Falls Prevention

Question 1

research shows that a combined effect of what interacting factors increase fall risk?

Answer 1

1. muscle weakness
2. foot problems
3. heart rate/rhythm problem
4. history of falls
5. vision problems
6. dizziness
7. multiple meds
8. difficulty with walking/balance

Question 2

list risk factors for falls

Answer 2

1. change in meds
2. pain
3. lack of sleep
4. being sad or worried
5. reduced activity level
6. move to new home
7. change in use of cane or walker

Question 3

why a fear of falling matters

Answer 3

a lasting concern about falling that can lead to an individual avoiding activities that he/she remains capable of performing

1. may stop you from activities
2. leg weakens with inactivity
3. inactivity leads to falls
4. may make the person feel alone
5. may cause depression
6. falling and fear of falling as you age should NOT be accepted as a normal process of aging

Question 4

what are intrinsic factors?

Answer 4

these factors are internal and specific to the individual

Question 5

what are extrinsic factors?

Answer 5

these factors are external to the individual

Question 6

T/F: often a fall is a result of the interaction between the intrinsic and extrinsic factors

Answer 6

TRUE

Question 7

list common intrinsic factors

Answer 7

1. LE weakness/inflexibility
2. previous falls
3. gait and balance disorders
4. decreased gait speed
5. decline in vision
6. fear of falling
7. depression
8. functional and cognitive impairment
9. dizziness
10. low BMI
11. urinary incontinence
12. female sex
13. decreased sensation
14. osteoporosis
15. neurological conditions
16. cardiovascular conditions

Question 8

list common extrinsic factors

Answer 8

1. taking over 4 prescription meds
2. stairs
3. clutter
4. wet surfaces
5. loose rugs/carpets
6. cords
7. poor lighting
8. hurrying/rushing
9. lack of health professional’s knowledge

Question 9

the most effective program is _______

Answer 9

multi-factorial

1. physical activity
2. education
3. environmental modifications
4. fall risk assessments
5. review of meds

Question 10

in addition to lessening the rate of falls, prevention exercises:

Answer 10

1. reduces the severity of injury when falls do occur
   
   1. 37% for all injurious falls
   2. 43% for severe injurious falls
   3. 61% for falls that produced fractures

Question 11

successful programs for fall prevention may include what?

Answer 11

1. PT
2. exercise
3. education
4. med management
5. environmental modification
6. other approaches targeted to individual risk factors that may contribute to falls (such as impairments in vision, foot problems, continence)

Question 12

what are the benefits of exercise in fall preventions

Answer 12

1. reduce fear of falling
2. improve flexibility, strength, endurance
3. improve cardiovascular health
4. help decrease depression
5. reduce sleep disorders

Question 13

list examples of exercises that help prevent falls

Answer 13

1. walking program
2. Tai Chi
3. Yoga
4. Stepping On
5. Otago Exercise Program
6. Matter of Balance
7. Aerobic Exercise
8. Bowling, dancing, gardening

Question 14

what is the Otago Exercise Program?

Answer 14

1. designed specifically to prevent falls
2. consists of a set of leg muscle strengthening and balance retraining exercises progressing in difficulty, and a walking plan
3. the exercises are individually prescribed and increase in difficulty during a series of 5 home visits by a trained instructor
4. the exercises take about 30 minutes to complete. Participants are expected to exercise 3x/week and go for a walk at least 2x/week
5. participants record the days they complete the program

Question 15

is Otago Exercise program effective?

Answer 15

overall the exercise program is effective in reducing by 35% both the number of falls and the number of injuries resulting from falls in clients 80 years of age or older

improved participants’ strength and balance and maintained their confidence in carrying out everyday activities without falling

Question 16

is Stepping On effective?

Answer 16

YES

1. return on investment $1.00
2. seven weekly 2-hour classes including peer discussion, exercise, expert lectures
3. evidence has proven that Stepping On reduces falls by 31% in the community
4. You should feel safe standing and walking independently before you begin SO

Question 17

what are the steps of Stepping On?

Answer 17

1. Introduction, overview and risk appraisal
2. Exercises and moving about safely
3. Home hazards
4. Community safety and footwear
5. Vision and falls and vitamin D
6. Medication management and mobility mastery experiences
7. Review and plan ahead

Question 18

what is a goal with Tai Chi?

Answer 18

participants should be able to stand on one leg for 5 seconds

Question 19

list some ways to find evidence-based falls prevention programs

Answer 19

1. local senior center
2. area agency on aging (www.eldercare.gov)
3. hospitals or health clinics
4. YMCA for programs like Tai Chi

Question 20

what does education for falls prevention include?

Answer 20

1. risk factors for falls
2. fall prevention
3. fall injury reduction
4. medication management
5. home safety
6. physical activity
7. emergency plans
8. what to do if you do fall

Question 21

T/F: start up costs for PT fall prevention are usually cost-neutral as the program involves coordination of existing services, most of which are Medicare reimbursable

Answer 21

TRUE