Developing an audit checklist to assess outdoor falls risk

Falls by older people (aged 65+ years) are linked to disability and a decrease in mobility, presenting a challengeto active ageing. As such, older fallers represent a vulnerable road user group. Despite this, there is little researchinto the causes and prevention of outdoor falls. This paper develops an understanding of environmental factorsthat cause falls or fear of falling by using go-along interviews with recent fallers to explore how they navigate theoutdoor environment, and which aspects of it they perceive facilitate or hinder their ability to go outdoors and fearof falling. While there are a number of audit checklists that are focused on assessing the indoor environment forrisk or fear of falls, nothing exists for the outdoor environment. Many existing street audit tools are focusedon general environmental qualities and have not been designed with an older population in mind. This paperpresents a checklist that assesses aspects of the environment that are most likely to encourage or hinder those whoare at risk of falling outdoors, it is developed through accounting for the experiences and navigational strategies ofelderly individuals. The audit checklist can assist occupational therapists, urban planners, designers and managers inworking to reduce the occurrence of outdoor falls among this vulnerable user group

Flexor Tendon Sheath Ganglions: Results of Surgical Excision

The purpose of our study was to review the clinical features and determine the results following surgical excision of a flexor tendon sheath ganglion. A retrospective analysis of 24 consecutive patients (25 ganglions) who underwent excision of a painful flexor tendon sheath ganglion by the same surgeon was performed. The patient’s medical and operative records were reviewed. Each patient was invited to return for an evaluation, which consisted of a clinical interview, completion of a questionnaire, and physical examination. Those patients that were unable to return underwent a detailed telephone interview. Sixteen patients returned for a clinical evaluation, while eight patients underwent a telephone interview. There were 15 women and nine men, with an average age of 43 years (range, 21–68 years). The dominant hand was involved in 15 patients. The long finger was most commonly involved (11 cases). The ganglion arose from the A1 pulley in 13 cases, between the A1 and A2 pulleys in three cases, and from the A2 pulley in nine cases. At an average follow-up of 18.5 months (range, 5–38 months), all of the patients were satisfied with their final result. No patient developed a recurrence and all returned to their previous functional level. There were two minor complications that resolved uneventfully; one patient experienced mild incisional tenderness, while an additional patient experienced transient digital nerve paresthesias. We conclude that surgical excision is a simple, safe, and effective method for treating a painful ganglion of the digital flexor tendon sheath

Mobility scooter driving ability in visually impaired individuals

<p><b>Purpose:</b> To investigate how well visually impaired individuals can learn to use mobility scooters and which parts of the driving task deserve special attention.</p> <p><b>Materials and methods:</b> A mobility scooter driving skill test was developed to compare driving skills (e.g. reverse driving, turning) between 48 visually impaired (very low visual acuity = 14, low visual acuity = 10, peripheral field defects = 11, multiple visual impairments = 13) and 37 normal-sighted controls without any prior experience with mobility scooters. Performance on this test was rated on a three-point scale. Furthermore, the number of extra repetitions on the different elements were noted.</p> <p><b>Results:</b> Results showed that visually impaired participants were able to gain sufficient driving skills to be able to use mobility scooters. Participants with visual field defects combined with low visual acuity showed most problems learning different skills and needed more training. Reverse driving and stopping seemed to be most difficult.</p> <p><b>Conclusions:</b> The present findings suggest that visually impaired individuals are able to learn to drive mobility scooters. Mobility scooter allocators should be aware that these individuals might need more training on certain elements of the driving task.Implications for rehabilitation</p><p>Visual impairments do not necessarily lead to an inability to acquire mobility scooter driving skills.</p><p>Individuals with peripheral field defects (especially in combination with reduced visual acuity) need more driving ability training compared to normal-sighted people – especially to accomplish reversing.</p><p>Individual assessment of visually impaired people is recommended, since participants in this study showed a wide variation in ability to learn driving a mobility scooter.</p><p></p> <p>Visual impairments do not necessarily lead to an inability to acquire mobility scooter driving skills.</p> <p>Individuals with peripheral field defects (especially in combination with reduced visual acuity) need more driving ability training compared to normal-sighted people – especially to accomplish reversing.</p> <p>Individual assessment of visually impaired people is recommended, since participants in this study showed a wide variation in ability to learn driving a mobility scooter.</p