TUG test results in patients found through general practice falls risk screening

An innovative approach to falls risk assessment within primary care, and using a voluntary-service led exercise intervention, shows significant results in reducing Timed Up and Go scores.

Timed Up and Go test results in patients found through general practice falls risk screening. Preliminary evaluation of the North Tyneside Falls Prevention Service (NTFPS).

Introduction: Falls are a major health and health economic burden but case ascertainment remains inadequate. The NTFPS was developed to proactively screen for falls risk factors in primary care. We present data from the Service's strength and balance training classes run with Age UK North-Tyneside.

Methods: General practice case notes of those >60 years are screened for falls risk factors and syncope. Patients excluded if known to existing services. Screening questionnaire sent and those at risk invited to attend comprehensive multidisciplinary assessment per NICE guidelines.

All given advice on exercise and falls prevention and supplied with relevant literature. Where significant gait and balance problems identified per senior physiotherapy musculoskeletal and falls assessment (including Timed-up and Go Test[TUG], Short Physical Performance Battery), patients may receive:

• Targeted home exercises, leaflets
• Referral to associated Age UK strength and balance classes depending on mobility, ability, TUG (>13.5 sec high risk of falling)
• Community physiotherapy, day hospital referral
• Suggestions for referral for orthopaedic review

Strength and balance training classes:

Ten x weekly, 1 hour sessions of targeted, individualised exercises in small group setting (up to 10 participants) delivered by personal trainer.

We report on the first consecutive 187 individuals to complete the strength and balance training programme.

Results: Total 187 Mean age 76.6 years (range 60-89), 129(69%) female TUG results as below:

Conclusion: This novel approach identifies patients with significant gait and balance abnormalities otherwise not coming to the attention of services. Appropriate triage and referral results in highly significant reductions in TUG results, with concomitant benefits in terms of falls risk reduction. Longer follow up data are needed to examine the longevity of these benefits.

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