The Weighting of Balance Disorders in Subjects at Risk of Falling Performed by Physical Therapists in Argentina. Cross-Sectional, Survey-Type Studys at risk of falling performed by physical therapist in Argentina. Cross-sectional study, survey type.
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Abstract
Introduction: Falls are unintentional events that result in losing balance and hitting the body on the
ground or another firm surface that stops it. An objective and instrumented gait and balance analysis is an excellent tool for estimating the risk of falls in patients. Our objective was to describe how physical
therapists in Argentina weigh balance impairment in the context of neurorehabilitation, vestibular
rehabilitation, and older adults. To identify the barriers and facilitators self-perceived by the physical
therapists that make it difficult/easy to carry out the weighting of balance impairments.
Methods: We conducted an observational, descriptive, cross-sectional survey-type study. We used the recommendations given by the Checklist for Reporting of Survey Studies. The survey was addressed to all physical therapists in Argentina who work in neurorehabilitation, vestibular rehabilitation, and older
adults.
Results: 204 Physical therapists completed the survey. 78.79% of the respondents answered that they
always weigh their patients. Biomechanical limitations, sensory strategies, anxiety, and fear of falling were the least weighted factors. The main barrier was patient characteristics (36.76%) and the primary facilitator training (33.33%). 93.63% indicated that they would like training in this area in the future.
Conclusion: Among the physical therapists surveyed, there is a prevalence of weighting their patients;
they identify that patient characteristics are a barrier when performing it and that training in its use is a
facilitator.
Registry: ClinicalTrials.gov: NCT05285150
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Caídas [Internet]. Ginebra: Organización Mundial de la Salud; 2021 abr 21 [citado 2023 nov 10]. Disponible en: https://www.who.int/es/news-room/fact-sheets/detail/falls.
Talbot LA, Musiol RJ, Witham EK, et al. Falls in young, middle-aged and older community dwelling adults: perceived cause, environmental factors and injury. BMC Public Health. 2005;5:86. https://doi.org/10.1186/1471-2458-5-86.
Schniepp R, Huppert A, Decker J, et al. Fall prediction in neurological gait disorders: differential contributions from clinical assessment, gait analysis, and daily-life mobility monitoring. J Neurol. 2021;268(9):3421-3434. https://doi.org/10.1007/s00415-021-10504-x.
Horak FB. Postural orientation and equilibrium: what do we need to know about neural control of balance to prevent falls? Age Ageing. 2006;35 Suppl 2:ii7-ii11. https://doi.org/10.1093/ageing/afl077.
Pollock AS, Durward BR, Rowe PJ, et al. What is balance? Clin Rehabil. 2000;14(4):402-406. https://doi.org/10.1191/0269215500cr342oa.
Davis JR, Campbell AD, Adkin AL, et al. The relationship between fear of falling and human postural control. Gait Posture. 2009;29(2):275-279. https://doi.org/10.1016/j.gaitpost.2008.09.006.
Ehrhardt A, Hostettler P, Widmer L, et al. Fall-related functional impairments in patients with neurological gait disorder. Sci Rep. 2020;10(1):21120. https://doi.org/10.1038/s41598-020-77973-4.
Muir SW, Berg K, Chesworth B, et al. Balance impairment as a risk factor for falls in community-dwelling older adults who are high functioning: a prospective study. Phys Ther. 2010;90(3):338-347. https://doi.org/10.2522/ptj.20090163.
Noohu MM, Dey AB, Sharma S, et al. International classification of function, disability and health framework for fall risk stratification in community dwelling older adults. Geriatric Care. 2017;3(1):6526. https://doi.org/10.4081/gc.2017.6526.
de Clercq H, Naude A, Bornman J. The perspectives of healthcare practitioners on fall risk factors in older adults. Health SA. 2020;25:1495. https://doi.org/10.4102/hsag.v25i0.1495.
Arienti C, Lazzarini SG, Pollock A, et al. Rehabilitation interventions for improving balance following stroke: an overview of systematic reviews. PLoS One. 2019;14(7):e0219781. https://doi.org/10.1371/journal.pone.0219781.
Howe TE, Rochester L, Neil F, et al. Exercise for improving balance in older people. Cochrane Database Syst Rev. 2011;(11):CD004963. https://doi.org/10.1002/14651858.
