=CHAIR STAND TEST=Falls
•Leading cause of severe injury in older people
•Each year, falls occur in over a third of persons over age 65, and in over half of persons over age 75.
•Of those who fall, 20% to 30% suffer moderate to severe injuries that make it hard for them to get around or live independently, and increase their risk of early death
•In 2000, the total direct medical costs of all fall injuries for people 65 and older exceeded $19 billion: $0.2 billion for fatal falls, and $19 billion for nonfatal falls.
•In a study of people age 72 and older, the average health care cost of a fall injury totaled $19,440, which included hospital, nursing home, emergency room, and home health care, but not doctors’ services===http://www.cdc.gov/homeandrecreationalsafety/Falls/data/cost-estimates.html===

What causes falls?
•A study performed to identify and rank risk factors for falling among institutionalized and not institutionalized elderly persons found that 3 factors were strongly associated with falling among subjects(2)•Poor balance •Number of prescribed medications•Hip weakness. The link to the study can be found here: http://archinte.ama-assn.org.proxy.kumc.edu:2048/cgi/reprint/149/7/1628UCSF Fall Risk Assessment•Poor balance- Tinettis, Functional Mobility Page 1, check box for balance problems, Functional Mobility Page 2, written comments on functional assessment. •Number of prescribed medications- Medication Reconciliation at SOC, medication changes on daily note, medication profile •Hip weakness- How do we test?= MMT only
How important is testing for muscle weakness in our patients?
Muscle Weakness and Falls in Older Adults: A Systematic Review and Meta-Analysis(4)
Search of MEDLINE produced 759 citations, and CINAH produced 334 citations, other titles and abstracts 127 relevant articles.Inclusion criteria:1. 50% of study sample were aged 65 and older.2. Muscle strength was evaluated as a risk factor3. Falling was one of the outcomes studied4. Prospective design (muscle strength was measured before the follow-up for the occurrence of falls).5. Studies of patients during hospitalization for an acute event were excluded.13 independent studies were extracted.Forest Plot Link to the study can be found here:
http://onlinelibrary.wiley.com.proxy.kumc.edu:2048/doi/10.1111/j.1532-5415.2004.52310.x/full
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A 30-s chair-stand test as a measure of lower body strength in community-residing older adults
//C Jessie Jones, Robert E Rikli//, //William C Beam//. Research Quarterly for Exercise and Sport. : Jun 1999.
76 community dwelling adults were studied.Two 30 second chair stand tests 2-5 days apart, and maximum weight-adjusted leg-press performance. Test-retest intraclass correlations of .84 for men and .92 for women.
They also found a moderate correlation between chair-stand performance and maximum weight adjusted leg press performance for both men and women with r values ranging from .71 to .78. This is great information for home health since we do not carry around weights to perform a 1 repetition maximum test.
The results of this study suggest that the 30-s chair stand has good test-retest reliability and provides a reasonably valid indication of lower body strength in generally active, community-dwelling older adults. It provides practitioners with a simple and effective tool for assessing lower body strength and detecting muscle weakness in generally active, community residing older adults. The link to this article can be found here:
http://proquest.umi.com.proxy.kumc.edu:2048/pqdweb?index=2&did=42448738&SrchMode=3&sid=1&Fmt=4&VInst=PROD&VType=PQD&RQT=309&VName=PQD&TS=1333516840&clientId=25203&aid=1

Chair stand test on youtube:

http://www.youtube.com/watch?v=soDEx4l3fWA