Implementation of falls risk evaluation at one-year after total hip arthroplasty: a cross-sectional study

Tony Adebero; Pavlos Bobos; Lyndsay Somerville; James Howard; Edward M Vasarhelyi; Brent Lanting; Susan W Hunter

doi:10.1186/s40945-022-00141-6

Implementation of falls risk evaluation at one-year after total hip arthroplasty: a cross-sectional study

Arch Physiother. 2022 Jul 15;12(1):16. doi: 10.1186/s40945-022-00141-6.

Authors

Tony Adebero¹, Pavlos Bobos^{1

2

3}, Lyndsay Somerville⁴, James Howard⁴, Edward M Vasarhelyi⁴, Brent Lanting⁴, Susan W Hunter^{5

6}

Affiliations

¹ Faculty of Health Sciences, Department of Health and Rehabilitation Sciences, University of Western Ontario, London, ON, Canada.
² Applied Health Research Centre, Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, ON, Canada.
³ Dalla Lana School of Public Health, Institute of Health Policy, Management and Evaluation, Department of Clinical Epidemiology and Health Care Research, University of Toronto, Toronto, ON, Canada.
⁴ Schulich School of Medicine & Dentistry, Department of Surgery, University of Western Ontario, London, ON, Canada.
⁵ Faculty of Health Sciences, Department of Health and Rehabilitation Sciences, University of Western Ontario, London, ON, Canada. susan.hunter@uwo.ca.
⁶ School of Physical Therapy, University of Western Ontario, London, ON, Canada. susan.hunter@uwo.ca.

Abstract

Background: Research has demonstrated an increased risk of falls after total hip arthroplasty (THA). Yet, people's knowledge on falls risk factors and how falls prevention strategies are being used after THA have not been examined. If a person's knowledge of falls and self-efficacy about falls prevention strategies is low this would indicate a pressing need for interventions to lessen risk. The study objectives were: 1) to determine the falls knowledge and what fall prevention strategies people used after (THA) and 2) to determine the outcomes of a falls risk assessment at 12-months after unilateral THA.

Methods: Overall, 108 people completed the Falls Risk for Older People - Community Setting (FROP-Com) scale, a falls questionnaire (covered occurrence of falls, knowledge on falls risk factors, falls prevention strategies implemented after THA surgery), 6-m Walk Test (6mWT), 30-Second Chair Stand Test (30CST), Timed-up and Go (TUG) Test, and Activities-specific Balance Confidence Scale (ABC).

Results: Twenty-five (23.2%) people fell at least once in the 12 months after THA. Scores on the FROP-Com ranged from 2-20 with an average of 8.2 ± 3.6 indicating a mild falls risk. The importance of falling compared to other health concerns was rated as moderate to high (6.8 ± 2.9) and the majority of participants (n = 98, 90.7%) believed falls can be prevented after THA. Total scores on the ABC scale ranged from 30.6% to 100.0% with an average score of 84.4 ± 15.5%, indicating high function. Only 47 people (43.5%) reported receiving falls prevention education. A total of 101 falls prevention strategies were completed by 67 people (62%), the most common strategy was environmental modifications (e.g., installation of grab bars) at 37.4%, while exercise was mentioned by only 2%. The majority of people had functional deficits in 30CST (62%) and TUG (76.9%) at 12-months after unilateral THA.

Conclusions: Almost a quarter of the sample had experienced a fall in the 12-months after THA and functional deficits were common. The majority of the sample had proactively implemented falls prevention strategies after the surgery. Yet importantly, people after THA had limited exposure to falls prevention education and implemented a limited range of prevention strategies.

Keywords: Accidental falls; Aged; Hip arthroplasty; Osteoarthritis.