Lai CH, Chen HC, Liou TH, et al. Exercise Interventions for individuals with neurological disorders: a systematic review of systematic reviews. Am J Phys Med Rehabil. 2019;98(10):921-930. https://doi.org/10.1097/PHM.0000000000001247.
Van Sant AF. Movement system diagnosis. J Neurol Phys Ther. 2017;41 Suppl 3:S10-S16. https://doi.org/10.1097/NPT.0000000000000152.
Sibley KM, Straus SE, Inness EL, et al. Balance assessment practices and use of standardized balance measures among Ontario physical therapists. Phys Ther. 2011;91(11):1583-1591. https://doi.org/10.2522/ptj.20110063.
Oates A, Arnold C, Walker-Johnston J, et al. Balance assessment practices of Saskatchewan physiotherapists: a brief report of survey findings. Physiother Can. 2017;69(3):217-225. https://doi.org/10.3138/ptc.2016-47.
Sibley KM, Straus SE, Inness EL, et al. Clinical balance assessment: perceptions of commonly-used standardized measures and current practices among physiotherapists in Ontario, Canada. Implement Sci. 2013;8:33. https://doi.org/10.1186/1748-5908-8-33.
Sharma A, Duc NT, Thang TL, et al. Consensus-based checklist for reporting of survey studies (CROSS). J Gen Intern Med. 2021;36(10):3179-3187. https://doi.org/10.1007/s11606-021-06737-1.
Wainwright SF, Shepard KF, Harman LB, et al. Novice and experienced physical therapist clinicians: a comparison of how reflection is used to inform the clinical decision-making process. Phys Ther. 2010;90(1):75-88. https://doi.org/10.2522/ptj.20090077.
Soubra R, Chkeir A, Novella JL. A systematic review of thirty-one assessment tests to evaluate mobility in older adults. Biomed Res Int. 2019;2019:1354362. https://doi.org/10.1155/2019/1354362.
van Bloemendaal M, van de Water AT, van de Port IG. Walking tests for stroke survivors: a systematic review of their measurement properties. Disabil Rehabil. 2012;34(26):2207-2221. https://doi.org/10.3109/09638288.2012.680649.
Caldara B, Asenzo AI, Brusotti Paglia G, et al. Adaptación cultural y validación del Dizziness Handicap Inventory: versión Argentina. Acta Otorrinolaringol Esp. 2012;63(2):106-114. https://doi.org/10.1016/j.otorri.2011.09.006.
Whitehead AL, Julious SA, Cooper CL, et al. Estimating the sample size for a pilot randomised trial to minimise the overall trial sample size for the external pilot and main trial for a continuous outcome variable. Stat Methods Med Res. 2016;25(3):1057-1073. https://doi.org/10.1177/0962280215588241.
National Library of Medicine. Medical Subject Headings. Expert
testimony [Internet]. Bethesda; NLM; 1966. [citado 2023 jun 26].
Disponible en: https://www.ncbi.nlm.nih.gov/mesh/68005104.
Hill R. What sample size is “enough” in internet survey research. Interpersonal Computing and Technology. 1998;6(3-4):1-2.
Gill-Body KM, Hedman LD, Plummer L, et al. Movement system diagnoses for balance dysfunction: recommendations from the Academy of Neurologic Physical Therapy's Movement System Task Force. Phys Ther. 2021;101(9):pzab153. https://doi.org/10.1093/ptj/pzab153.
Renteria C, Berg K. Colombian physiotherapists' use of functional outcome measures in their practice. Physiother Can. 2019;71(3):239-249. https://doi.org/10.3138/ptc.2018-31.
Grimshaw JM, Shirran L, Thomas R,et al. Changing provider behavior: an overview of systematic reviews of interventions. Med Care. 2001;39(8 Suppl 2):II2-45.
French SD, Green SE, O'Connor DA, et al. Developing theory-informed behaviour change interventions to implement evidence into practice: a systematic approach using the Theoretical Domains Framework. Implement Sci. 2012;7:38. https://doi.org/10.1186/1748-5908-7-38.
Birken SA, Lee SY, Weiner BJ. Uncovering middle managers' role in healthcare innovation implementation. Implement Sci. 2012;7:28. https://doi.org/10.1186/1748-5908-7-28