Falls Flashcards
Incidence of falls?
1/3 over 60s
1/2 over 80s
Stroke
Parkinson’s
What problems arise from falling?
Increase mortality rates Injures - soft tissue, fracture Multiple falls Psychological consequences Hospitalisation Cost of falls - 1.7 billion
What are some of the standards and guidelines?
NSF
NICE
CSP
WHO
What are the NSF guidelines?
NHS should work with councils to prevent falls and reduce injuries
People should be aware of special falls service for advice on prevention
What do NICE guidelines outline?
Older people should be asked about falls
Specialist falls service
Professionals should be competent in falls assessment and prevention
What are the CSP guidelines?
Improve ability to withstand threats to balance
Improve safety and surroundings
Prevent consequences of a long lie - confused, burns, hypothermia
Optimise patient confidence
What are the risk factors of falls?
Over 400 risks
Intrinsic and extrinsic
Risks include:
Gait and balance Dizziness Neuromuscular factors Footwear and feet Medications (4 or more)
What is the MDT involved in falls treatment?
Medics - medications,
Medics- target cardiac problems, medication (diuretics = drop in BP, sedatives - increase dizziness)
Nurses- continence, check medication is being taken
Physio - gait/balance/strength/dizziness/footwear
Ot’s - adls/ environment/ cognitive/ visual impairment
Dietician/psychologist/orthotist/optician/podiatrist
What does a physio falls assessment involve?
Gait and use of AIDS Balance Msk Dizziness Feet and footwear Confidence Social interaction Environment
How do you test gait?
Use of AIDS
A __m walk test
What do gait changes include?
Step length
Velocity
Base of support
What decreases with balance?
Muscle weakness
Decreased proprioception
Visual acuity and depth
What does balance treatment involve?
Feedforward and feedback Hip/ankle strategies Trunk and head Stepping reactions Protective reactions Use of appropriate OM
What are the appropriate outcome measures?
BERG POMA 180 turn TUSS - time unsupported Functional reach
How do you treat balance?
50hrs of strength and balance training Adapting motor skills Strategies for stability Specific training Wii fit
