Date Presented 04/200/21 Rural-dwelling older adults experience health care disparities and limited access to physical activity programming. The purpose of this study was to examine fall-related outcomes following a 12-week yoga intervention designed for rural older adults. Significant improvements in the Canadian Occupational Performance Measure and MiniBESTest were observed, suggesting that yoga could be an appropriate and accessible strategy for addressing fall prevention and occupational performance in rural-dwelling older adults. Primary Author and Speaker: Alicia Oestreich Additional Authors and Speakers: Julia Bieber, Christine Auriemma, Casey Flanigan, Hannah Frolli, Maria McGloin, Meghan O'Brien, Emma Oliver, and Tara Schorr

Date Presented 04/20/21 Most research studying fall experiences and fall prevention program preferences focuses on older adults, overlooking the falls that occur in midlife. This pilot study gathered preliminary data on fall experiences, consequences, and fall prevention preferences of adults in midlife. Almost all participants experienced functional consequences from their fall and had interest in learning about fall prevention, suggesting that fall prevention programs could be beneficial for middle-aged adults. Primary Author and Speaker: Meredith H. Lee Additional Authors and Speakers: Rachel Reed Contributing Authors: Samantha Grant, Jodi Thomas, and Roy St. Laurent

Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. Using a quasi-experimental design, the feasibility of the Stroll Safe outdoor fall prevention program was examined. Process, scientific, management, and resource assessments were conducted. Results reveal that the program is feasible to implement among active, community-dwelling older adults. Further study using an efficacy trial is warranted. This study helps to build the body of knowledge in outdoor fall prevention, an area of research and practice that is critical to productive aging. Primary Author and Speaker: Tracy Chippendale

Importance: Falls have a considerable physical and psychological impact on people with spinal cord injury (SCI). Occupational therapy practitioners require evidence to support the timely development of occupation-based programs that can be applied to fall prevention in daily life. Objective: To determine what is known about falls after SCI, including wheelchair users and people who are ambulatory, and to understand elements of fall prevention to be addressed by occupational therapy practitioners. We applied the Canadian Measure of Occupational Performance and Engagement to understand elements to be addressed in fall education and prevention with this population. Data Sources: We searched eight databases using the key words falls and spinal cord injury with no limit set on dates. Study Selection and Data Collection: Studies were included that reported on falls among adults with SCI and measured one or more of the following: incidence of falls, consequences of falls, contributing factors for falls, the person’s experience of falls, and strategies to prevent falls. Findings: Thirty-five articles were included. The majority of the articles included information on the incidence (n = 20), consequences (n = 26), and contributing factors (n = 30) of falls. Two articles analyzed the person’s experience of falls, and 1 study reviewed a fall prevention program for people with SCI specifically. Conclusions and Relevance: Research on participants’ experience of falls and fall prevention programs used in spinal cord rehabilitation is extremely limited. Future research on the lived experience of falls for people with SCI is warranted. What This Article Adds: This review of evidence on falls after SCI highlights gaps in the current available evidence.

OBJECTIVE. Accidental falls among community-dwelling older adults are preventable and increase the risk of morbidity, hospitalization, and institutionalization. We updated and broadened a 2008 systematic review examining the evidence for the effectiveness of fall prevention interventions in improving fall-related outcomes, occupational performance, quality of life, and health care facility readmissions for community-dwelling older adults. METHOD. We searched and analyzed literature published from 2008 to 2015 from five electronic databases. RESULTS. Fifty articles met the inclusion criteria and were critically appraised and synthesized—37 provided Level I; 5, Level II; and 8, Level III evidence. Analysis was organized into four intervention themes: single component, multicomponent, multifactorial, and population based. Mixed evidence was found for single-component and multifactorial interventions, strong evidence was found for multicomponent interventions, and moderate evidence was found for population-based interventions. CONCLUSION. These findings can inform the delivery and integration of fall prevention interventions from acute care to community discharge.

The purpose of this study was to report the development of the Falls Behavioral (FaB) Scale for Older People, an assessment designed to evaluate behavioral factors that could potentially protect against falling. Instrument development included content analysis, expert review, and factor analysis. Ten behavioral dimensions were identified including Cognitive Adaptations, Protective Mobility, Avoidance, Awareness, Pace, Practical Strategies, Displacing Activities, Being Observant, Changes in Level, and Getting to the Phone. The final 30item scale had a Content Validity Index of 0.93. Test–retest reliability was ICC = 0.94 (p < .01). Construct validity was established by showing that, as expected, scale scores were positively associated with increasing age (rs = 0.46, p < .01) and negatively associated with greater physical mobility (rs = −0.68, p < .01). People who had fallen utilized safer behaviors than those who had not reported a fall (p < .05) providing a benchmark for using the scale in future studies. The FaB is an easily completed, reliable, and valid tool for determining the presence or absence of protective behaviors. It has potential to assist in goal setting for falls prevention and to evaluate behavioral outcomes of fall prevention programs.

Objective. This study examined adherence to home modification recommendations made by an occupational therapist and attempted to identify predictors of adherence. Method. An experienced occupational therapist visited the homes of 178 people (mean age = 76.4 years) to evaluate for and recommend appropriate home modifications for falls prevention. One year later, a research assistant visited these persons’ homes to assess adherence. Results. At least one home modification was recommended in 150 of the 178 homes visited. The most common recommendations were to remove mats and throw rugs (48%), to change footwear (24%), and to use a nonslip bathmat (21%). In the 121 homes revisited after 12 months, 419 home modifications had been recommended, and 216 (52%) were met with partial or complete adherence. The only significant predictors of adherence were a belief that home modifications can prevent falls and having help at home from relatives. Conclusion. A major barrier to adherence to home modification recommendations is that many older people do not believe that home modifications can reduce their risk of falling.