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Circumstances of falls during sit-to-stand transfers in older people: A cohort study of video-captured falls in long-term care

Published:November 16, 2022DOI:https://doi.org/10.1016/j.apmr.2022.10.012

      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

      Long-term care

      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 (GEE) 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 = 1.95; 95% confidence interval = 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 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.

      Key words

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