Tailored interventions to prevent functional decline after a Sentinel Fall presenting to the Emergency Department (iSeFallED) - protocol for a pragmatic mixed-methods implementation study
Abstract
Background: Falls are a leading cause of emergency department (ED) presentations among older adults and frequently signal the onset of functional decline, reduced mobility, and recurrent falls. While evidence-based falls prevention strategies, particularly strength and balance training, can substantially reduce fall risk, secondary prevention is rarely initiated in ED settings. Building on insights from the observational SeFallED study, the iSeFallED study aims to implement an individualized secondary falls prevention program directly within the ED. The intervention integrates comprehensive geriatric assessment, tailored exercise options, wearable sensor-based monitoring, and perturbation-based treadmill training, combined with participatory research methods to ensure patient-centered refinement.
Methods: iSeFallED is a pragmatic mixed-methods implementation trial enrolling adults aged 60 years and older who present to the ED of the Klinikum Oldenburg or the Evangelisches Krankenhaus Oldenburg following a fall and are discharged without hospital admission. A risk stratification algorithm developed from SeFallED data assigns participants to one of three intervention arms. Individuals classified as having mild risk for functional decline receive educational materials on physical activity and falls prevention. Participants identified as having at least moderate risk may choose between a home-based, tablet-guided strength and balance program or supervised group-based training…
How strong is the evidence?
Evidence Hub reads this as a clinical trial, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 350 participants or records.
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