物理治疗与身体康复杂志

Aim: The present study investigated the incidence, characteristics, and risk factors predictive of falls in different patient populations hospitalized in a geriatric rehabilitation hospital.

Purpose: The aims were to evaluate evidence of risk factors for falls among patients in stroke rehabilitation and to offer recommendations for clinical practice and future research.

Method: An integrative review of the literature published from 1991 to 2020 was conducted that describes empirical investigations of risk factors for post stroke falls during patient rehabilitation. We searched Medline, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycInfo, and Embase databases, using the search terms “accidental falls, ”fall risk, ”risk factors, ”risk assessment, ”stroke,” and “cerebrovascular disorders.” We extracted information regarding study design, sample, potential risk factors, analytic methods, findings, and limitations from the 20 articles that met the inclusion criteria, and was rated the level of evidence for each study.

Findings: Available empirical evidence points to impaired balance, visuospatial hemineglect, and impaired performance of activities of daily living as risk factors for falls during inpatient rehabilitation for stroke. Associations between falls and cognitive function, incontinence, visual field deficits, and stroke type were less clear, while relationships between falls and age, gender, stroke location, and impaired vision and hearing were not supported.

Conclusion: The relatively sparse literature pertaining to risk factors for falls among stroke rehabilitation inpatients indicates that deficits affecting balance, perception, and self care significantly increase the likelihood of falls. Particularly intriguing is the less well established role of post stroke cognition in falls in this population. A conceptual model is needed to guide scientific inquiry and clinical practice in this area. Rehabilitation professionals have long known that stroke survivors often sustain falls during their inpatient rehabilitation stay and that these falls may have catastrophic consequences. Preventing such falls is crucial, and identifying key risk factors for falls during post-stroke rehabilitation will ultimately enable clinicians to better target fall prevention efforts with patients and their families. This integrative review reveals the need for further research to better delineate the multifactorial nature of fall risk during inpatient stroke rehabilitation, with particular attention to the largely unexplored domains of cognition. Clinical

Relevance: When clinicians in the inpatient stroke rehabilitation setting evaluate which patients are at greatest risk to fall, stroke specific risk factors such as impaired balance, visuospatial hemineglect, and self care deficits may be better predictors than more general risk factors such as age, incontinence, and sensory impairments. Patients with these stroke. specific deficits may benefit from the use of aggressive fall prevention interventions.

Background: Physiotherapy in the Intensive care unit has shown beneficial effects to the patient, as it improves their quality of life, increases their bodily functions, improves their respiratory muscle strength and reduces hospital as well as ICU length of stay.

Aim: The aim of this study is to evaluate the characteristics of physiotherapist and their different ways of treatment approach in patient care admitted in intensive care unit.

Material and Method: In this study a survey questionnaire consisting of 32 items, were electronically sent to 70 participants via mail to different tertiary hospitals in Karnataka and the response were received in the same manner.

Conclusion: The most common interventions were positioning, active, passive, breathing exercises and percussion. Critical barriers toward physiotherapy are multifactorial and related to physiotherapists, patients, team, equipment, and legal procedures. This study concluded that a proper protocol for rehabilitation in the ICU is necessary to enhance the performance and the quality of life of patients in ICU.

Introduction: Coronavirus disease 19 (COVID-19) is a new virus linked to the same family of viruses as Severe Acute Respiratory Syndrome (SARS). Concern has aroused regarding association between increased risk of complication and death among COVID-19 patients with underlying diseases.

Objective: To highlight the effect of physiotherapy intervention on function performance of COVID 19 inpatient with comorbidities.

Case presentation: Sixty one years old, male with past medical history of hypertension (HTN), diabetes millets (DM), ischemic heart disease (IHD). In addition, there was history of angioplasty 10 years ago in India. On 24 June 2020, he was admitted with tachypnea and fever and found to be COVID positive in AL Nahada Hospital. He was intubated due to desaturation to 60% despite being on 15L oxygen in non-rebreathing mask. Post intubation, he was shifted to Royal Hospital on Mechanical Ventilator (MV) and admitted in COVID ICU. On 26 June, patient was extubated on NIV since he was conscious, and stable hemodynamic.

Management and outcome: manual muscle testing (MMT) and berg functional balance scale (BBS) were used as outcome measures to evaluate the efficiency of physiotherapy intervention. These interventions were early mobilization and breathing exercises.

Result &Conclusion: The results of this case study suggest that the physiotherapy intervention used in this case aided to speed up improvement and recovery. The results of this report warrant for further studies with larger sample size and more controlled study design to test for the effect of early physiotherapy intervention in functional performance of Covid-19 patients.

Abstract fall is defined as a sudden and unintentional loss of balance, which usually results in landing on the floor. The increase in number of geriatric population will lead to increase in the problem of falls. Its causes can be multifactorial & results are often devastating. Studies have shown that loss of strength, balance, coordination, endurance, and environmental hazards have been strongly associated with falls.

Objectives: The purpose of this study was to determine the efficacy of the home-based rehabilitation including balance, resistance & endurance training and the environmental modification strategies to prevent the risk of falls in the geriatric population.

Aims: The main aim of management was to maximize independence in mobility and functions and prevent further falls.

Methodology: Single subject case study of an 82-years-old male with the chief complaint of falls and minor injuries due to it. Along with the loss of strength, balance & coordination. He was given a home-based rehabilitation for 2months, 5 times a week which included resistance training, balance training & endurance training on alternate days (walking, static cycling). Along with that home setting modifications were done through a home Safety Checklist. Alternations in function were assessed by the Timed Up & Go Test, Five Times Sit to Stand Test, Single Leg Stance Test and The Fall Efficacy Scale International (FES-I).

Result: A decline in the rate of falls in the individual. TUG, 5XSST showed a reduction in time taken, time taken for SLST increased, reduction in score of FES-I and environmental modifications found out to be quite effective.

Conclusion: Home-based rehab program together with home settings modification are an effective way to prevent falls in the elderly.