Effect of Muscle Strengthening on the Incidence of Psychomotor Disadaptation Syndrome After a Fall in Elderly Persons
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 发起方
- 入组人数
- 200
- 试验地点
- 2
- 主要终点
- Incidence of psychomotor disadaptation syndrome
研究概览
简要总结
The post-fall syndrome or psychomotor disadaptation syndrome can be considered as a complication of a fall and can lead to a total loss of autonomy. This syndrome remains little studied, despite its important frequency in acute geriatric services or geriatric rehabilitation care, and despite its recognized seriousness. Decreased grip strength seems to be a risk factor for psychomotor disadaptation syndrome in after a fall, which is why we hypothesize that muscle strengthening adapted to the elderly subject would limit the appearance of this syndrome. By limiting this risk, it would reduce complications such as loss of functional independence, but also reduce the number and duration of hospitalization of elderly patients.
详细描述
The participants will be referred by the attending physicians, the physicians of the emergency department or the conventional hospitalization services of the University Hospital of Strasbourg to the "fall" consultation held at the Robertsau Hospital in geriatrics. Participants will be evaluated by experienced geriatricians. As part of their routine care, participants will receive
- A medical assessment
- Medical history,
- Significant medical history and assessment of comorbidities using the Charlson score,
- Medications and ONS (Oral Nutritional Supplements),
- Lifestyle,
- Complete clinical examination with orthostatic hypotension test and ECG,
- Cognitive assessment with MMSE,
- Retrieval of latest imaging and biology results.
If and only if the subject has signed his consent, the following measurements will be performed:
- Grip strength using a manometer,
- Gait assessment (gaitride® treadmill).
As in current practice, the patient will then be referred by the investigator to the ABRAPA day hospitals. They will then receive adapted management at the day hospital within 4 to 6 weeks of inclusion.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Prevention
- 盲法
- Triple (Participant, Care Provider, Investigator)
入排标准
- 年龄范围
- 70 Years 至 —（Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Subject over 70 years of age at the time of signing the consent, with no upper limit,
- •History of a fall,
- •Subject affiliated with a social health insurance plan, beneficiary or beneficiary's assistant
- •Subject able to understand the objectives and risks of the research and to give dated and signed informed consent.
排除标准
- •Osteoarticular limitations compromising muscle strengthening,
- •Unstabilized cardiac pathologies,
- •Unstabilized chronic pathologies,
- •Unstabilized ventricular and supraventricular rhythm disorders or ECG abnormalities at the inclusion visit,
- •Swallowing disorders (CNO)
- •Acute coronary syndrome < 1 month,
- •Unstabilized or oxygen-dependent respiratory failure,
- •Cognitive impairment compromising muscle strengthening achievement (MMSE<22/30),
- •Evolving cancers,
- •Subject under guardianship or curatorship,
- •Severe malnutrition,
- •Severe functional limitation.
结局指标
主要结局
Incidence of psychomotor disadaptation syndrome
时间窗: 2 years
The primary endpoint will be the incidence of psychomotor disadaptation syndrome after a fall in subjects over 70 years of age who are receiving or not receiving adapted muscle strengthening. The determination of the psychomotor disadaptation syndrome is clinical and includes retropulsion, fear of falling, fear of verticality, oppositional hypertonia or an abrupt break with the previous functional state without obvious organic cause. It can be identified after of a fall by the family, by the nurses and physiotherapists in charge of the participants, by the doctors and physiotherapists of the HDJ, by their GP, by the emergency physicians if the patient is referred to the emergency room, by the hospital doctors in case of hospitalization, and will be identified during the visits at 1 and 2 years and during the telephone calls every 4 months.
次要结局
- Incidence of psychomotor disadaptation syndrome complications following a fall(2 years)