Effects of the delivery of physiotherapy on the treatment course of elderly fallers presenting to the emergency department: Protocol for a randomized clinical trial

Marie Blandin; Marie Gallet; Christelle Volteau; Philippe Le Conte; Thomas Rulleau; Guillaume Le Sant

doi:10.1371/journal.pone.0303362

Effects of the delivery of physiotherapy on the treatment course of elderly fallers presenting to the emergency department: Protocol for a randomized clinical trial

PLoS One. 2024 May 8;19(5):e0303362. doi: 10.1371/journal.pone.0303362. eCollection 2024.

Authors

Marie Blandin¹, Marie Gallet¹, Christelle Volteau¹, Philippe Le Conte¹, Thomas Rulleau¹, Guillaume Le Sant^{1

2}

Affiliations

¹ Nantes Université, CHU Nantes, Movement - Interactions - Performance, MIP, UR 4334, Nantes, France.
² IFM3R, School of Physiotherapy, St-Sebastien-sur-Loire, France.

Abstract

The use of physiotherapy (PT) in the hospital emergency department (ED) has shown positive results including improvements in patient waiting time, treatment initiation, discharge type, patient outcomes, safety and acceptability of the intervention by medical staffs. These findings originate from studies that primarily focus on musculoskeletal and orthopaedic conditions. Despite a significant number of people visiting the ED, there is a shortage of literature evaluating PT in the ED for elderly populations. The objective of this study is the evaluate the effect of delivering PT in the ED (versus no delivery) in patients aged 75 and over with 'falls' complaints. The main objective is the evaluate the effect on the discharge disposition (discharge home, hospitalization). Secondarily, we will evaluate the effect delivering PT on patient-length of stay, the number of falls at 7 days after admission to the ED, changes between the initial and final medical decision regarding patient orientation, and medical staff satisfaction. This study will follow a prospective longitudinal design involving participants aged 75 years and over. We plan to recruit a total n = 336 patients admitted to the ED with a 'fall' chief complaint. After consent, participants will be randomized into either the 'PT-group' (receiving a prescription and execution of PT within the ED), or to the 'no-PT group' (no delivery of PT within the ED). The PT intervention will involve a standardized assessment of motor capacities using validated clinical examinations, and the delivery of rehabilitative exercises based on individual needs. Outcomes will be recorded from the patient's medical record, and a phone call at 7 days. A questionnaire will be sent to medical staff. The results of this study will help to determine whether PT might be beneficial for the management of this increasing proportion of individuals who come to the ED. Trial registration: (Trial registration number: ClinicalTrials.gov NCT05753319). https://classic.clinicaltrials.gov/ct2/show/NCT05753319.

Copyright: © 2024 Blandin et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Publication types

Clinical Trial Protocol
Research Support, Non-U.S. Gov't

MeSH terms

Accidental Falls*
Aged
Aged, 80 and over
Emergency Service, Hospital*
Female
Humans
Length of Stay
Male
Physical Therapy Modalities*
Prospective Studies
Randomized Controlled Trials as Topic

Associated data

ClinicalTrials.gov/NCT05753319

Grants and funding

This study is supported by a grant from the University Hospital of Nantes (CHU Nantes, Appel d’offre interne Paramedical, 2022, Marie BLANDIN). Funders had no role in the design of the research; will not participate in data collection, management, data analysis and interpretation; writing, review, or approval of the manuscript or the decision to be submitted for publication.