Balance and Falls Flashcards
Roughly what percentage of patients over age 65 fall every year? How many of those falls causes injury?
25%
1 in 5
What is the most common cause of TBI in older patients?
Falls
What is the definition of a fall according to the World health Organization?
“Inadvertently coming to rest on the ground, floor, or other lower level, excluding intentional change in position, to rest on furniture, wall or other objects
What are the psychosocial consequences of falling?
fear of falling
anxiety
isolation
depression
What are some intrinsic risk factors for falls?
medical or neuropsychiatric conditions
impaired vision and hearing
-age related changes in neuromuscular function,gait and posture
Who should we screen for falls?
people who scores over 4 on the stay independent brochure or if they answered any of the three fall related questions
What 3 questions help determine if a person needs to be screened for falls?
Have you fallen in past 12 months?
Do you feel unsteady when standing or walking?
Do you worry about falling?
(if yes to any of these then screen for falls)
What are the 4 factors of a multifactorial fall risk assessment?
focused history
physical exam
functional assessment
environmental assessment
What are the components of a focused history for falls?
History of Falls- need details
medication review
review of risk factors for falls
living environment
What are the components of the physical exam and functional assessment for falls?
Sensory exam (vision, vestibular, somatosensory and sensory integration)
Neuromuscular (strength, ROM, and flexibility)
Aerobic Endurance
Movement analysis
functional balance and gait
perceived functional ability and fear of falling
footwear
What are the best predictor outcome measure for Falls?
activities-specific balance confidence (ABC) Scale
fear of falling avoidance behavior questionnaire
TUG
What factors should be considered for every space in a pts home when doing an environmental assessment?
- surfaces
- lighting
- steps/stairs
- door widths
- thresholds
- objects (clutter, cords, toys, furniture, etc.)
- phone
What modifications to the environment can you change to help decrease the fall risk for a pt?
- enhance lighting
- remove throw rugs or secure them
- add hand rails
- change layout of the room
- remove clutter
- widen doors
- change accessibility of food and utensils
- obtain elevated commode and add non slip surfaces to shower
What type of PT interventions can be used to address reactive postural control?
using perturbations to test ankle, hip, knee, and stepping strategies
What type of PT interventions can be used to address anticipatory postural control?
functional activities and dynamic activities
What type of PT interventions can be used to address stability limits?
reaching activities and functional activities
What type of PT interventions can be used to address sensory orientation?
surface changes
functional activities
eyes open/eyes closed
What type of PT interventions can be used to address balance?
What should the intensity be?
progression of balance exercises/activities (static to dynamic, surface changes, add resistance, change speed, add dual task)
50 hours over 3-6 months
True or False: There are no adverse effects of using an assistive device and they reduce the number of falls or fallers
False, they do not reduce the number of falls or fallers
they increase BOS and can provide support as well as tactile cues about the ground
What community programs are available to help prevent falls in aging adults?
Otago Exercise program (17 strength and balance exercises, 30 mins/day, 3 x week and a walking program 30 min/day 3x/week)
Matter of balance (2hr/week for 8 wks-coping strategies to reduce dear of falling, prevention strategies, and exercises)
Stay active and Independent for Life (SAIL) (exercise for strength balance and fitness 3x/wk for 1 hr)
Moving for Better Balance (2hr classes 1x/week for 12 wks, this is a slow and therapeutic Tai Chi like class)
