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Upadki chorych hospitalizowanych na oddziale geriatrycznym

100%

Mazur K., Otremba I., Bieniek J., Szewieczek J.

Annales Academiae Medicae Silesiensis

2014

vol. 68

issue 4

218-225

INTRODUCTION Falls as a major cause of injuries and disability have been a subject of numerous studies in community-dwelling elderly people. However, few studies have analysed falls among inpatients. The aim of the study was to evaluate the risk factors of falls in patients of a geriatric ward and the effectiveness of a falls prevention program. MATERIALS AND METHODS The study included 100 consecutive patients admitted to the Geriatric Ward aged 80.2 ± 7.65 (mean ± SD) (69 women and 31 men). Barthel and IADL scales were used to assess independence and mobility, VAS – to assess the pain level, and MMSE – for mental status examination. Balance was assessed using a stabilometric platform, and the risk of falling using the Tinetti scale. The body structure was analysed using the bioimpedance method. All the patients were qualified to an appropriate category of the falls prevention program. RESULTS The most common risk factors for falling were: asthenia – 78%, age ≥ 80 years – 61%, leg pain – 53%, back pain – 50%, dizziness – 49%, visual impairment – 47%, a history of falls – 45%, and osteoarthritis – 44%. Among the respondents, 9% had 1–3 fall risk factors, 27% – 4–6, 44% – 7–9, 20% – ≥ 10 factors. Four patients had experienced a fall. All the cases were connected with noncompliance of patients with falls prevention. Among those who had fallen , three subjects had normal cognitive function, another one – delirium. One fall was complicated with a slight facial injury. CONCLUSIONS Geriatric ward patients constitute a group with a high risk of falls. The main risk

W S T Ę P Upadki stanowiące główną przyczynę urazów osób starszych były przedmiotem licznych badań w środowisku mieszkalnym i komunalnym. Nieliczne analizy poświęcono upadkom u chorych hospitalizowanych. Celem pracy była ocena czynników ryzyka upadków u chorych na oddziale geriatrycznym oraz analiza skuteczności programu profilaktyki upadków. M A T E R I A Ł I M E T O D Y Badaniem objęto 100 kolejnych chorych przyjętych do Oddziału Geriatrii, o średniej wieku 80,2 ± 7,65 roku ( x ± SD), w tym 69 kobiet i 31 mężczyzn. Zastosowano skale Barthel oraz IADL (ocena samodzielności i zdolności poruszania się), VAS (ocena natężenia bólu), MMSE (ocena stanu umysłowego). Zachowanie równowagi oceniono za pomocą platformy stabilometrycznej, ryzyko upadku za pomocą skali Tinetti. Metodą bioimpedancji analizowano strukturę ciała. Wszyscy chorzy kwalifikowani byli do jednej z trzech kategorii programu profilaktyki upadków. WYNIKI Do najczęstszych czynników ryzyka upadku należały: osłabienie – 78%, wiek ≥ 80 lat – 61%, ból kończyn dolnych – 53%, ból kręgosłupa – 50%, zawroty głowy – 49%, upośledzenie wzroku – 47%, upadki w przeszłości – 45%, choroba zwyrodnieniowa stawów – 44%. U 9% badanych stwierdzono 1–3 czynniki ryzyka upadku, u 27% – 4–6, u 44% – 7–9, zaś u 20% ≥ 10 czynników ryzyka upadku. Upadku doznało 4 chorych z zaburzeniami równowagi, którzy nie zastosowali się do zaleceń profilaktyki upadków; w 3 przypadkach byli to pacjenci bez istotnych zaburzeń poznawczych, w 1 – z zespołem majaczeniowym. Jeden upadek był powikłany lekkim urazem twarzy, pozostałe były niepowikłane. WNIOSKI Pacjenci oddziału geriatrycznego stanowią grupę obarczoną dużym ryzykiem upadków. Do najważniejszych czynników ryzyka upadku na oddziale geriatrycznym należą majaczenie i nieprzestrzeganie przez chorych zaleceń personelu.

The impact of movement rehabilitation on functional recovery to everyday activities in stroke patients – preliminary report

88%

Walla G., Żmudzka-Wilczek E., Mazur K., Paweł R., Nawrat-Szołtysik A.

Physiotherapy and Health Activity

2015

vol. 23

issue 1

23-28

Background: The main objective of this study was to demonstrate the beneficial effects of rehabilitation on self-sufficiency and recovery to everyday activities in patients after stroke. Material/Methods: The study group comprised 20 patients (11 women and 9 men), who were randomly allocated into two groups of 10 participants each. The first was the control group whose members underwent a 3-week rehabilitation program used in the Neurological Department of the District Hospital in Zawiercie. The study group received the same rehabilitative program but enriched with selected elements of the Bobath concept. On the first and last days of the study each of the patients was assessed with respect to self-sufficiency in performing daily activities using Functional Measure ”Repty” (FMR - simplified version of Functional Independence Measure), upper extremity proximal motor control (the Frenchay Arm Test - FAT) and lower extremity strength (the Timed Up and Go Test - TUG). Results: The results revealed that patients with enriched rehabilitative program exhibited improvement in a greater numer of physical functions as assessed by the FMR (improvement by 26.4%) compared to the control participants (14.28%). The Frenchay Arm Test and the Timed Up and Go Test showed improvement in upper extremity control and locomotion in the study and control participants. The mean reduction in TUG time was 2.5 s and 3.4 s in the control and study participants, respectively; the results are statistically significant. A FAT task, ie., lifting a cylinder and replacing it improved by a mean of 2 and 0.5 inches; there were also gains in the performance of other tasks such as drinking water from a glass and combing hair. Conclusions: The final results revealed an improvement of physical function in all patients. However, rehabilitation program enrichment with selected elements of the Bobath concept helped the patients achieve better functional recovery; a 3-week rehabilitation program more effectively contributed to improving self-sufficiency, locomotion and arm function.

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1 Annales Academiae Medicae Silesiensis

1 Physiotherapy and Health Activity

1 2015

1 2014

2 Mazur K.

1 Bieniek J.

1 Nawrat-Szołtysik A.

1 Otremba I.

1 Paweł R.

1 Szewieczek J.

1 Walla G.

1 Żmudzka-Wilczek E.

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Upadki chorych hospitalizowanych na oddziale geriatrycznym

The impact of movement rehabilitation on functional recovery to everyday activities in stroke patients – preliminary report