Lecture 9: falls and balance

Question 1

describe falls

Answer 1

• a major cause of morbidity and mortality
• physical injury is only one aspect of the consequences of a fall
• fear of falling can have a major impact on a patient’s psychological health

Question 2

mechanisms of falls

Answer 2

• interaction between intrinsic and extrinsic factors
• intrinsic factors are characteristics that are inherent to each individual and that are result of changes related to aging, disease or medication
• Extrinsic factors include environmental hazards as well as actvitiy related factors

Question 3

describe some intrinsic factors of falls

Answer 3

• Decreased vision, decreased contrast sensitivity
• decreased hearing
• age related gait changes: decreased height of step in both sexes, narrow waddling gait in women, wide short step gait in men
• Disease states

Question 4

describe some extrinsic factors of falls

Answer 4

• evaluate the home environment for fall hazards
• the most common are loose rugs, slippery floors, uneven door thresholds, poor lighting, inappropriate bathroom fixtures and home furnishings
• approximately 10% of falls are related to stairways

Question 5

describe intervention to prevent falls

Answer 5

• remember that falling is a symptom, not a diagnosis
• -> deserves a complete evaluation just as any other presenting symptom would developing a differential list of potential causes
• once potential causes are risks are identified, intervention can be specific
• -> eg improve sensory input, change home hazards, buy apropriate footware

Question 6

what are 2 things that prevent falling

Answer 6

• improve lower extremity strength
• balance training on good foot wear
  (use it or lose it)

Question 7

prevention and treatment of osteoporosis

Answer 7

• calcium
• vitamin D
• Fosomax
• estrogen
• calcitonin
• exercise
• smoking cessation
• caffeine limitations
• External hip protectors