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Geriatrics > Balance an Falls > Flashcards

Balance an Falls Flashcards

1
Q

Fall – Operational Definition

A

Unintentional loss of balance that leads to failure of postural stability”
Unexpected change in position which usually results in landing on the floor

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2
Q

Fall WHO definition:

A

Event which results in a person coming to rest inadvertently on the ground or floor or other lower level surface

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3
Q

How many fall deaths annually?

A

27,000

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4
Q

Fall Risk Assessment Recommendations

A

Use of structured note template
Recommend home safety evaluations
Increase attention to high risk medications
Use STEADI materials
Increase public health messaging about falls and preventability

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5
Q

To prevent falls, providers should focus first on these modifiable risk factors;

A 
lower body weakness
difficulties with gait and balance
use of psychoactive medications
postural dizziness
poor vision
problems with feet/shoes
home hazards
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6
Q

Wellness

A

Generally described as multifaceted, and as a process or outcome which maximizes potential and health

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7
Q

Domains of Wellness

A

Physical
Psychological
Social

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8
Q

Physical Wellness

A

Multiple factors involved (p 447)

PTs can most affect nutrition and exercise

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9
Q

Nutrition

A

Remember that low BMI correlated with increased mortality in elderly

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10
Q

APTA position on nutrition:

A

the role of the physical therapist to screen for and provide information on diet and nutritional issues to patients, clients, and the community within the scope of physical therapist practice

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11
Q

What is used clinically to assess nutrition?

A

Mini Nutritional Assessment

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12
Q

Benefits of exercise:

A

Reduce bone density loss (if WB)
Counteract loss of lean muscle mass/strength loss
Improve flexibility
Improve body composition

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13
Q

Health priorities for wellness:

A

Active living
Injury prevention
Secondary prevention in chronic disease and disability management

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14
Q

Psychological wellness includes:

A

emotional
spiritual
intellectual

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15
Q

Emotional wellness:

A

sense of well-being, ability to cope with ups and downs

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16
Q

Spiritual wellness:

A

provides meaning and connects oneself to something greater

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17
Q

Intellectual wellness:

A

ability to learn, self-efficacy

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18
Q

Social wellness:

A

meaningful relationships and presence of a social support structure

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19
Q

Occupational/Vocational wellness:

A

purpose in life, reason to get up in the morning

20
Q

Types of Programs

A

Balance/fall prevention
Strength training
Aerobic training
Walking/mobility activities

21
Q

Who are senior athletes?

A

Former competitive athletes
Lifelong athletes, “sports people”
Nonathletes that start exercising later in life (after 40)

22
Q

Young-old

A

65-74 years

23
Q

Old

A

75-84 years

24
Q

Old-old

A

85-99

25
Q

Body system changes

A

MSK

Cardiopulm

26
Q

Bone/joint changes

A

Deterioration of joint surfaces
Breakdown of collagen fibers
Decrease in viscosity of synovial fluid
= loss of flexibility and increase in joint stiffness

27
Q

Who demonstrate decreasing bone density?

A

master’s cyclists and swimmer

28
Q

Who is normal bone loss not seen in?

A

those with vigorous WB activities

29
Q

Muscular system changes:

A

Decrease in size, number and type of muscle fibers, especially type II

30
Q

What is the change in percentage type I from?

A

to relative increase in endurance and decrease in force production/power, especially in women, especially in UE

31
Q

How can sarcopenia be prevented?

A

Resistance training

PRT

32
Q

General weight loss:

A

General strength loss 1-3% per year,

33
Q

Macrotrauma

A

Fewer collision injuries
More likely to avulse muscle/bone than strain muscle or rupture ligament
Time needed for recovery can be devastating to senior athlete

34
Q

Microtrauma

A

Elderly more susceptible due to:
Stiffer collagen
Arthritic changes in WB joints
Lower muscle mass/shock absorption

35
Q

Tendinopathy

A

Elderly more at risk due to changes in collagen

Consider role of eccentric strengthening with tendinopathy

36
Q

Cardiopulmonary

A

Predictable decline with increasing age, less in the physically active.
Modest declines until 60-70 years and then rapid decline in VO2 max.
Physical activity can slow the decline, cutting it in half.
Trained subjects perform better than sedentary at all ages (

37
Q

Functional nonpainful (FN):

A

unlimited and unrestricted movement, painfree

38
Q

Functional painful (FP):

A

unlimited and unrestricted movement that reproduces symptoms or brings on secondary symptoms

39
Q

Dysfunctional nonpainful (DN):

A

restricted movement, lack of mobility or stability, painfree

40
Q

Dysfunctional painful (DP

A

restricted movement, lack of mobility or stability, reproduces symptoms or brings on secondary symptoms

41
Q

SFMA Lab

A

Toe touch
Overhead reach
Total body rotation
Single limb stance (eyes open and closed)
Overhead deep squat
Back scratch/back patting
Clearing tests(impingement and horizontal adduction)
Cervical (flexion/extension, combined flexion/SB/rotation)

42
Q

Evidence for SFMA?

A

Poor inter-rater reliability
Fair to good intra-rater reliability with experience
Case study indicating use in treating patient with LBP
Robust evidence lacking whether use of movement screens superior to usual clinical exam
Opinion blog: abandon all movement screens?

43
Q

Injury prevention

Laureson:

A

favorable outcomes for all prevention techniques except for stretching

44
Q

Injury prevention Bizzini and Dvorak:

A

FIFA 11 plus warm-up confers 40-50% reduction in non-contact injuries among young soccer players when performed 2x/week

45
Q

Injury prevention Caveat:

A

most evidence from NON-ELDERLY athletes

46
Q

Fifa 11 plus

A

Evidence that it reduces risk of injury in young athletic population
Similar to evidence in favor of active warm-up and plyometric components
Unclear if results can be generalized to elderly population

Geriatrics (17 decks)

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