Authors: Aaron David Abrishami, Aviel Hanasab, Eliot Sadik, David Rowshanshad, Michael Tsiang, Levan Atanelov.
Introduction: Though physiatrists are trained in functional gait analysis, studies are lacking on effectiveness of physiatrist management on fall prevention in older adults. Steady Strides is a structured physiatrist-led, functional, goal-directed multifactorial intervention to help reduce falls. Our objective was to assess the effect of Steady Strides intervention on reducing falls in older adults at high fall risk.
Methods: A retrospective observational cohort study of 124 community dwelling older adults at risk of falls seen at outpatient clinic were identified to be at high risk of falls and included in the study if they reported: i) at least one fall in 3 months at baseline; and ii) limited improvement with prior physical therapy. All patients in this cohort had an initial evaluation with physiatrist and all were offered the Steady Strides physiatrist-led intervention. Patients who followed up with the physiatrist for the intervention, participants, were compared to those who did not, i.e., non-participants. All patients were called and number of falls within six months after the initial evaluation (primary outcome variable) was recorded. Demographic, clinical and participation (e.g., number of visits with physiatrist, physical and occupational therapists in 2-months after the initial presentation) data was extracted from medical records and analyzed in univariate, then multivariate analyses.
Results: Steady Strides participants had statistically lower number of falls at 6 months compared to non-participants (mean 4.59 vs 1.89, p<0.004). Univariate analysis demonstrated that participation in Steady Strides physiatry Research Article J Med - Clin Res & Rev; 2023 Volume 7 | Issue 12 | 2 of 8 intervention (incidence rate, [IR], 0.41, 95% Confidence Interval [CI] 0.24-0.67, p<0.001) as well as attending physical therapy sessions (IR 0.59, 95% CI 0.36-0.96, p=0.034) was correlated with reduced number of falls at 6 months. Steady Strides participation remained significant in the multivariable analysis (IR 0.31, 95% CI 0.15-0.61 p<0.001).
Discussion/Conclusion: This is a first reported effective structured physiatrist-driven fall prevention intervention that may have significant effect on fall reduction in older adults.
View/Download pdf