Measures of Impairment and Activity Limitation Associated with Falls In Ambulatory Nursing Home Residents
Severe, S. Kyle
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Background: The majority of fall risk data is collected from the community-dwelling population, which is not representative of geriatric sub-populations. Few publications are available exclusively studying falls and risk factors within specific sub-populations. The purpose of this study is to assess which measures of impairment and activity limitation are associated with increased number of past falls within nursing home residents. Methods: In this retrospective correlational study, ambulatory nursing home residents (N=17; 83.7 ± 11.71 years) were recruited from local nursing home facilities. Mini-Mental Status Examination (MMSE), gait speed (GS), lower extremity manual muscle testing (MMT), ankle plantar flexion/dorsiflexion (DF) active range of motion (AROM), hand grip strength, Timed Up and Go (TUG), 5 Times Sit-to-Stand (5TSTS), and assistive device (AD) assessment were recorded in a single visit along with gender, marital status, ethnicity, age, and number of oral medications and active diagnoses. Results: Pearson’s r correlations were calculated with the measures of impairment and fall history in the past 6 months. A moderate correlation existed between increased number of falls and the following measures: 5TSTS (0.585, p=0.007), TUG (0.475, p=0.027), and GS (0.457, p=0.032), right DF AROM (-0.436, p=0.040), and right DF strength (-0.504, p=0.023). The 5TSTS was significantly correlated to past falls at p<0.01 (99%CI). Conclusion: TUG, 5TSTS, gait speed, right ankle DF AROM, and right ankle DF strength were all correlated with increased number of falls, indicating that these measures as possible useful tools in determining fall risk within the ambulatory nursing home resident population.