Effects of case management on motor and environmental risk factors for falls in faller older people with possible mild cognitive impairment: a randomized clinical trial effects of case management in older people
摘要
Falls in the older people with possible mild cognitive impairment are considered a public health problem and their consequences bring physical, psychological and financial losses.
ObjectiveTo verify the effectiveness of an intervention based on case management on motor and environmental risk factors for falls in community-dwelling faller older people with possible mild cognitive impairment.
DesignThis is a randomized clinical trial.
SettingThe study developed in the years 2021 and 2022.
ParticipantsParticipants were faller older people with cognitive deficits. The participants were divided into two groups: Control Group (CG) and Intervention Group (IG).
InterventionsThe IG underwent case management for 16 weeks conducted remotely, which involved a multidimensional assessment, explanation of the identified risk factors for falls, completion of intervention proposal based on the identified risks.
Main outcome measuresThere were an initial assessment, a final assessment after 16 weeks, and a follow-up assessment after 6 weeks, remotely. The Short Physical Performance Battery (SPPB), Timed up and Go test (TUG) and TUG dual task, Manchester Index, Home Falls and Accidents Screening Tool (HOME FAST) were used, as well as foot inspection and shoe questionnaire.
ResultsThe total sample consisted of 52 older people, 25 from the CG and 27 from the IG. There was no significant interaction between groups and moments. The CG presented a worse performance in muscle strength when compared to the IG, regardless of the assessment. In feet and footwear, there was a significant difference between groups (CG and IG) in the initial assessment and between assessments in both CG and IG.
ConclusionThere was no effectiveness of an intervention based on case management on the motor risk factors for falls in faller older people with possible mild cognitive impairment. However, regarding environmental risk factors, specifically the use of footwear, it was possible to verify changes regarding the use after the intervention and follow-up, with adherence to the recommendations given.