Sturzrisikoassessment während der Rehabilitation nach osteoporotischen Frakturen

Zusammenfassung

Ein Sturz, insbesondere jener, der zu einer proximalen Extremitätenfraktur führt, ist meist Zeichen von funktionellen Defiziten, mangelnden Kompensationsfähigkeiten und stellt häufig einen Eintritt in eine Negativspirale dar. Rehabilitation nach osteosynthetisch versorgten Frakturen kann zu einer Verbesserung der Selbsthilfefähigkeit, Verlängerung der Autonomie und der Pflegeabhängigkeit beitragen. Dennoch ist es wichtig, bereits während der Rehabilitation aktuelle Defizite und Ressourcen aufzuzeigen. Im Sinnes des ICF (international classification of functioning) geht es nicht nur um das aktuelle Ereignis, sondern auch um die daraus resultierenden Funktionseinschränkungen, die zum Handicap führen. Die Kontextfaktoren und die Persönlichkeit spielen dabei eine relevante Rolle. Im Rahmen des Assessments werden klinische Eindrücke in nachvollziehbare Parameter geformt. Handlungsfelder im Rahmen des Entlassungsmanagements werden klar definiert und können gefüllt werden. Letzten Endes können auch Patienten die Alltagsrelevanz der Einschränkungen besser verstehen und sind vielleicht eher bereit, protektive Maßnahmen zu akzeptieren. In diesem Sinne werden einige Assessmentinstrumente vorgestellt und kritisch im Hinblick auf ihre prognostische Relevanz beleuchtet.

Summary

Falls are common in old age. Falls which are leading to a proximal femur fracture are most often signs and symptoms for functional decline and (pre-)frailty. Rehabilitation can help to regain mobility, prevent functional decline as well as dependency. Nevertheless already during the rehabilitation process the focus should be on deficits and resources. The model of ICF (international classification of functioning) brings together the aspects of disease or trauma, functional decline and therefore handicap, including social exclusion. The individual personality and the social environment are included in the comprehensive model. The comprehensive geriatric assessment is part of the rehabilitation process. The collected data lead to a rehabilitation plan including discharge management and preventive strategies for further falls and fractures. The publication shows different aspects of assessment tools and their prognostic value.

Schlüsselwörter

Osteoporose - Sturzrisiko - Assessment - Alter

Keywords

Osteoporosis - risk of falls - assessment - old age

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