STEADI Screening Evaluation Of Integrated Rehabilitation In Beijing District Urban And Rural Elderly Fall Risk Prevention

Research objectives:Stopping Elderly Accidents,Deaths,Injuries Tool Kit STEADI(Stopping Elderly Accidents,Deaths,Injuries Tool Kit)is a tool developed by Centers for Disease Control and Prevention(CDC)in the United States,which integrates screening,assessment and intervention to prevent accidental falls in the elderly.In this study,the self-assessment scale of elderly fall risk in 2019 Chinese version STEADI Kit was used to investigate the fall incidence and fall risk of urban and rural elderly in a district of Beijing,and the health education in the kit was combined with simple and feasible home exercise method to intervene the fall risk factors of urban and rural elderly.To explore the effect of STEADI2019 edition of screening evaluation and prevention integrated rehabilitation tool on reducing the fall risk of urban and rural elderly.Research methods:According to the inclusion and exclusion criteria,300 urban and rural elderly subjects were recruited to investigate the basic information of the elderly,including demographic data(name,gender,age)and fall risk factors(education level,chronic disease type,residence style,spouse or not,whether they participated in physical exercise).Fall risk was assessed by STEADI kit containing 12 items of self-assessment scale of fall risk,and fall situation and risk factors affecting falls of urban and rural elderly were analyzed.According to the scores of the self-assessment scale of fall risk,140 elderly people who agreed to participate in the intervention were divided into four groups,namely,urban at risk group,urban at risk group,rural at risk group and rural at risk group with 35 cases each.Balance function and lower limb strength were evaluated by the 3m stand up and walk test,the four-stage balance test and the 30 s chair sit-stand test in the STEADI kit.Moreover,the intervention method of STEADI kit was adopted to carry out fall prevention health education for the elderly in the risk-free group(including fall prevention science,such as changing suitable shoes,etc.),and the intervention cycle of the elderly in the risk group was 3 months,once a day,10-20 minutes each time,on the basis of the fall prevention health education combined with the simple and feasible sitting and standing training in the kit.The changes of various indexes of the elderly before and after intervention were compared by using wechat as a form of supervision.Research results:(1)The survey showed that the incidence of falls among urban and rural elderly was18.67% and 20.67% respectively.Based on STEADI screening method in integrated rehabilitation,it is concluded that the proportion of urban elderly at risk of falling is 28%,and the proportion of rural elderly at risk of falling is 34%.(2)The elderly with or without fall risk in urban and rural Chaoyang District of Beijing had statistical differences in gender,age,education level,number of chronic diseases,living style,spouse or not,whether to participate in physical exercise and 12 items of the self-assessment scale of fall risk.Regression analysis results show that the main common risk factors for falls among urban and rural elderly in Chaoyang District of Beijing are old age(>70 years old),living alone,lack of physical exercise,multiple chronic diseases,five items in the self-assessment scale of fall risk,including falling in the past year,sometimes feeling unstable walking,fear of falling,lower limb sensory disorders,and taking drugs that may cause dizziness or fatigue.Among them,the unique fall risk factor of urban elderly is low education level;The risk factor specific to the rural elderly is female.Before intervention,except for standing with feet together in the four-stage balance test,there were differences in fall risk scores between urban and rural risk groups and non-risk groups(P<0.05)in the 30 s chair sitting-standing test,front and back wrong half standing,toe heel touch standing,one-foot standing and 3m stand up and walk test,as well as in the other 30-30 s chair sitting-standing test,four-stage balance test.After 3 months of health education,there were no statistical differences in 30 s chair sitting-standing test,four-stage balance test,3m standing up and walking test and fall risk scores of the elderly in urban and rural risk-free group after intervention compared with those before intervention(P>0.05).After 3 months of health education combined with sitting and standing training,after intervention,there were statistically significant differences between urban and rural risk groups in 30 s chair-standing test,four-stage balance test in front and back wrong half foot standing,toe heel touch standing and standing time on one foot,3m standing and walking test scores and fall risk scores compared with before intervention.There was no significant difference between urban and rural risk-free groups before and after intervention(P>0.05).Research conclusion:(1)The fall incidence and fall risk of the rural elderly in Chaoyang District of Beijing were higher than that of the urban elderly,but the difference was not significant.(2)Common factors affecting the elderly in urban and rural areas are old age(>70 years old),living alone,lack of physical exercise,suffering from multiple chronic diseases,five items in the self-assessment scale of fall risk,including falling in the past year,sometimes feeling unstable walking,worrying about falling,lower limb sensory disorders,taking drugs that may cause dizziness or fatigue.Among them,the unique fall risk factor of urban elderly is low education level;The unique fall risk factor of rural elderly was female.(3)STEADI integrated screening assessment and prevention rehabilitation can effectively improve the balance ability and lower limb strength of urban and rural elderly at risk and further reduce the risk of falling.It is a simple and easy home exercise kit recommended for the elderly.