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Special Pops Geriatrics > I Fell and I Can't Get Up > Flashcards

I Fell and I Can't Get Up Flashcards

1
Q

___ = maintaining the body’s center of mass over the base of support

A

Balance

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2
Q

___ = controlling the body’s position in space for the dual purposes of stability and orientation

A

Postural Control

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3
Q

What are the 3 systems perspectives that maintain postural control?

A

Individual
Task
Environment

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4
Q

For individual to have postural control “sensory input and then the integration of sensory information by the ___ and appropriate ____ response are all essential mechanisms required for balance”

The ___ is important for integrating and comparing sensory input and motor output and adapting the response as needed

A

CNS

Musculoskeletal

Cerebellum

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5
Q

What are the steps of feedback control for an individual to maintain postural control?

A

Sensory input –> Central processing –> Motor output

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6
Q

What is involved in the feed forward control for individual postural control?

A

Anticipatory Postural Adjustments (APA)

Central processing 
(think about doing a task) --> APA Motor Output (stabilizing muscles) --> Motor output (task performance) w/ ongoing sensory feedback
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7
Q

What are important sensory inputs required for balance? (x3)

A

VESTIBULAR
(info about position and movement of head w/ respect to gravity and inertial forces)

VISION
(info about position and motion of the head w/ respect to surrounding objects)

SOMATOSENSORY
(info about position and motion w/ reference to supporting surface and the body segments to each other)

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8
Q

___ is the fastest sensory input system we use to maintain postural control.

**we depend on this the most

A

SOMATOSENSORY

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9
Q

An old person has to stop walking to talk to you. What are they demonstrating difficulty with?

A

Dual tasking (walkie talkie test)

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10
Q

Pts w/ cognitive issues will have difficulty w/ ______.

A

Central processing

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11
Q

What components are included in central processing?

A
  • Scan the environment for cues
  • Focus and/or switch attention – Dual Tasking
  • Anticipate
  • Reaction time and speed of processing effect the outcome
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12
Q

What components are included in motor output? (x6)

A
  • Joint range of motion (ROM)
  • Muscle strength/force
  • Latency of muscle firing
  • Timing of antagonist and agonist muscles
  • Grading of muscle response
  • Power
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13
Q

What type of pts will have trouble w/ motor output?

A

Arthritis
Any neuromuscular issues (movement d/o)
Weak frail old people

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14
Q

Walking across a street is an (internally/externally) paced task

A

Externally paced

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15
Q

What are components that impact task?

A
  • Task requirements: speed, accuracy, force
  • Stability vs. mobility
  • Self paced vs external paced
  • Dual/multi-task
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16
Q

Where do most falls occur?

A

At home

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17
Q

__% of people >65 y/o fall yearly
__% of people >80 y/o fall yearly
__% of older adults who fall, fall repeatedly

A

30% of people >65 y/o fall yearly
50% of people >80 y/o fall yearly
50% of older adults who fall, fall repeatedly

18
Q

T/F: Falls are a leading cause of death for older adults

A

True

19
Q

___% of older fallers are injured
___% of older fallers admitted to hospital
___% of fxs in older adults result from falls

A

20% of older fallers are injured
15 % of older fallers admitted to hospital
87% of fxs in older adults result from falls

20
Q

Falls are the most common cause of ___ (type of injury) in older adults

A

TBI

21
Q

__ of pts die w/in 12 months of hip fx

___% of pts w/ hip fx have limited functional recovery

A

1/3

50%

22
Q

What are the consequences of elderly falls?

A

Decreased independence and QOL
Cause of 40% nursing home admissions
High health care cost
Post fall syndrome (scared of falling)

23
Q

20%-85% of elderly have a fear of ____, but >__% of them have not experienced it.

A

falling

50%
**60% of elderly pts who have fallen have fear of falling again

24
Q

What are predictors of Fear of Falling (FOF)?

A

Cognitive impairment
Decreased social activity
Poorer physical function

25
Q

What are self report measures you can use to evaluate fall risk/fear?

A

ABC

Falls Efficacy Scale

26
Q

50% of older people w/ DM have ____, which makes them 20x more likely to fall

A

peripheral neuropathy

27
Q

__-__% of people fall in the 1st year post-stroke

A

40-70%

28
Q

What type of fx are post-stroke pts likely to have and which side is usually impacted?

A

hip fx

Fall to their weak side and break that hip (decreased bone density from less weight bearing)

29
Q

A man has to walk w/ a cane and his L leg is healthy whereas his right is impaired. Which hand should the cane be in?

A

L hand

30
Q

What are predictors of falls that require medical attention?

A

Increased age
Slower gait (TUG)
Depression

31
Q

What vitamin should you monitor to decrease risk of falls?

A

Vitamin D

32
Q

All elderly adults >__ y/o should be screened annually by health care provider for falls, balance, and mobility impairments.

when are other times you need to screen for falls?

A

> 65 y/o

Following every hospitalization or transition of care (high rate of falls w/ 2 weeks of hospital d/c)

33
Q

The ____ provides basic information about falls, case studies, standardized gait and balance assessment tests, educational handouts about fall prevention

A

CDC STEADI Toolkit

STEADI–> Stopping Elderly Adult Deaths and Injuries

34
Q

What are the components of the STEADI algorithm?

A

1) Stay independent brochure
- fall risk questionnaire (>4 = increased risk)

2) Fall risk checklist

3) Key questions
- fall in past year
- unsteady w/ walking or standing
- worry about falling

4) Timed up and go

35
Q

> ___ seconds for the timed up an go test indicates an increased fall risk

A

12 seconds

36
Q

What are pt education recommendations to decrease risk of falls?

A
  1. Exercise regularly
  2. Annual medication review
  3. Annual vision check up
  4. Improve home safety
37
Q

Exercise programs should target 2+ of what 4 components?

A

Strength
Balance
Flexibility
Endurance

38
Q

What is the recommendation for fall prevention exercises?

A

High total dose: 50+ hours, 2x/wk for 6 months minimum

Additional strength training for people w/ muscle weakness >80 y/o

39
Q

____ is an evidence based balance training program that is individually tailored progressive home-based program of strengthening and balance exercises combined w/ walking

A

Otago Balance Program

40
Q

What are physical activity components that are targeted using the Otago Balance Program? (give some examples)

A

STRENGTHENING
- Sitting knee extension, standing knee flex, hip abduction, toe raises, heel raises

BALANCE
- knee bends, backward walking, walking/turning, sideways walking, tandem stance tandem walk, one leg stand, heel walk, toe walk, tandem walk backward, sit to stand, stair walking

41
Q

Fall rate decreased by __% using the Otago Balance Program w/ greatest benefit in people ___ y/o who had fallen in the past year

A

35%

> 80 y/o

Special Pops Geriatrics (8 decks)

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