• Robin R Varghese, PT.

KEEP FALLS OUT OF YOUR WAY!!! Are you afraid you might fall again?


Falls

Any incident which results in a person coming to rest accidentally on the ground or floor or other lower level is otherwise called as a fall.

The risks of an injury during falls depend on the age, gender and health of the individual.

Adults older than 60 years of age suffer the greatest number of fatal falls.

Falls should be considered a symptom rather than a diagnosis so that when a patient, usually an elderly person, presents with a history of falls, effort should be made to find the cause or causes

Risk factors are:

history of falls

weakness

poor balance

visual impairment

polypharmacy

environmental hazards

medical conditions like such as

-arthritis

-depression

-diabetes and

-Urinary Incontinence


Aging and Falls

Aging is accompanied by reduction of the functional and physiological capacity of the musculoskeletal and central nervous systems.

This in turn affects motor performance adversely.

These age related decline can increase the incidence of falls and re-falls among older people.

Does that mean one must fear aging?

Not at all.!!! This is the time to enjoy life, not to fear!

Falls are not a normal part of ageing.

Ageing is not considered a cause of disability until a person is over 94 years.

The risk level of falls in old people is in part due to physical, sensory, and cognitive changes associated with ageing and also, due to environment that are not adapted for older persons.

However, problems can arise earlier for the following reasons:


-Diseases that are preventable

-Loss of fitness and de-conditioning

-Negative beliefs about growing older

Fall risk factors

Intrinsic factors

Extrinsic factors.

These are the ​traits of an individual that increase their risk of falling

​These are the social and physical factors that relate to an external environment

​Seen amongst the oldest age group

​< 75 years are more likely to show them.

​Related to neurosensory impairment, certain drugs, or the presence of diseases

​Unrelated to disease or drug use

Combined

If both intrinsic and extrinsic factors are present, falls are classified as combined.


Inactivity and Falls

Inactivity is defined as 30 minutes or less of moderate to vigorous activity per week.

  • Studies show that inactive older adults have greater muscle atrophy.

  • Muscle tissue usually provides padding and protection to joints and also preserves bone density.

  • Weak fallers tend to fracture bones more easily due to muscle atrophy.

  • Inactivity can also lead to increase in intramuscular adipose tissue which again leads to increasing health challenges.


Are Exercise and Physical activity different from each other?

Physical activity refers to any activity that increases heart rate, breathing rate and energy demands.

Exercise is a more targeted activity designed to increase fitness. It can be defined as a structured form of physical activity designed to improve fitness and well-being.

The aim is to increase the physical activity generally.

Exercise is a targeted intervention to reduce the risk of falls.

An older adult need to do both.


Can one do any exercise to prevent falls?

Exercises should be individually prescribed and monitored by a trained professional.

This is because exercise is dose-dependent and needs to be set at a suitable level for it to be effective.

A Cochrane Review shows the effect of exercises in preventing falls as below:

reduce falls rate (by 23%)

reduce the number of people experiencing more than one fall (by around 15%)

and may reduce the risk of fractures (by 27%)


Physical therapy management

Physiotherapy goals

  • Prevention of further falls by working on mobility, balance and strength (the most effective intervention)

  • Training clients to cope with further falls and minimize the consequences of a long lie. Also teach clients how to get off the floor or to call for help, and keep warm in the meantime.

  • Ensuring their living environment is as safe as possible.

  • Restoration of confidence and self-esteem to improve their quality of life


Physiotherapy Interventions for fall reduction:


These interventions are to be done only by the guidance of your physical therapist. Unguided trials can lead to adverse effects. Therefore we recommend you to kindly pay attention to be in line with the instructions given to you by your therapist.


  • Multicomponent programme which include balance and strength exercises are more effective in fall prevention than single-component programme.

  • Exercise interventions for fall prevention may include stability-challenging conditions and perturbations.

  • Holistic mind-motor exercise which includes multitasking, has been proven to be more effective in fall prevention than exercises focusing on a single physical function.

  • Your therapist will also provide you with detailed information on home hazard and footwear modification and education about fall risk.

  • Home exercise programme should be customized to each patient, and must be based on intended outcome.

If an older adult has greater strength, better balance and endurance, then the physical therapist will maximize their independence. This will make them more independent and their risk of falls will reduce.


Fall prevention

  • Exercise regularly.

  • Review all medication

  • Regular eye check-up and maximizing of vision

  • Make homes safer to avoid tripping hazards by:

-adding grab bars inside and outside the tub or shower and next to the toilet,

-adding railings on both sides of stairways

-and improving the lighting in their homes.


We at Valley Healing hands, Brownsville, Texas provide the best physical therapy services for aging related falls, falls reduction and falls prevention. Our therapists are polite and affectionate towards our geriatric patients and are skilled enough to handle your apprehensions and to walk you through the process to be confident with every step you take. Check out what our patients have to say about us and reach out to us for an evaluation. Patients love our services, you too will!




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