Caros colegas,
Nos ultimos dois anos e em especial no ano de 2002 tenho trabalhado com a
questão da prevenção de quedas. Estou na Universidade Federal Fluminense
coordenando um projeto de extensão, onde uma equipe multiprofissional vem se
interessando em conhecer mais os mecanismos da queda e de que maneira a prática
de atividades fisicas especificas podem contribuir para equação deste sério
problema. Temos algumas propostas e pistas estão sendo investigadas, entretanto
tratando-se de evento multifatorial muito ainda temos de investigar. Fica aqui
um chamado aqueles que se interessam no asunto para trabalharmos aqui na lista,
seja discutindo metodologias, pesquisa em andamento e divulgando artigos
cientificos sobre a tematica.
Regularmente apresentarei algum resumo e infelizmente para alguns a maioriasão
sempre em outra lingua.
Segue abaixo o primeiro resumo do ano de 2003. Para quem já vem acompanhando as
mensagens anteriores verificará que temos muitos emails enviados sobre esta
tematica e com resumos de artigos como este.
Stalenhoef P.A., Diederiks J.P., Knottnerus J.A., Kester A.D., Crebolder H.F.
A risk model for the prediction of recurrent falls in community-dwelling
elderly. A prospective cohort study.
J Clin Epidemiol 2002 Nov;55(11):1088-94.
The object of this article was to determine the predictive value of risk
factors for recurrent falls and the construction of a fall risk model as a
contribution to a mobility assessment for the identification of
community-dwelling elderly at risk for recurrent falling in general practice.
The design was a prospective cohort study (n = 311). There were four primary
health care centers. A sample stratified on previous falls, age, and genderof
community-dwelling elderly persons aged 70 years or over (n = 311) was taken
from the respondents to a mail questionnaire (n = 1660). They were visited at
home to assess physical and mental health, balance and gait, mobility and
strength. A 36-week follow-up with telephone calls every 6 weeks was conducted.
Falls and fall injuries were measured. During follow-up 197 falls were reported
by 33% of the participants: one fall by 17% and two or more falls by 16%.
Injury due to a fall was reported by 45% of the fallers: 2% hip fractures, 4%
other fractures, and 39% minor injuries. A fall risk model for the prediction
of recurrent falls with an area under the curve (AUC) of 0.79, based on
logistic regression analysis, showed that the main determinants for recurrent
falls were: an abnormal postural sway (OR 3.9; 95% Cl 1.3-12.1), two or more
falls in the previous year (OR 3.1; 95% Cl 1.5-6.7), low scores for hand grip
strength (OR 3.1; 95% Cl 1.5-6.6), and a depressive state of mind (OR 2.2; 95%
CI 1.1-4.5). To facilitate the use of the model for clinical practice, the
model was converted to a "desk model" with three risk categories: low risk (0-1
predictor), moderate risk (two predictors), and high risk (>/=3 predictors). A
fall risk model converted toa "desk model," consisting of the predictors
postural sway, fall history, hand dynamometry, and depression, provides added
value in the identification of community-dwelling elderly at risk for recurrent
falling and facilitates the prediction of recurrent falls.
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