Fall Reduction Strategies
Are Your Stairs and Steps Safe?
20/11/10 10:51
At Distinctive Home Physical Therapy, your safety is our number one concern. We want to make sure that your home is safe and free of obstruction, especially your stairs and steps.
Here is a list of helpful tips from the CDC:
Here is a list of helpful tips from the CDC:
| STAIRS AND STEPS: Look at the stairs you use both inside and outside your home. |
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Physical Therapy Topics: Vision and Falls
15/06/10 07:37
excerpt by Stephen R. Lord, Ph.D.
Impaired balance in older people manifests as falls and fall-related injuries. Approximately one-third of older people living in the community fall at least once a year, with many suffering multiple falls (Campbell et al., 1989; Tinetti et al., 1988). Falls are the leading cause of injury-related death and hospitalization in people age 75 years and older (Baker and Harvey, 1985). Falls can also result in disability, restriction of activity and fear of falling, all of which reduce quality of life and independence. Furthermore, falls can contribute to the placement of an older person into institutional care (Lord et al., 2001).
There are a number of complementary tests of visual function relevant to risk of falling in older people. These include tests of standard high-contrast visual acuity (letter charts), low-contrast visual acuity (letter charts with gray rather than black letters), visual contrast sensitivity, depth perception, stereopsis and visual field size.
Recent research has shown that while standard measures of visual functioning such as visual acuity and visual field size are fair predictors of falls, other tests that address more closely the visual functions required for maintaining balance and detecting hazards are superior (Ivers et al., 1998; Lord and Dayhew, 2001; Nevitt et al., 1989). For example, we have recently found that of nine measures of vision, impaired depth perception was the strongest risk factor for multiple falls in community-dwelling older people (Lord and Dayhew, 2001). Furthermore, subjects with good vision in both eyes had the lowest rate of falls, whereas subjects with good vision in one eye but only moderate or poor vision in the other had elevated falling rates that were equivalent to those of patients with moderate or poor vision in both eyes. This suggests that the ability to judge distances accurately and perceive spatial relationships is important for negotiating and avoiding obstacles and hazards in the environment.
read full article here
Impaired balance in older people manifests as falls and fall-related injuries. Approximately one-third of older people living in the community fall at least once a year, with many suffering multiple falls (Campbell et al., 1989; Tinetti et al., 1988). Falls are the leading cause of injury-related death and hospitalization in people age 75 years and older (Baker and Harvey, 1985). Falls can also result in disability, restriction of activity and fear of falling, all of which reduce quality of life and independence. Furthermore, falls can contribute to the placement of an older person into institutional care (Lord et al., 2001).
There are a number of complementary tests of visual function relevant to risk of falling in older people. These include tests of standard high-contrast visual acuity (letter charts), low-contrast visual acuity (letter charts with gray rather than black letters), visual contrast sensitivity, depth perception, stereopsis and visual field size.
Recent research has shown that while standard measures of visual functioning such as visual acuity and visual field size are fair predictors of falls, other tests that address more closely the visual functions required for maintaining balance and detecting hazards are superior (Ivers et al., 1998; Lord and Dayhew, 2001; Nevitt et al., 1989). For example, we have recently found that of nine measures of vision, impaired depth perception was the strongest risk factor for multiple falls in community-dwelling older people (Lord and Dayhew, 2001). Furthermore, subjects with good vision in both eyes had the lowest rate of falls, whereas subjects with good vision in one eye but only moderate or poor vision in the other had elevated falling rates that were equivalent to those of patients with moderate or poor vision in both eyes. This suggests that the ability to judge distances accurately and perceive spatial relationships is important for negotiating and avoiding obstacles and hazards in the environment.
read full article here
Fall reduction strategies using Physical Therapy
24/10/09 16:21
Fall Reduction Strategies using Physical Therapy
Falls can be one of the best indicators of poor health and declining function, and are often associated with significant morbidity. It is estimated that between 1992 and 1995 24 percent of emergency visits were linked to falls, most of which were by seniors over the age of 65. The cost of falls can be staggering as hospital stays are twice as long for elderly patients who are hospitalized after a fall than for elderly patients who are admitted for another reason.
It is important to seek a professional and have a proper evaluation done. A thorough physical therapy evaluation will properly screen a person for many of the risk factors that can lead to falls. During the evaluation, the therapist will perform an environmental assessment which will help determine if there are hazards around the home that can lead to slip ups. For example, a therapist may recommend that you remove clutter, add grab bars, or remove slippery floor mats.
During the initial evaluation, many other risk factors will be assessed to properly diagnose why an individual may be falling frequently. By getting an accurate history of current medications, cognitive status, visual issues, vertigo, and other medical conditions such as hypotension, a therapist can begin to develop a strategy that will minimize risk of future falls.
A physical therapist can then test one’s strength, balance, coordination, endurance, and sensation which will accurately indicate the root of the problem. It is very important to have all the systems properly screened so that the cause of the problem is exposed. During an evaluation, the therapist will likely have the patient tested with a valid outcome measure such as the Berg or Tinetti scale. This is important in the rehabilitation process because we can properly assess the effects of the treatment using these outcome measurement tools.
Based on the initial evaluation, the therapist will come up with a detailed plan of care. The treatments can include activities such as strengthening, balance training, coordination training, gait training, and functional training. In most cases, the therapist will attempt to improve one’s proprioception with various exercises. Proprioception is defined as the sense of orientation of one’s limbs in space. A natural decline of proprioception is common with advanced age. Some examples of proprioceptive training may be standing on one leg, or standing on a foam pad to challenge ones balance. This type of training must be done with a therapist to prevent accidents.
Keep in mind that it will take dedication and time to slowly reduce the risk of falls. Usually within four to six weeks one may begin to experience the benefits of physical therapy. With a through evaluation, and carefully selected treatment strategies, physical therapy can be a great tool to help prevent falls and improve ones overall balance confidence.
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