Evaluation of Balance and Movement in Order to Prevent the Risk of Falling in the Post-operative Period

Primary outcomes

1. Test UP and GO. The time of performance is measured in seconds and lower values indicate better balance control and lower fall risk.

   Time frame: Just Baseline

   Participants have been instructed to get up from a chair, walk up to a sign marked on the floor 3 meter ahead on the chair, turn around in their own circles, walk up to the chair and sit down. The time of performance is measured in seconds and lower values indicate better balance control and lower fall risk.

2. Four Square Step Test. The time of performance is measured in seconds

   Time frame: Just Baseline

   This test evaluates the dynamic balance of patients. The test involves the execution of a pre-established series of steps (forward, lateral, backward) within four squares. The time taken to complete one clockwise and one counterclockwise revolution is taken as a reference parameter.

   The 15-second threshold helps us assess the risk of falling in the population being studied.

   Times longer than 15 seconds are associated with a higher risk of falling. The young population is around 6-7 seconds.

3. Barthel Index. It is a questionnaire

   Time frame: Just Baseline

   The index, has it to establish the patient's degree of independence. It is made up of 10 items that include the municipalities daily activities (ADL Activities of Daily Living). Each item is assigned a score, the sum (maximum 100) indicates the degree of autonomy of the patient in carrying out the activities of daily life, the higher the score, the greater the autonomy of the subject.

4. Cumulative Illness Rating Scale. The scale has a cumulative score, which can range from 0 to 56

   Time frame: Just Baseline

   It is a standardized tool used in the medical field to measure the patient's health as objectively as possible. The tool is clinical in nature and requires the physician to evaluate and measure the clinical and functional severity of 14 categories of disease. For each of these pathologies a severity value must be defined, based on the clinical history, the physical examination and the symptoms declared by the patient. The scale has a cumulative score, which can range from 0 to 56. According to its developers, the maximum score is not compatible with the patient's life.

5. Stabilometric Test

   Time frame: Just Baseline

   The posturographic analysis has been led by stabilometric platform. The partecipations underwent a static analysis (stabilometric examina-tion) maintaining standing position with feet placed together with an angle of 30 grades between right and left heels at 2 cm of distance, firstly with open eyes for 51.2 seconds and after that with closed eyes for 51.2 seconds too, in order to analyse the time and frequency of oscillations and self-adjustments of the patient excluding the visual input.

6. Morse Scale. It is a questionnaire.

   Time frame: Just Baseline

   The Morse scale is a quick and easy way to assess a patient's likelihood of falling. The questions in the questionnaire should be addressed to the patient or, if there are physical and cognitive problems that prevent him from responding to a family member. It is a scale composed of 6 items: (i) history of falls, (ii) presence of pathologies at risk, (iii) outpatient aids, (iv) intravenous therapy, (v) type of gait and (vi) mental state". Each answer has a score.

   The sum of the scores obtained defines the risk of falling:

   0 to 24 = low risk 25 to 50 = medium risk equal to or > 51 = high risk

7. International classification of functioning, disability and health

   Time frame: Just Baseline

   The general function of the ICF classification is to provide a standard and unified language that serves as a reference model for the description of health and related states. It defines the components of health and some related components such as education and Work.

   The domains (= a practical and meaningful set of physiological functions, anatomical structures, actions, tasks, or related life areas) contained in the ICF can, therefore, be seen as domains of the health and related domains. These domains are described from a bodily, individual and social point of view in two lists main:

   • Body functions and structures
   • Activities and Participation

   The ICF is therefore no longer a classification of diseases (1980 version) but has instead become one classification of components of health.