FALL PREVENTION

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FALL PREVENTION
http//www.virtualphysicaltherapists.com/
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• Falls are the leading cause of injury death for
  Americans 65 years and older.
• Every 20 minutes, an older adult dies from a fall
  in the US, and many more are injured, costing 50
  billion a year. Approximately a third of older
  adults who live at home, and half of those living
  in nursing homes, fall at least once a year.

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Only 37 percent of elderly patients are asked
about falls in the primary care setting. Most
falls are preventable, and many common causes can
easily be corrected. The Centers for Disease
Control and Prevention (CDC) and the American
Geriatric Society recommend a yearly fall
assessment screening for all adults 65 years of
age and older, but for most, this is NOT
done. Seniors are prone to underreporting falls,
usually out of denial, fear of losing their
independent living status, or because of memory
and recall difficulty.
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• Fall Risk Assessments should be part of regular
  check-ups for our seniors and performed every six
  months.
• Anyone who falls outside of sports activity
  should undergo a gait and balance assessment.
  Those who have had multiple falls within a year
  should be evaluated more thoroughly to determine
  their fall risks and identify and mitigate them.
  Falls are rarely due to a single cause or risk
  factor and are often the accumulated effect of
  impairments in multiple domains.

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• Perform a Fall Risk Assessment to Identify Risk
  Factors
• Our Fall Prevention Program is based on the CDCs
  STEADI program.
• VPTs Fall Prevention Program is based on the
  CDCs STEADI program. A questionnaire to
  identify risk factors, including medications,
  home hazards, visual impairment, cognition,
  feet/footwear issues, Vitamin D deficiency, and
  comorbidities, is reviewed with our trained
  therapists.

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Our therapists then perform an extensive
assessment, including range of motion and
strength of the lower extremities and specific
balance testing. Multiple studies have shown an
association between walking speed and survival,
so many of our screening tests for falls involved
timed movement. (Extreme caution is taken by our
clinicians when testing patients remotely.
Patients with moderate to high fall risk must
have someone assisting them during our screening.)
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Individuals with a low fall risk are provided
with educational materials on fall prevention and
an Otago exercise program and are advised to have
a yearly follow-up. Those individuals with
moderate and high fall risk are recommended
for further evaluation to determine the root
cause of the balance deficit. This includes a
comprehensive vestibular assessment, gait
analysis, strength, range of motion, neurological
screen, and specific balance tests, including Sit
to Stand, Single Leg Stance, and Timed Up and Go.
Those with a high fall risk require physical
assistance to complete the assessment.
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• Five Times Sit to Stand (5X STS) This test
  assesses strength. Have the patient start seated
  in an armless chair with a firm seat, ask him or
  her to stand up and sit down five times as
  quickly as possible, and record the time required
  to complete the five repetitions.
• Single Leg Stance (SLS) This test assesses
  balance. Have the patient stand on one leg with
  arms crossed. Time how long the patient can
  remain in this position without touching the
  suspended foot to the ground, moving the hands
  away from the chest, or displacing the
  weight-bearing foot.
• Time Up and Go (TUG) This test assesses gait.
  Have the patient start in a seated position, rise
  to a stand, walk three meters and return to a
  seated position in the chair, and record the time
  required to complete the exercise.

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Patients who take more than 10 seconds to do the
5X STS and TUG tests and those who can balance
for less than 10 seconds during the SLS probably
require further scrutiny. The underlying
physical condition determines the individualized
treatment plan, which may include vestibular,
neurological, strength, and/or specific balance
exercises. Each exercise program is provided
with a video demonstration. The focus of the
treatment plan is to educate and empower to
remove any risks, improve any deficits and reduce
their overall risk of a fall. Follow-up
appointments are based on individual patients
needs.
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• Eliminate Risk Factors
• 1. Improve your Balance. Exercise is critical
  to improving your strength and balance. Exercises
  should include strength, balance, and
  proprioceptive training.
• 2. Vestibular Assessment Our balance center is
  actually in our inner ear. Any disturbances can
  cause balance problems, make you dizzy, and make
  the room feel like it is spinning. Having a
  specialist assess your vestibular system is
  essential in eliminating potential risk factors.

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• 3. Medications Some medicines have side effects
  that cause dizziness, drowsiness, or
  confusion, so changing or reducing the dose of
  medicines that may affect your gait or balance is
  important.
• 4. Footwear Look at your footwear to see if any
  of your shoes might increase your risk of
  falling. Make sure to wear nonskid soles.
• 5. Reviewing your home for potential hazards.
  These may include poor lighting, loose rugs,
  and/or cords on the floor. This review may be
  done by yourself, a partner, or a healthcare
  provider.
• 6. Vision Getting your vision checked by an eye
  doctor.
• 7. Vitamin D Take Vitamin D to strengthen your
  bones.

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Virtual physical therapists

• info.virtualphysicaltherapists_at_gmail.com

• http//www.virtualphysicaltherapists.com/