Determinants of falls risk in older orthopaedic patients

The ageing population faces an increased risk of falling and of the fall
consequences. It is estimated that about 33% of the elderly fall each year and
falls often result in injuries, disability and inactivity. The strongest risk
factors for fall in elderly include previous falls, strength impairments, gait
impairments, balance impairments and medication. A specific population in which
many of the fall risk factors are present are older orthopaedic patients.
Visits of these patients to orthopaedic outpatient departments are often the
direct or indirect result of a fall. Insight in fundamental determinants of
fall risk in elderly orthopaedic patients is lacking but necessary for
developing and implementing specific interventions for this diverse, but highly
fall prone population.

The overall aim of the present study is to identify the determinants of
(recurrent) falls before and after orthopaedic surgery, either due to
fall-related injuries or to lower limb joint replacements, in subpopulations of
older orthopaedic patients. Primary Objectives:
To study differences in retrospective and prospective fall risk and its
associations with (determinants of) strength, balance and gait, 1) between
patients that receive surgery to either the lower extremities or the upper
extremities because of a fall, 2) between patients with osteoarthritis (OA)
that receive either a total hip arthroplasty (THA) or a total knee arthroplasty
(TKA), 3) between patients that receive surgery at the hip either because of OA
or because of a fall.

The study will be a longitudinal observational cohort study with a follow-up of
one year.

The risks associated with participation in this study are considered to be very
low. The burden of participating in this study will be, in addition to care as
usual, the filling in of a questionnaire 5 times (at baseline, 3, 6, 9 and 12
months) and registering the number of falls using a weekly diary for 12 months
for the whole study population. In addition to the usual assessments at the
regular follows-up, also the timed up and go test and a two times 50m walk will
be part of the study. A small representative part of the study population will
be asked to visit the facilities of the Faculty of Human Movements Sciences at
the VU University. These participants will be asked to walk on a treadmill,
perform the Physiological Profile Assessment and wear inertial sensors at home
for three times one week.