Influence of regional anesthesia on fall risk in adults over 60 years

Background - Age-related changes can influence gait and contribute to a higher fall risk. Other influencing factors might be certain anesthetic procedures which affect therapeutic decisions. The study's goal was to evaluate whether brachial plexus blockade impacts the postoperative fall risk in...

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Main Authors: Weichmann, Jennifer (Author) , Barbari, Jan el (Author) , Siegwart, Laura (Author) , Hetjens, Svetlana (Author) , Hogan, Aidan (Author) , Grützner, Paul Alfred (Author) , Trinler, Ursula (Author)
Format: Article (Journal)
Language:English
Published: January 2025
In: Clinical biomechanics
Year: 2025, Volume: 121, Pages: 1-8
ISSN:1879-1271
DOI:10.1016/j.clinbiomech.2024.106383
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/j.clinbiomech.2024.106383
Verlag, lizenzpflichtig, Volltext: https://www.sciencedirect.com/science/article/pii/S0268003324002158
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Author Notes:Jennifer Weichmann, Jan Siad El Barbari, Laura Cosima Siegwart, Svetlana Hetjens, Aidan Hogan, Paul Alfred Grützner, Ursula Trinler
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Summary:Background - Age-related changes can influence gait and contribute to a higher fall risk. Other influencing factors might be certain anesthetic procedures which affect therapeutic decisions. The study's goal was to evaluate whether brachial plexus blockade impacts the postoperative fall risk in adults ≥60 years. - Methods - 40 adults ≥60 years without predisposing fall risk factors receiving brachial plexus blockade were included. Gait parameters during single- and dual-task conditions were assessed using the GAITRite® walkway at three measurement points: preoperatively, within 24 h, and two weeks postoperatively. Additionally, a geriatric assessment including Berg Balance Scale, Timed Up and Go test and Montreal Cognitive Assessment was conducted, alongside pain intensity via Numeric Rating Scale. Statistical analysis involved ANOVA with repeated measures. - Findings - All gait parameters showed a performance reduction within 24 h. Significant changes occurred during single-task in stride length (P = 0.018) and stride width variability (P < 0.01), further during dual-task in stride width (P = 0.015) and velocity (P = 0.039). Notable changes were also observed in the Berg Balance Scale (P < 0.0001), the Timed Up and Go test (P < 0.001), and Montreal Cognitive Assessment (P = 0.037). After two weeks the study parameters returned to the performance prior to surgery. Performance declined with increasing age. Pain intensity remained low. - Interpretation - While brachial plexus blockade offers various advantages for patients due to its tolerability and controllability an increased gait instability and thus fall risk within the first postoperative day must be considered especially in older adults.
Item Description:Online verfügbar: 17. November 2024, Artikelversion: 23. November 2024
Gesehen am 13.05.2025
Physical Description:Online Resource
ISSN:1879-1271
DOI:10.1016/j.clinbiomech.2024.106383