Abstract
Objective
To characterize the circumstances of falls during sit-to-stand transfers in long-term
care (LTC), including the frequency, direction, stepping and grasping responses, and
injury risk, based on video analysis of real-life falls.
Design
Cohort study.
Setting
LTC.
Participants
We analyzed video footage of 306 real-life falls by 183 LTC residents that occurred
during sit-to-stand transfers, collected from 2007 to 2020. The mean age was 83.7
years (SD=9.0 years), and 93 were female (50.8%).
Intervention
Not applicable.
Main Outcome Measures
We used Generalized Estimating Equations to test for differences in the odds that
a resident would fall at least once during the rising vs stabilization phases of sit-to-stand
and to test the association between the phase of the transfer when the fall occurred
(rising vs stabilization) and the following outcomes: (1) the initial fall direction;
(2) the occurrence, number, and direction of stepping responses; (3) grasping of environmental
supports; and (4) documented injury.
Results
Falls occurred twice as often in the rising phase than in the stabilization phase
of the transfer (64.0% and 36.0%, respectively). Falls during rising were more often
directed backward, while falls during stabilization were more likely to be sideways
(odds ratio [OR]=1.95; 95% confidence interval [CI]=1.07-3.55). Falls during rising
were more often accompanied by grasping responses, while falls during stabilization
were more likely to elicit stepping responses (grasping: OR=0.30; 95% CI=0.14-0.64;
stepping: OR=8.29; 95% CI=4.54-15.11). Injuries were more likely for falls during
the stabilization phase than the rising phase of the transfer (OR=1.73; 95% CI=1.04-2.87).
Conclusion
Most falls during sit-to-stand transfers occurred from imbalance during the rising
phase of the transfer. However, falls during the subsequent stabilization phase were
more likely to cause injury.
Keywords
List of abbreviations:
BC (British Columbia), CI (confidence interval), COM (center of mass), GEE (Generalized Estimating Equations), LTC (long-term care), OR (odds ratio)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: November 16, 2022
Accepted:
October 29,
2022
Received in revised form:
September 8,
2022
Received:
May 17,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
K.v.S. and S.N.R. presented early-stage analysis of this work at the 2017 International Society for Posture and Gait Research World Congress in Fort Lauderdale, USA.
This work was supported by operating grants from the Canadian Institutes of Health Research (CIHR; funding reference numbers AMG-100487, TIR-103945, and TEI-138295) and the AGE-WELL Core Research Program (AW CRP 2015-WP5.2; AW CRP 2020-04). V.K. was supported by a Michael Smith Foundation for Health Research (MSFHR) Postdoctoral Award (#18481) and an AGE-WELL NCE Postdoctoral Award in Technology and Aging. K.v.S. was supported by an MSFHR Postdoctoral Award (#16606) and a Human Frontier Science Program Fellowship (LT001080/2017). O.M.G.A. was supported by a Natural Science and Engineering Research Council (NSERC) Undergraduate Research Award (#610014) and a Graduate Dean's Entrance Scholarship from Simon Fraser University. N.S. was supported by a Graduate Dean's Entrance Scholarship from Simon Fraser University. None of the funding agencies influenced the experimental design; the collection, analysis or interpretation of data; the writing of the manuscript; or the decision to submit the manuscript for publication.
Identification
Copyright
© 2022 by the American Congress of Rehabilitation Medicine.
