Minnesota Falls Prevention Initiative

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Stand Up Be Strong! MN APTA Evidence-Based
Falls Prevention
MN Chapter American Physical Therapy
Association www.mnapta.org 651-635-0046
Co-sponsored by the MN Department of Human
Services
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Stand Up Be Strong! MN APTA Evidence-Based
Falls Prevention

• You will be able to
• Measure fall risk due to lower body weakness
• Incorporate screening of older adults into your
  program
• Understand action steps to reduce this risk
• Project Manager
• Kris Gjerde, PT,
• Minnesota Chapter
• American Physical Therapy Association

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Minnesota Falls Prevention Initiative

• MN Board on Aging RFP Community Service/ System
  Change/ Service Development (CSSD) grants to
  foster decreased nursing home utilization
• MN Chapter APTA system change proposal
  community based fall
  risk screen and action steps piloted in 10
  Western MN Counties
• MN APTA Collaborative partners
  PrimeWest Health
  Services Area
  Agencies on Aging
  Local Health Care providers
  County public health
  departments
• Other CSSD Falls Prevention grantees
• Mayo Medical School-in home assessment by
  geriatric fellow, Olmstead County MN
• Fairview Ridges-in home assessment by PT Dakota
  County

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Stand Up Be Strong!
MN Chapter American Physical Therapy
Association Kris Gjerde, PT Project Manager
651-635-0046 www.mnapta.org
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Specific Project Goals

• Create a community-based system that makes
  assessment of fall risk prevention of falls
  routinely available
• Enable individuals to assess lower body strength
  and related fall risk
• Enable individuals to take action to decrease
  risk or maintain low risk

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MN APTA Stand Up Be Strong!

• Demonstration project designed to prevent falls
  in older adults
• Community based system change
• Co-sponsored MN Dept of Human Services

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Why Is This Unique?

• MN CSSD grants are highly competitive
• MN Chapter received the first state grant to a
  professional association
• Innovative approach to sustainable system change
  
• Use of membership network to disseminate public
  health program

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MN APTA Workgroup

• Reviewed the evidence
• Identified Fall Risk Factors
• Decreased strength and balance
• Medication use
• Vision impairment
• Unsafe home environment
• Unsafe outside environment
• Having fallen in past year
• Fear of falling

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Stand Up!Guiding Evidence

• Rand Report on Falls for CMS, 2003
• Multifactor approaches are most effective
• Two most effective interventions are lower body
  strengthening medication review
• Strengthening was mentioned but not provided in
  the nine national programs reviewed by Rand

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Stand Up! Development

• Combined the expertise of MN APTA members
• Assumptions
• Physical therapists will serve as trainers
  consultants
• Focus community dwelling older adults
• Adults currently perform single repetition of sit
  to stand
• Requirements of screening tool
• Enables self assessment
• Applicable to groups or individuals
• Community based, not medical intervention
• Includes action steps that allow variable
  technique

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MN APTA Falls Prevention Initiative

• Oct. 2005 MN APTA invited members in 10 pilot
  counties to participate
• Apr 2006 MN APTA trained 30 PTs
• May-Dec. 2006 PTs trained 587 community partners
• Jun. 2006 Community partners started screening
  participants
• Jan. 2007 Statewide dissemination began

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Primary Fall Risk Screen

• Have you fallen in the past year?
• Are you afraid that you might fall?
• Do you frequently need to use your arms to rise
  from chairs?
• YES indicates that you may be at risk

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Physical Prescreen

• Cross your arms
• Rise to standing position
• Successful rise continue with timed sit to
  stand
• Unable Proceed to high risk category

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Timed Sit to Stand
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Risk Score
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Action Steps

• High Risk Consult your doctor or Physical
  Therapist for advice instruction to improve
  your strength. Do the exercises only if you feel
  safe doing them on your own.
• Moderate Risk Do the exercises. Seek assistance
  if you do not feel safe
• Low Risk Continue your active lifestyle, add
  the exercises to your program
• Groups Add the two exercises to your program
• Reassess every 3 months

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Exercises

• Sit to Stand
• Side Hip Raise

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Reach

• 576 Physical Therapist trained
• 1296 Community Partners trained
• 1855 Individuals screened

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June 2006 June 2007

• Adults aged 65 and older
• Risk Score 1662 total Percent
• High 741 45
• Moderate 518 31
• Low 359 22
• Unknown 44 2

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Uptake

• Follow up calls at 1, 3, 6 months
• Retention of information
• Action taken after screening
• MD, PT visit
• Performed exercises
• Increased activity
• Falls since screen
• Overall functional mobility
• 4 mobility questions from SF 36

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Whats Next?

• Screen Older Adults in your community
• Assisted Living
• Home Health
• Senior Centers
• Area Agency on Aging
• EMS, Sheriff Dept, Fire Dept
• Parish Nurse
• Faith based programs

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To Learn More

• www.mnapta.org
• www.healthyagingprograms.org
• www.cdc.gov
• www.aoa.gov
• www.minnesotasafetycouncil.org/
• www.stopfalls.org

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Stand Up Be Strong!

• Kris Gjerde, PT
• Minnesota Chapter
• American Physical Therapy Association
• www.mnapta.org