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Fall Prevention

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Oct232022
Blog

Falls are the leading cause of injury death for Americans 65 years and older.

Every 20 minutes, an older adult dies from a fall in the US, and many more are injured, costing $50 billion a year.  Approximately a third of older adults who live at home, and half of those living in nursing homes, fall at least once a year.

 

 

Only 37 percent of elderly patients are asked about falls in the primary care setting. 

Most falls are preventable, and many common causes can easily be corrected.  The Centers for Disease Control and Prevention (CDC) and the American Geriatric Society recommend a yearly fall assessment screening for all adults 65 years of age and older, but for most, this is NOT done.

Seniors are prone to underreporting falls, usually out of denial, fear of losing their independent living status, or because of memory and recall difficulty.

Fall Risk Assessments should be part of regular check-ups for our seniors and performed every six months.  

Anyone who falls outside of sports activity should undergo a gait and balance assessment. Those who have had multiple falls within a year should be evaluated more thoroughly to determine their fall risks and identify and mitigate them. Falls are rarely due to a single cause or risk factor and are often the accumulated effect of impairments in multiple domains.

 

 

 

1. Perform a Fall Risk Assessment to Identify Risk Factors

Our Fall Prevention Program is based on the CDC’s STEADI program.

VPT’s Fall Prevention Program is based on the CDC’s STEADI program.  A questionnaire to identify risk factors, including medications, home hazards, visual impairment, cognition, feet/footwear issues, Vitamin D deficiency, and comorbidities, is reviewed with our trained therapists.

Our therapists then perform an extensive assessment, including range of motion and strength of the lower extremities and specific balance testing.  Multiple studies have shown an association between walking speed and survival, so many of our screening tests for falls involved timed movement. (*Extreme caution is taken by our clinicians when testing patient’s remotely. Patients with moderate to high fall risk must have someone assisting them during our screening.)

Individuals with a “low fall risk” are provided with educational materials on fall prevention and an Otago exercise program and are advised to have a yearly follow-up. Those individuals with “moderate” and“high fall risk” are recommended for further evaluation to determine the root cause of the balance deficit.  This includes a comprehensive vestibular assessment, gait analysis, strength, range of motion, neurological screen, and specific balance tests, including Sit to Stand, Single Leg Stance, and Timed Up and Go.  Those with a “high fall risk” require physical assistance to complete the assessment.

  • Five Times Sit to Stand (5X STS): This test assesses strength. Have the patient start seated in an armless chair with a firm seat, ask him or her to stand up and sit down five times as quickly as possible, and record the time required to complete the five repetitions.
  • Single Leg Stance (SLS): This test assesses balance. Have the patient stand on one leg with arms crossed. Time how long the patient can remain in this position without touching the suspended foot to the ground, moving the hands away from the chest, or displacing the weight-bearing foot.
  • Time Up and Go (TUG): This test assesses gait. Have the patient start in a seated position, rise to a stand, walk three meters and return to a seated position in the chair, and record the time required to complete the exercise.

*Patients who take more than 10 seconds to do the 5X STS and TUG tests and those who can balance for less than 10 seconds during the SLS probably require further scrutiny.
The underlying physical condition determines the individualized treatment plan, which may include vestibular, neurological, strength, and/or specific balance exercises.  Each exercise program is provided with a video demonstration. The focus of the treatment plan is to educate and empower to remove any risks, improve any deficits and reduce their overall risk of a fall.  Follow-up appointments are based on individual patients’ needs.

Eliminate Risk Factors

  1. Improve your Balance.   Exercise is critical to improving your strength and balance. Exercises should include strength, balance, and proprioceptive training.
  2. Vestibular Assessment: Our balance center is actually in our inner ear. Any disturbances can cause balance problems, make you dizzy, and make the room feel like it is spinning. Having a specialist assess your vestibular system is essential in eliminating potential risk factors.
  3. Medications: Some medicines have side effects that cause dizziness, drowsiness, or confusion, so changing or reducing the dose of medicines that may affect your gait or balance is important.
  4. Footwear: Look at your footwear to see if any of your shoes might increase your risk of falling. Make sure to wear nonskid soles.
  5. Reviewing your home for potential hazards. These may include poor lighting, loose rugs, and/or cords on the floor. This review may be done by yourself, a partner, or a healthcare provider.
  6. Vision: Getting your vision checked by an eye doctor.
  7. Vitamin D:  Take Vitamin D to strengthen your bones.
Category: BlogBy VPTOctober 23, 2022
Tags: balanceFallFall Risk AssessmentFall Risk FactorsLeading cause of injuryolderPreventionseniorsSingle leg stancesit to standSTEADI programTimed up and go

Author: VPT

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Fall Prevention

You are here:
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  3. Fall Prevention

Fall Prevention

Falls are a major issue for seniors and a primary cause of the loss of independence for many.  In the United States, about a third of older adults who live at home, and about half of the people living in nursing homes fall at least once a year. Many of the common causes of falls can be prevented.  The Centers for Disease Control and Prevention (CDC) and the American Geriatric Society recommend yearly fall assessment screening for all adults 65 years of age and older.

  • Falls are a leading disrupter to aging in place and independent living for seniors
  • Physical therapy reduces trips to urgent care, costly specialist consultations, unnecessary imaging, treatments and prescription medications (including opioids)
  • Virtual physical therapy provides therapeutic benefits of a customized fall prevention program in the comfort of your own home

VPT’s Fall Prevention Program is based on the CDC’s STEADI program.  A questionnaire to identify risk factors including medications, home hazards, visual impairment, cognition, feet/footwear issues, Vitamin D deficiency, and comorbidities is also reviewed with our trained therapists and incorporated into the program.

Individuals with a “low fall risk” are provided with education materials on fall prevention, an Otago exercise program, and advised to have a yearly follow-up. Those individuals with “moderate” and “high fall risk” are recommended for further evaluation to determine the root cause of the balance deficit.  This includes a comprehensive vestibular assessment, gait analysis, strength, range of motion, neurological screen, and specific balance tests including Sit to Stand, Single Leg Stance, and Timed Up and Go.  Those with a “high fall risk” require physical assistance to complete the assessment.

The underlying physical condition determines the individualized treatment plan which may include vestibular, neurological, strength, and/or specific balance exercises.  Each exercise program is provided with a video demonstration. The focus of the treatment plan is to educate and empower to remove any risks, improve any deficits and reduce their overall risk for a fall.  Follow-up appointments are based on individual patient’s needs.

More Information

  • STEADI Program
  • Vestibular Rehabilitation
  • Fall Risk Assessment Tool
  • APTA - Physical Therapy & Fall Prevention

Schedule your FREE 15 minute fall risk assessment with one of our specialists. 

Schedule Now
By VPTFebruary 16, 2021

Author: VPT

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PreviousPrevious post:Eliminate Back Pain!NextNext post:Relief from Wrist & Hand Pain

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