The National Institute of Clinical Evidence (NICE) guidelines also advocate the use the TUG for assessment of gait and balance in the prevention of falls in older people. The TUG is recommended as a routine screening test for falls in guidelines published by the American Geriatric Society and the British Geriatric Society. However, reported threshold values vary from 10 to 33 seconds in the literature.
A faster time indicates a better functional performance and a score of ≥13.5 seconds is used as a cut-point to identify those at increased risk of falls in the community setting. The subject wears his regular footwear and uses his customary walking aid (cane or walker) if necessary. The subject walks through the test once before being timed to become familiar with the test. To perform the TUG test as described in the original derivation study, the patient is timed while they rise from an arm chair (approximate seat height 46 cm), walk at a comfortable and safe pace to a line on the floor three metres away, turn and walk back to the chair and sit down again. The TUG (Timed Up and Go) test was developed in 1991 as a modified timed version of the Get up and Go test. The TUG test is another commonly used screening tool for falls risk in the inpatient and the community setting. A recent systematic review examined the predictive value of the rule in elderly inpatients at risk of falls and found that at a score ≥2 points, the STRATIFY rule had only limited predictive ability with moderate summary estimates of sensitivity (0.67, 95% CI 0.52 – 0.80) and specificity (0.57, 95% CI 0.45 – 0.69). The STRATIFY rule yields a possible score between 0 and 5 (each item scoring 1 if present or 0 if absent). Thomas Risk Assessment Tool in Falling elderly inpatients), which consists of five items that address risk factors for falling including past history of falling, patient agitation, visual impairment affecting everyday function, need for frequent toileting, and transfer ability and mobility. One such example is the STRATIFY clinical prediction rule (St. These tools serve to identify patients at risk of falling however, the sensitivity and specificity of existing tools is low. There are a number of performance orientated mobility assessment tools that assess aspects of balance and gait involved in normal daily activities. Gait instability has been identified as a relatively consistent risk factor for falls and the majority of screening programmes to identify those at risk of falls comprise an assessment of gait and balance. The causes of falling are multi-factorial and include extrinsic (environment-related), intrinsic (person-related) and behavioural (activity-related) factors. Falls account for 40% of all injury deaths and lead to 20-30% of mild to severe injuries ranging from soft tissue injuries to fractures in the elderly. Approximately 30% of community dwelling people aged 65 years and over will fall each year. Falls are a leading cause of injury and activity limitation in older adults and the adverse effects associated with falling result in significant personal, social and economic burden.
0 kommentar(er)
