A Critical Analysis of Fall Prevention

in a Primary Care Setting

Michael Balot

Background of the Authors

Department of Prevention, Rehabilitation and Sports Medicine,
Technische Universitt Mnchen, Munich, Germany: Dr. phil.
Siegrist, B. Geilhof, Prof. Dr. med. Halle
Institute for Biomedicine of Aging, Universitt Erlangen-Nrnberg,
Nrnberg, Germany: PD Dr. phil. Freiberger, J. SalbInstitute of
Sport Science and Sport, Universitt Erlangen-Nrnberg, Nrnberg,
Germany: C. Hentschke
(Siegrist et al., 2016)

Background of the Authors (Continued)

Institute of General Practice, Technische Universitt Mnchen,
Munich, Germany: Dr. med. Landendoerfer; Prof. Dr. med. Linde,
Dr. med. Blank
DZHK (German Centre for Cardiovascular Research), partner site
Munich Heart Alliance, Munich, Germany and Else KrnerFresenius-Zentrum, Klinikum rechts der Isar, Technische
Universitt Mnchen, Munich, Germany: Prof. Dr. med. Halle
(Siegrist et al., 2016)

(Allen, 2013)

Background on Geriatric Falls

Fractures and Geriatric Falls

The incidence of fractures occurring due to a fall is 89%
Fractures are associated with
Reduced mobility
Admission to LTC facilities
Increased costs of healthcare
Increased rates of mortality
(Siegrist et al., 2016)

Current Interventions/Research
General Practitioners are afforded the opportunity to screen
patients at risk for falls due to the nature of their practice
Prevention of Falls Network Europe (ProFANE) recommends that geriatric
patients be screened annually for fall risk
(Siegrist et al., 2016)

The Cochrane Review revealed that group- and home-based

exercise interventions reduce the prevalence of falls in the
geriatric population living in the community
(as cited in Siegrist et al., 2016)

Purpose

Methods
Cluster Randomized Two Level Trial
Southern Germany

Included patients >65 y/o residing in the community who were at

increased risk of falls
Clinical Data reviewed by independent GP not involved in study
Measurement: # of falls an unexpected event in which the
participant comes to rest on the ground, floor, or lower level
Secondary Outcomes

Physical Function Assessments & Fear of Falls

Timed-Up-and-Go Test (TUG) Physical Function

Chair-Stand Test (CST) Strength
Modified Romberg (mRomberg) Balance
Falls Efficacy Scale-International (German version) Fear of Falling

Intervention
Physician and Staff member training
16 Week supervised exercise program (1h/w)

Strength & Power Training

Balance & Gait Training
Behavioral Aspects
Self Management Program
Perceptual and Functional Training by a Fall Protection Instructor

Control Group

Study Flow Pt 1:

Recruitment of GPs and Participants

Study Flow Pt. 2:

Participant Participation

Results 1

Results 2

general practice is an ideal setting for

the
an exercise-based fall prevention program to
prevent falls in community-dwelling elderly at
risk.

Conclusion

Future Directions
Testing within different age ranges
Young Old vs Medium Old vs Old Old

Men vs. Women

Why were most participants women?

Testing out different exercise interventions or different methods

of training GPs

Critical Analysis

Limitations & Criticisms

Further Critical Analysis

Is this study able to be replicated?

Recommendations for future directions?
Did this study have enough arms?
Was this enough exercise?

References
Allen, R. (2013). New Technology Detects Falls by Seniors. Retrieved from
http://www.alternativesforseniors.com/blog/new-technology-detects-falls-by-seniors/
KINECT. (2014). Sharpened Modified Romberg Test. Retrieved from https://www.kinnect.com.au/wpcontent/uploads/2014/09/Sharpened-Modified-Romberg-Test1.pdf
Greenberg, S. A. (2011). Assessment of Fear of Falling in Older Adults: The Falls Efficacy Scale-International. Try
This: Best Practices in Nursing Care to Older Adults, 29. Retrieved from https://consultgeri.org/try-this/generalassessment/issue-29.pdf
Siegrist M, Freiberger E, Geilhof B, Salb J, Hentschke C, LandendoerferP,Linde K, Halle M, Blank WA. (2016). Fall
prevention in a primary care settingthe effects of a targeted
complex exercise intervention in a cluster
randomized trial. Dtsch Arztebl Int,113, 365 72. DOI: 10.3238/arztebl.2016.0365
STEADI. (n.d.) The 30-Second Chair Stand Test. Retrieved from
https://www.cdc.gov/steadi/pdf/30_second_chair_stand_test-a.pdf
STEADI. (n.d.) The Timed Up and Go (TUG) Test. Retrieved from
https://www.ons.org/sites/default/files/TUG_Test-a.pdf