Overview of Falls Flashcards
describe the epidemiology of falls
30-40% community dweller above 65 fall yearly
40-60% no injury
30-50% minor injury
balance/stability definition
the ability to control the centre of mass (COM) relative to the base of support (BOS)
give definition of instability
An inability to control the COM relative to the BOS
what are the causes of instability
Motor system - peripheral or central
Sensory system - peripheral or central
Cognitive input - executive function
what is steady state stability
control the COM relative to the BOS in unperturbed conditions.
what is reactive balance
ability to recover from an unexpected perturbation.
what is proactive balance
ability to activate muscles for balance in advance of a potentially destabilising movement in order to avoid instability.
list examples of geriatric syndromes
dementia delirium depression
gait and mobility impairment
incontinence
frailty
iatrogenic complications e.g. constipation and pressure ulcers
consequences of impaired balance control
decreased functional independence
risk of falls
fear of falling
avoidance - inactivity
definition of a fall
Unexpected displacement when subject comes to rest unintentionally on the ground’.
Failure of body to remain upright
how are fallers classified
depends on frequency of falls
occasional faller
recurrent faller
at risk of falling
injurious fall
non-injurious fall
what are the 2 categories for risk factors of falls
extrinsic -relate to environment and task
intrinsic - relate to person
list the intrinsic factors for falls
medical - postural hypotension, CVS, 4 medications including sedatives,
muscle weakness - nutrition and disuse
visual impairment - cataract, macular degeneration, diabetic retinopathy
previous falls hx
cognitive impairment
sensory impairment
gait, balance deficit
possible causes of dizziness
Vestibular disease
Cerebrovascular
Cardiovascular
Syncope*
Carotid sinus hypersensitivity*
Drop attacks*
Cardiac - arrhythmia
what to consider as visual risk factors for falls
acuity
contrast sensitivity
depth perception
what is acuity
a measure of the ability of the eye to distinguish the details of object
what is contrast sensitivity
ability to distinguish between finer and finer increments of light versus dark (contrast)
what is depth perception
your eyes’ ability to judge the distance between two objects.
what could be possoble environmental factors to falls
Surfaces
Hazards
Obstacles
Lighting
Footwear & clothing
what objects could be considered risk falls for falls
Loose rugs / slippery floors / heating / broken steps / uneven surfaces
Steps / rails
Lighting / trailing flexes
Footwear
Other - clothing / behaviour
Other / pets
what is long lie
older person is unable to get up after a fall,
what is long lie usually associated with
high mortality, fear of falling, muscle damage, pneumonia, pressure sores, continence and dehydration.
signs of post fall syndrome
Fear of falling
Functional decline
Loss of independence
Spiral of inactivity
Depression and social isolation
Impact on quality of life
risk factors for hip fracture
decreased activity
gait/balance disorder
decreased BMD
increased age
previous fal
visual problem
medications
low body weight
