Preventing Falls and Improving Quality of Life

By Robin Harrington, PT, OCS, LMT

Are you or someone you know at risk for falling? If so, this is no laughing matter. Injuries from falls often require hospitalization. Several studies have stated that 30 to 50 percent of falls don't require medical attention, but the psychological affect could result in the individual limiting their activities and decreasing their quality of life (1). A study by Tinetti and Speechley reported that 50 percent of fallers experienced multiple falls (2). Most falls occur during movement, with trips or slips being identified as the most common.

One of the most common injuries associated with falls is hip fracture. According to a recent study in the Journal of the American Physical Therapy Association, less than 50 percent of patients will regain their prior level of function following hip fracture. Participation in a Fall Prevention Program is a proactive way to help prevent falling and to avoid adding to this alarming statistic. The key is to identify those individuals at risk and to have them seen by an expert in fall prevention before an injury occurs. Research performed by Anne Shumway-Cook and others has shown that exercises designed to increase strength, improve function, and enhance mobility reduce the risk of falls in the older adult population. Physical therapists are experts in identifying areas of diminished strength, mobility and balance and are uniquely qualified to educate and instruct in specific exercises to address these deficits.

What specifically can a physical therapist (PT) do for someone at risk for falling? Functional and balance testing along with a thorough past medical history by a physical therapist provide the basis for an individualized fall prevention program to be designed and implemented. Depending on the individual and their history, the PT will perform appropriate tests to determine what impairments may be contributing to the loss of balance or falls. These tests consist of reproducing everyday activities in a standardized format to determine those at risk for falling. The PT challenges the individual in these activities while in a safe clinical setting to identify those areas of difficulty. The PT then designs a customized exercise program to improve the individual's ability to perform these activities safely.

Many factors can contribute to increasing an individual's risk for falling. These factors include: deficits in strength and flexibility, sedentary lifestyle, multiple medications, improper footwear, decreased foot sensation, decreased eye sight just to name a few. Environmental factors can also contribute to an increase in falls as balance is challenged on uneven or slick surfaces such as grass, hills, gravel, sidewalks, and rugs. Also, pattern changes with walking such as shuffling, decreased stride length, speed and weight shifting put an individual at risk. Sometimes simple modifications to the home can make it inherently safer and help to further reduce the risk of falls. A PT can educate the individual on home modifications to make the environment safer, analyze changes in walking patterns and help an individual identify and correct those environmental factors that may increase their risk of falling.

The Fall Prevention Program is not only for those who have already experienced falls, but also for those who are concerned about falling. It is for people of all ages. The ultimate goal for the PT is to decrease the percentage of fall related injuries. Keep in mind that decreasing your activity level due to fear or apprehension may actually increase your risk of falling. If you have fallen or have a fear of falling, contact a physical therapist and ask about a Fall Prevention Program. You don't have to wait until you have sustained a life-altering injury. There is help available now.

Kentucky Orthopedic Rehab Team (KORT) has many locations in Kentucky and Southern Indiana. All locations have the Fall Prevention Program available. You can find more information on KORT at www.kort.com or call 1-800-645-KORT. Please contact a KORT clinic near you to make an appointment. If you have any questions regarding this article please contact Robin Harrington, PT at 502-339-4678 KORT-Summit Physical Therapy.

There is an excellent article regarding Physical Therapy and fall prevention in the Journal of the American Physical Therapy Association July 2005, Volume 85, Number 7, pg. 648, title- Incidence of and Risk Factors for Falls Following Hip Fracture in Community-dwelling Older Adults.

References:

1) Chiu A.Y.Y, Au-Yeung S.S.Y, Lo S.K. A comparison of four functional tests in discriminating faller from non-fallers in older people. Disability and Rehabilitation 2003; vol.25, no.1, 45-50

2) Tinetti ME, Speechley M. Predictors and prognosis of inability to get up after falls among elderly persons. Journal of American Medical Association 1989; 269: 65-70

3) Above listed article in last paragraph

Robin is a Physical Therapist with a specialty in Orthopedics. She has a Masters from the University of Louisville in Physical Therapy with a Bachelors in Exercise Science and Sports Medicine. She works at KORT-Summit Physical Therapy located at 9424 Brownsboro Road. She can be reached at 502-339-4678.