falls Flashcards
what is falls
a fall is defined as unintentionally coming to rest on the ground or at some other level
incidence
1/3 over 60s fall per year, over 1/2 over 80s fall per year, 25% stroke patients fall, 37% inpatient strokes fallm 54% PF patients fall
dangers of falling
mortality rates, injuries, multiple falls, psychosocial consequences, hospitalization due to falls, cost of falls- approx £2000 per fall, can tise to other £15,00 per patient if they have a fracture
standards and guidelines- NSF
the NHS working in partnership with councils, takes action to prevent falls and reduce resultant fractures or other injuries in their populations of older people. older people who have fallen receive effective treatment and rehabilitation and, with their careers, receive advice on prevention through specialised falls service
standards and guidelines- NICE
older people should be asked routinely if they have fallen. specialist falls service. all professionals dealing with patients at risk of falls should develop and maintain competence in falls assessment and prevention. home assessment if falls on stairs
standards and guidelines- CSP
improve the ability to withstand threats to their balance. improve safety of their surroundings. prevent consequence of a long line- help to get of floor, help to raise alarm if fallen on floor, in each room have. a telephone, keeping warm if fallen on floor. optimise confidence- exercise, strength and balance training
risk factors
gait and balance disorders, dizziness, neuromuscular factors, footwear and feet, other include- previous falls, medication, dependence in ADL, environmental hazards, cognitive impairments, visual impairment
physio assessment and treatment- gait
knowledge of fair assessment and use of aids. use of appropriate OM- 10m/6m/3m/POMA, with age gait changes- step length, velocity, support time, BOS, fallers- walking speeds- average normal, step lengths. research shows that improve fair leads to reduced falls
physio assessment and treatment- balance
knowledge of balance assessment and 5 key areas (vestibular/ somatosensory/ vision/ central control/ mechanics/ MSK), feet forward and feedback system, hip/ankle strategies, trunk and head RR, stepping/ protective reaction, fallers- reduced balance measure using laboratory and clinical measures
with age why does balance reduce
due to otolith degeneration, muscle weakness, decreased proprioception, visual acuity and depth
OM for balance
berg score of less than 45=risk of falls/POMA- score less than 19=risk of falls/18- turn/ TUSS/FR
balance treatment
balance treatment development- quiet stance, perturbed stance, AP stability, mediolateral stability, adaption motor strategies, research shows specific balance training can reduce falls, types of training- tai-chi, computerised, general ,wiifit,
physio assessment and treatment- MSK
MSK assessment and treatment with ageing- reduced strength, evidence shows that can be re-educated into 90s, weak hip/ knee and ankles associated with falls. specific graded exercise programme reduces falls in the elderly- OTAGO exercises. types of strengthening exercises- theraband, isometric, isokinetic
physio assessment and treatment- dizziness
can be a result of- BP problems, heart problems, medication or vestibular. if vestibuler- Cooksey-cawthrone exercise very effective at reducing dizziness. no evidence on the effect on falls
physio assessment and treatment- feet and footwear
awareness of feet and footwear assessment and treatment. foot problems related to falls. footwear- recent research related to podiatry intervention- low heels- barefoot hard soles
