Browsing by Subject "Falls (Accidents) in old age"
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Item Fall prevention nurse education in the long-term care setting(Texas Tech University, 2004-08) DiBenedetto, Paula JFalls are the number one cause of injury among elderly persons. This has been a tremendous concern for long-term care administrators, nurses and families, in the twenty-first century. The purpose of this study was to examine nurses' attitudes/perceptions in regard to elder falls, and their knowledge of fall prevention measures, prior to and post implementation of a fall prevention education program. A quasi-experimental pre-post test design was used. The instrument was pilot tested in long-term care settings. Four groups of vocational nursing students were randomly assigned to the control group (n=59) and the experimental group (n=56), for a total of 115 participants. Participants included those vocational nursing students present on the day of the program. Three research questions were tested, using ANCOVA and multiple regression techniques. There have been many studies that examined factors associated with falling among elderly persons. However, this project entailed the implementation of a nursing education program for staff in the long-term care setting, and the development of an instrument to assess nurses' attitudes/perceptions, as well as knowledge. The findings show that there were significant differences between post-test scores of the experimental and control groups for both attitudes and knowledge with regard to fall prevention in the long-term care setting. Background variables were not significant in relation to attitudes. However, three background variables were significant in relation to knowledge. It is suggested that the program be replicated and extended over a longer period of time to explore the reduction of falls in long-term care facilities. This study and its application of fall prevention education designed for nurses working in the long-term care setting has practical implications for administrators, nurses, and families. The incorporation of fall prevention techniques in the long-term care setting by these key individuals can help to ensure a safe environment for elderly persons. Educational opportunities may improve staff attitudes/perceptions, and nursing practice in reducing the risk of elderly persons experiencing falls. Further research that explores the educational means of reducing falls in long-term care settings is recommended.Item Kinematic and motor variability and stability during gait: effects of age, walking speed and segment height(2007-12) Kang, Hyun Gu, 1978-; Dingwell, Jonathan B.To understand how falls occur during walking in older adults, we need to understand how the nervous system maintains stability, and how aging affects walking. Four studies were conducted to better understand the effect of age on gait. Older adults display higher gait variability compared to young adults, possibly because of their slower walking. We compared gait stability at multiple controlled walking speeds. Greater gait variability in healthy elderly existed independent of slower walking. Their diminished strength and flexibility partly explained this difference. To explain slower walking in the elderly, some have suggested that muscle weakness and stiffness may force people to walk slower. Others have suggested that people choose to walk slower to be more stable. We compared dynamic stability of gait at multiple speeds. Healthy older adults also exhibited more stability at slower speeds, yet walked at speeds comparable to young adults despite the lower strength and flexibility. Therefore, weakness and stiffness may not force healthy older adults to walk slower. The goal of the nervous system during walking may be to maintain stability of superior segments. We tested whether superior segments are more stable than inferior segments during walking. Superior segments exhibited less orbital stability during preferred walking speed, in contrast to previous suggestions. This highlighted the importance of trunk control during gait. The effects of aging on the fluctuations in the muscle activity during gait are not well understood. We quantified the stride-to-stride fluctuations of EMG as a measure of muscle activation patterns in state-space. Variability increased with speed except in the gastrocnemius. Orbital stability was less in older adults, suggesting that deviations in the EMG amplitude pattern were not readily corrected. Less local stability was seen in older adults, suggesting that older adults were more sensitive to perturbations. Together, these findings suggest that trunk control is important during gait. Strength and flexibility deficits help explain higher variability and lower stability in older adults. Future work will need to address the effect of strength interventions, neurophysiological decline on gait stability and fall risk.Item The effect of selected residential carpeting on the balance and gait of older healthy adults(Texas Tech University, 1999-05) Dickinson, Joan I.Although carpet on pad is the most common residential floor covering used in the home, there are no recommendations or design guidelines for carpet selection specific to different age groups. Furthermore, the contribution of carpet and pad to balance and gait problems in the older adult is largely unknown. The purpose of this research was to determine whether selected residential carpet and pad contributed to balance and gait problems among healthy, communitydwelling older adults. Twenty-five older adults (mean age 73.25; s.d. ± 7.48) were recruited through various organizations located in Lubbock, TX. Subjects were free from existing conditions that may have affected balance control. Balance was measured using the NeuroCom Computerized Posturography balance machine, while gait speed, number of steps, manner of turning, weaving, sitting to standing, standing to sitting, timed one-leg stance, and change in gait speed were measured for the gait component. Subjects were exposed to the Sensory Organization Test (SOT) while standing on the selected residential carpet (i.e., a 36 ounce, 1/2 in. pile height, 1/8 in. gauge, cut pile carpet) and pad (i.e., a rebonded polyurethane, six pound density, 7/16 in. thick padding). Subjects also walked a 12'-0" gait course on the carpeting and vinyl tile. Postural sway significantly increased on the carpet only when subjects had their eyes closed and the forceplate on the balance machine moved. Balance strategy was not affected by the carpet. Subjects were able to adapt to the sensory limitations by adopting an ankle strategy regardless of the floor surface. The older adults walked significantly slower on the carpet versus the vinyl tile suggesting that these subjects were more hesitant when they encountered a compliant surface. The results of this study indicate limited subject difficulty maintaining static or dynamic balance when standing on the selected carpet. Thus, healthy, community-dwelling senior citizens may want to consider installing this type of carpet in their home. In the future, however, replications of this study are needed using larger sample sizes. If the findings are conclusive, then older adults may feel confident that this type of carpeting does not contribute to falling within the residential environment.