admitted to a hospital because of falls. This figure is predicted to rise further to 3,766 by 2030. The number of falls can be reduced by up to 30% through development of a multi-agency falls pathway focussing on early identification and prevention, and multi-factorial assessment and intervention for people at high risk of falling (1). The role of the health-care assistant (HCA) has developed rapidly in general practice and HCAs can make an increasingly useful contribution to the skill mix in general practice. The project aimed to evaluate; the suitability of HCAs delivering GaitSmart assessments in the GP clinical pathway, GaitSmart protocol for detecting gait deficiency and improving gait and patient reported outcomes (Gait Speed, GaitSmart Score, Falls Efficacy Scale Questionnaire (FES-I) and Edmonton Frailty Score (EFS). The programme produced positive patient outcomes, thus reducing the burden on physiotherapists. Participants who completed the three-session GaitSmart intervention programme showed an average improvement in their gait characteristics
References
NICE Clinical guideline [CG161] Falls in older people: assessing risk and prevention. Published: 12 June 2013.
Nyman, S. R., & Victor, C. R. (2012). Older people's participation in and engagement with falls prevention interventions in community settings: an augment to the Cochrane systematic review. Age and ageing, 41(1), 16–23. https://doi.org/10.1093/ageing/afr103
Osho, O., Owoeye, O., & Armijo-Olivo, S. (2018). Adherence and Attrition in Fall Prevention Exercise Programs for Community-Dwelling Older Adults: A Systematic Review and Meta-Analysis. Journal of aging and physical activity, 26(2), 304–326. https://doi.org/10.1123/japa.2016-0326
Brant, C., & Leydon, G. M. (2009). The role of the health-care assistant in general practice. British journal of nursing (Mark Allen Publishing), 18(15), 926–933. https://doi.org/10.12968/bjon.2009.18.15.43562
Bosley, S., & Dale, J. (2008). Healthcare assistants in general practice: practical and conceptual issues of skill-mix change. The British journal of general practice: the journal of the Royal College of General Practitioners, 58(547), 118–124. https://doi.org/10.3399/bjgp08X277032
Verghese J, Holtzer R, Lipton RB, Wang C. Quantitative gait markers and incident fall risk in older adults. J Gerontol a Biol Sci Med Sci. 2009 Aug;64(8):896-901. doi: 10.1093/gerona/glp033. Epub 2009 Apr 6. PMID: 19349593; PMCID: PMC2709543.
Perell KL, Nelson A, Goldman RL, Luther SL, Prieto-Lewis N, Rubenstein LZ (2001) Fall risk assessment measures: an analytic review, Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 56(12):M761-M766.
Rodgers, G., Mottley, A., & Hodgins, D. (2020). Novel Digital Gait Kinematic Solution to Improve Frailty. British Journal of Healthcare and Medical Research, 7(5), 01–10. https://doi.org/10.14738/jbemi.75.8894
Chmiel C, Senn O, Rosemann T, Del Prete V, Steurer-Stey C. CoCo trial: Color-coded blood pressure Control, a randomized controlled study. Patient Prefer Adherence. 2014; 8:1383-1392. Published 2014 Oct 16. doi:10.2147/PPA.S68213
Heaps J. Inertial Measurement Unit Characterisation for Gait Analysis. 3DMC 2019 Here East, London 5 –7 November 2019
McCarthy, I., Hodgins, D., Mor, A. et al. Analysis of knee flexion characteristics and how they alter with the onset of knee osteoarthritis: a case control study. BMC Musculoskelet Disord 14, 169 (2013). https://doi.org/10.1186/1471-2474-14-169 195
Monda M et al. Use of Inertial Measurement Units to Assess Age-Related Changes in Gait Kinematics in an Active Population. Journal of Aging and Physical Activity, 23: 18-23. 2015
Zügner R et al. Validation of Inertial Measurement Units with Optical tracking system in patients operated with Total Hip Arthroplasty. BMC Musculoskeletal Disorders 2019
Abellan van kan, G et al. Gait speed at usual pace as a predictor of adverse outcomes in community dwelling older people an international academy on nutrition and aging (iana) Task force. The Journal of Nutrition, Health & Aging© Volume 13, Number 10, 2009
Yardley, L., Beyer, N., Hauer, K., Kempen, G., Piot-Ziegler, C., & Todd, C. (2005). Development and initial validation of the Falls Efficacy Scale-International (FES-I). Age and ageing, 34(6), 614–619. https://doi.org/10.1093/ageing/afi196
Rolfson, D. B., Majumdar, S. R., Tsuyuki, R. T., Tahir, A., & Rockwood, K. (2006). Validity and reliability of the Edmonton Frail Scale. Age and ageing, 35(5), 526–529. https://doi.org/10.1093/ageing/afl041
Perera, S., Mody, S.H., Woodman, R.C. and Studenski, S.A., 2006. Meaningful change and responsiveness in common physical performance measures in older adults. Journal of the American Geriatrics Society, 54(5), pp.743-749.
Cabell L, Pienkowski D, Shapiro R, Janura M. Effect of age and activity level on lower extremity gait dynamics: an introductory study. J Strength Cond Res. 2013 Jun;27(6):1503-10. doi: 10.1519/JSC.0b013e318269f83d. PMID: 22964857.
Kerrigan, D. C., Lee, L. W., Collins, J. J., Riley, P. O., & Lipsitz, L. A. (2001). Reduced hip extension during walking: healthy elderly and fallers versus young adults. Archives of physical medicine and rehabilitation, 82(1), 26-30
Li, F., Fisher, K.J., Harmer, P., McAuley, E. and Wilson, N.L., 2003. Fear of falling in elderly persons: association with falls, functional ability, and quality of life. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 58(5), pp. P283-P290.
Clegg A, Young J, Iliffe S, Rikkert M O, Rockwood K. Frailty in elderly people. The Lancet, Volume 381, Issue 9868, 2013, P 752-762, ISSN 0140-6736
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Diana Hodgins, Jack Newby
This work is licensed under a Creative Commons Attribution 4.0 International License.
