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Special Populations > Geriatric Falls Assessment > Flashcards

Geriatric Falls Assessment Flashcards

1
Q

T/F: Falls are the most common cause of nonfatal injuries and hospital admissions for trauma

A

TRUE

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2
Q

Falls and the Elderly, stats

A
  1. 1/5 of falls cause serious injury (fracture, head injury)
  2. 20-30% of people who suffer moderate to severe injuries such as lacerations, hip fractures, or head trauma
  3. most fractures among older adults are caused by falls
  4. many people who fall, even if they are not injured, develop a fear of falling
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3
Q

T/F: falls are a normal part of getting older

A

FALSE

they are preventable

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4
Q

how would you define a fall?

A

an unintentional loss of balance that leads to failure of postural stability

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5
Q

what constitutes a recurrent faller?

A

2 or more falls in 6-12 months

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6
Q

Best Practices for managing at risk-fallers (older adults)

A
  1. ask about falls within past 12 months
  2. assess strength, balance, and gait
  3. assess for need of AD prescription
  4. provide supervised, structured exercise program
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7
Q

Best practices for managing those who have had 2+ falls in past year

A
  1. basic fall history
  2. assess for OH
  3. assess visual acuity
  4. assess strength, balance, and gait
  5. home assessment for fall hazards
  6. review medications
  7. assess appropriateness of AD
  8. assess cognitive status
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8
Q

Questions to ask about falling

A
  1. have you fallen?
  2. can you tell me what caused you to fall?
  3. did someone see you fall? if yes, did you have a LOC?
  4. did you go see your doctor or to the ED?
  5. did you get hurt?
  6. which direction did you fall?
  7. did you recently change any of your medications
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9
Q

what to consider when examining vision relating to postural control

A
  1. acuity
  2. contrast sensitivity
  3. depth perception
  4. visual field cut
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10
Q

what to consider when examining vestibular relating to postural control

A
  1. VOR function and gaze stability
    1. nystagmus
    2. saccades
    3. smooth pursuit
    4. head impulse test
    5. head shake test
    6. dynamic visual acuity test
    7. skew deviation test
    8. VOR cancellation
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11
Q

what to consider when examining the somatosensory system pertaining to postural control

A
  1. cutaneous sensation
  2. proprioception
  3. vibration
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12
Q

what test can be performed to look at sensory integration?

A

CTSIB

(Clinical Test of Sensory Interaction and Balance)

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13
Q

List the 6 conditions in the CTSIB?

A
  1. eyes open on firm surface
  2. eyes closed on firm surface
  3. eyes open with sway referenced visual surround
  4. eyes open on sway referenced support surface
  5. eyes closed on sway referenced support surface
  6. eyes open on sway referenced support surface and surround
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14
Q

falls in which conditions of the CTSIB indicate vestibular dysfunction?

A

conditions 5 and 6

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15
Q

falls during which CTSIB conditions indicate surface dependence?

A

conditions 4, 5, 6

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16
Q

list several balance strategies

A
  1. ankle strategy
  2. hip strategy
  3. stepping strategy
  4. reaching strategy
  5. suspensory strategy
17
Q

describe a suspensory balance strategy

A

lowers COG to enhance postural stability

flexing knees, lowering COG

18
Q

a strength, ROM, and endurance program should be at least _______ in duration

A

10 weeks

19
Q

how does a home evaluation play into falls prevention?

A

it is a key preventative method to prevent falls

allows the following:

  1. exploration of potential risk factors
  2. ID changes are necessary
  3. ID sources of payment and other potential resources
  4. locate quality supplies and qualified installers
20
Q

what are the 3 parts of a home eval?

A
  1. assess commonly used areas inside and outside the home
  2. observe the person moving around the environment
  3. determine the person’s fall risk and health status
21
Q

how does functional performance testing inform our clinical practice relating to older adults?

A
  1. objective, accurate record
  2. measures what is pertinent to the patient
  3. informs impairments
  4. informs goal setting
  5. comparison of age-based normative data
  6. prognostic
22
Q

list some limitations of MMT in older adults

A
  1. ceiling effect of available strength
  2. make test → inaccuracies of available test
  3. break test → can be aggressive in frail pts
  4. subjective grading
  5. pt effort, understanding, willingness affects results
  6. testing position may not reflect functional performance (open-chain testing vs closed-chain function)
23
Q

list types of functional outcome measures

A
  1. self-report → pt perception of impairment, function, QOL
  2. patient outcome measure → ask pts about impact of condition on activities and roles in life
  3. observer-rated measures → measures observed by PT
  4. physiological measures → measure single biological entity (ie cognitive ability, pain, exertion)
24
Q

what is the difference between specificity and sensitivity?

A

specificity → good for ruling in

sensitivity → good for ruling out

25
Q

what is the difference between +/- LR?

A
  • +LR → likelihood that a + test is accurate
  • -LR → likelihood that a - test is accurate
26
Q

list several walking tests that can be used in geriatrics

A
  1. 2 MWT, 6 MWT
  2. Gait speed
  3. DGI
  4. FGA
  5. TUG
  6. Figure 8 Walking test
27
Q

list several mobility scales that can be used in geriatrics

A
  1. 30-second CRT (chair rise test)
  2. 5x and 10x STS
  3. Floor transfer
28
Q

list several balance tests that can be used in geriatrics

A
  1. BESTest, BESTmini, BESTbrief
  2. Berg Balance Scale
  3. Activities Specific Balance Confidence (ABC) scale
  4. Functional reach test
  5. 4 square step test
  6. Tinetti performance-oriented mobility assessment (POMA)
  7. Single leg stance
29
Q

list several outcome measures that assess physical performance

A
  1. physical performance test
  2. physiological profile assessment (PPA)
  3. short physical performance battery (SPPB)
  4. grip strength
30
Q

list several multidiscipline fall risk tools

A
  1. Morse Fall Scale
  2. Hendrich II Fall Risk Model (acute care setting only)

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