Toshio Teranishi, RPT, PhD, Izumi Kondo, MD, PhD, Genichi Tanino, RPT, MSc, Hiroyuki
Miyasaka, OTR, MSc, Hiroaki Sakurai, RPT, MSc, Junko Kaga, RPT, BA, Yukari Suzuki, RPT,
PhD, Ayako Matsushima, RN, Minako Kawakita, RN, Shigeru Sonoda, MD, PhD
Jpn J Compr Rehabil Sci 4: 7-13, 2013
Purpose: A simple and discriminative method for
evaluating the ability to maintain balance, the Standing
test for Imbalance and DisEquilibrium (SIDE), was
developed for fall risk management. As a preliminary
step toward clinical application of the SIDE, this study
aimed to determine a method of assessing the expected
fall risk by analyzing fall cases using a decision tree
classification for the management of basic movements.
Subjects and method: The subjects of this study were
513 patients who had been discharged from a
convalescence rehabilitation ward over a one-year
period (from January 1, 2010 to December 31, 2010).
In cases when a fall occurred, we investigated the
period from hospitalization and the classification of
the patient, which was made with a decision tree
describing the permitted activities of the patient and
the management of the activities. The frequency of fall
occurrence was determined by considering the number
of patients who fell during every 15-day period during
hospitalization.
Results: One hundred twenty patients fell during
hospitalization. In total, 163 falls occurred. The
incidence of falls was 4.65‰. Thirty patients suffered
multiple falls. The falls occurred significantly more
frequently during the first 15 days after admission.
From classification by the decision tree, 62 falls
occurred while the patients were being managed using
physical restraints and/or sensors, 55 falls occurred
during unpredictable actions of patients when the
patients were not using physical restraints or sensors,
and 26 falls occurred during permitted activities of
patients.
Conclusion: Simple assessments of balance and
adherence are necessary to reduce the occurrence of
patient falls during the early period after admission.
Key words: convalescence rehabilitation ward, fall, classification, decision tree