Preventing falls on an elderly care rehabilitation ward

Abstract

Objective: Comparison of two flooring types – carpet and vinyl – in the bed areas, and two modes of physiotherapy – conventional therapy and additional leg strengthening exercises – in avoiding falls. Design: Randomized 2 × 2 controlled trial. Setting: Elderly care rehabilitation ward in a community hospital. Subjects: Fifty-four consecutive patients referred for rehabilitation. Outcome measures: The incidence of falls, and the change in strength. Results: There were 10 falls on carpet, and only a single fall on vinyl floor covering (relative risk 8.3, 95% confidence interval 0.95–73, p = 0.05). There were four falls in those receiving additional exercise, and seven falls in those receiving only conventional physiotherapy (relative risk 0.21, 95% confidence interval 0.04–1.2, p = 0.12). Fifty-nine per cent of patients were able to complete strength measurements on admission and discharge. In these, handgrip strength improved more in those given additional exercise than conventional physiotherapy (2.1 kg versus – 0.3 kg, p < 0.05). Conclusion: There is no evidence to support either intervention in preventing falls on a rehabilitation ward, but within this low-powered study, there was a strong trend towards vinyl being superior.