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The aim of this monocentric, block-randomized, controlled, open-label, parallel-group study is to assess whether patients presenting to the emergency department (ED) with a fall within the past 7 days would benefit from a physiotherapy intervention, as compared to patients without physiotherapy intervention at the time of ED presentation. Primary objective of this study is to assess "fear of falling" 7 days after ED presentation with versus without a physiotherapy intervention.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| intervention group | Experimental | The study intervention is a brief physiotherapeutic assessment, a brief information on the expected course of the condition, and a brief instruction on self-management, including two exercises for daily self-guided therapy. |
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| control group | No Intervention | The control group will receive written information on the expected course of the condition, written instructions on self-management and written instructions on exercises for daily self-guided therapy. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| physiotherapeutic intervention | Other | The intervention consists of a brief physiotherapeutic assessment, the short physical performance battery, a brief information on the expected course of the condition, a check of fall hazards at home using the "Bundesamt für Unfallverhütung" (bfu) checklist, and instructions on self-management (eg. staying active, adaptation of behavior and surrounding at home). Additionally, two exercises for daily self-guided therapy will be instructed, namely, sit-to-stand and balance performance exercises. |
| Measure | Description | Time Frame |
|---|---|---|
| Change in short International Falls efficacy scale (sFES-I) | Change in the fear of falling between groups at day 7, measured by the short International Falls efficacy scale (sFES-I). It is a 7-item questionnaire where individuals are instructed to score their concern of falling during an activity on a 4 point Likert scale with 1 as not concerned at all and 4 as very concerned. The item scores are summed up to obtain a total, with a higher score indicating a higher fear of falling. | At Day 0 and Day 7 ± 7 days |
| Measure | Description | Time Frame |
|---|---|---|
| Feasibility of the intervention | Feasibility of the intervention assessed by a questionnaire filled out by the physiotherapist | At Day 0 |
| Objective functional levels in the intervention group | Functional levels measured by SPPB in the intervention group |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Roland Bingisser, Prof. Dr. med. | Department of Emergency Medicine, University Hospital Basel | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Department of Emergency Medicine, University Hospital Basel | Basel | 4031 | Switzerland |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 39548032 | Derived | Benhamou J, Espejo T, Riedel HB, Dreher-Hummel T, Garcia-Martinez A, Gubler-Gut B, Kirchberger J, Overberg JA, Perrot G, Bingisser R, Nickel CH. On-site physiotherapy in older emergency department patients following a fall: a randomized controlled trial. Eur Geriatr Med. 2025 Feb;16(1):205-217. doi: 10.1007/s41999-024-01091-x. Epub 2024 Nov 16. |
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| At Day 0 and Day 7 ± 7 days |
| Satisfaction with ED work-up | Patients' satisfaction with ED work-up assessed by questionnaire | Day 7 ± 7 days |
| Change in short International Falls efficacy scale (sFES-I) | Change in the fear of falling, measured by the short International Falls efficacy scale (sFES-I). It is a 16-item questionnaire where individuals are instructed to score their concern of falling during an activity on a 4 point Likert scale with 1 as not concerned at all and 4 as very concerned. The item scores are summed up to obtain a total, with higher the score, higher being the concern for falling. | At Day 0, Day 7 ± 7 days, Day 21 ± 3 days, Day 42 ± 3 days |
| Utilization of medical resources | Comparison of the use of medical resources between both groups (ED visits, GP visits, hospitalization, physiotherapy, imaging; all since inclusion) | Day 7 ± 7 days, Day 21 ± 3 days, Day 42 ± 3 days |
| Occurence of falls | Occurence of falls following randomization from patient recollection | Day 7 ± 7 days, Day 21 ± 3 days, Day 42 ± 3 days |