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Prevention of  Falls in Elderly Adults

9/23/2015

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Each year, one in every three adults ages 65 or older falls. The risk of falling increases with each decade of life. The long-term consequences of fall injuries, such as hip fractures and traumatic brain injuries, can impact the health and independence of older adults. Thankfully, falls are not an inevitable part of aging. In fact, many falls can be prevented.
 
Most falls are caused by the interaction of multiple risk factors. The more risk factors a person has, the greater their chances of falling. Risks factors are categorized by intrinsic and extrinsic. 
Intrinsic Factors 

·         Advanced age
·         Previous falls
·         Muscle weakness
·         Gait & balance problems
·         Poor vision
·         Postural hypotension
·         Chronic conditions
·         Fear of falling

Extrinsic Factors

·         Lack of stair handrails
·         Poor stair design
·         Lack of bathroom grab bars
·         Dim lighting or glare
·         Obstacles & tripping hazards
·         Slippery or uneven surfaces
·         Psychoactive medications


If you are 65 or older and answer yes to any of the following questions talk to your health care provider about your risk and a suitable prevention program.
  1. Have you fallen in the past year?
  2. Do you feel unsteady when standing or walking?
  3. Do you worry about falling?
Your health care provider may review your medications and stop, switch, or reduce the dosage of drugs that increase fall risk. They may recommend vitamin D supplements of at least 800 IU/day with calcium. They may refer you to a physical therapist if you have gait, balance, or lower body weakness deficits. They may also recommend other health professional to manage additional risk factors (i.e poor vision, or suspected neurological condition).
In order to prevent falls healthcare providers should focus on the risk factors that are modifiable.  Muscle weakness, poor balance, excessive medications, and home hazards are examples of modifiable risk factors. 

Most fall prevention programs focus on improving muscle strength and balance to reduce risk of falling, while a few programs address the fear of falling. The National Council on Aging has listed information about several evidenced based fall prevention programs.Click to view this information.
At Stover PT I have frequently worked directly with older adults at risk for falling and successfully implemented strength and balance programs that were individually tailored and successful at achieving functional goals for most of my career. In 2014 I underwent training in 2 evidenced based fall prevention programs (Otago exercise program and Tai Chi moving for better balance). I am excited to offer my patients these services in addition to my 20 year knowledge and experience in outpatient orthopaedic physical therapy practice. 
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Otago is an excellent choice for the elderly adult with limited mobility and resources. Otaga uses very simple movements and only requires the use of adjustable ankle weights. Additionally, due to its New Zeland roots, it has a hint of basic MDT incorporated into the program. This makes Otago an excellent choice for the older adult who has additional spinal problems to manage.
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Tai Chi moving for better balance is a great program for the more mobile community dwelling older adults who enjoys group activity. This Tai Chi program uses 8 forms modified from the traditional 24 form Yang style Tai Chi that is widely used in China and boasts many health benefits.
Ask your primary care physician for a referral if you think you may benefit from these or similar fall prevention programs.
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    Stover PT Blog

    Thanks for visiting my blog page. My name is Don Stover. I am a seasoned physical therapist (PT) in Oklahoma City OK. with over 20 years in the biz. I have a lot of knowledge and training in orthopedic PT and spine care. I will be sharing my thoughts on physical therapy for orthopedic problems such as spinal pain, extremity joint pain, sports injuries, and health/fitness, I hope you enjoy reading!

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