According to the CDC each year, one in every three adults ages 65 or older falls and 2 million are treated in emergency departments for fall-related injuries. In 2011, emergency departments treated 2.4 million nonfatal fall injuries among older adults; more than 689,000 of these patients had to be hospitalized. Approximately 10% of those sustain serious fractures.
About 50% of those who sustain a fracture do not fully recover and many lose independence for life. Direct costs do not account for the long-term effects of these injuries such as disability, dependence on others, lost time from work and household duties, and reduced quality of life.
Prevention is cost effective
Medicare is now covering physical therapy for fall prevention for those deemed “At Risk,” having at least two falls in a 12-month period. Progressive Physical Therapy and Rehabilitation, as a member of the American Physical Therapy Association, is actively participating in the National Falls Free© Initiative program.
How can a physical therapist help?
If you are worried about falling or if you recently had a fall, your physical therapist can conduct a brief check (“screening”) of your fall risk. If the screening shows that you are at risk, the therapist will perform a thorough evaluation, including:
- A review of your medical history
- A review of your medications
- A simple vision test
- Feet and footwear assessment
- A home safety assessment
- A simple screen of your thinking abilities
- A check of your heart rate
- Blood pressure measurements while you change positions (from sitting to standing)
- Assessment of any nervous system disorders, such as stroke or Parkinson disease
The therapist also will:
- Measure your leg strength, using simple tests such as timing how long it takes you to risk from a chair
- Determine how quickly and steadily you walk
- Assess your balance—for instance, by having you stand on one leg or rise from a chair and walk
- Use special tests to measure your balance
Based on the evaluation results, your physical therapist will design an exercise and training program to improve your balance and strength. A recent systematic review of many published studies found that exercise-based programs in the home or in group settings are effective in preventing falls. These programs are especially effective when balance exercises are performed in a standing position without using much arm support.
Balance training
Balance training has been shown to be an important and effective part of falls prevention. Your physical therapist will design exercises that challenge your ability to keep your balance, including such exercises as single-leg standing.
Doing more than one thing at the same time – safely
Older adults who have difficulty walking and talking at the same time are at a higher risk of falling. To help increase your safety during daily activities, your physical therapist can design a “dual-task” training program. This kind of training will challenge you to maintain walking speed while you do another task, such as counting backwards, engaging in a conversation, or carrying a bag of groceries.
Strength training
Older adults who have difficulty walking and talking at the same time are at a higher risk of falling. To help increase your safety during daily activities, your physical therapist can design a “dual-task” training program. This kind of training will challenge you to maintain walking speed while you do another task, such as counting backwards, engaging in a conversation, or carrying a bag of groceries.
Aerobic training
Aerobic exercise is physical exercise of relatively low intensity and long duration; it can help improve almost every aspect of your health. Walking is one of the safest forms of aerobic exercise, no matter what kind of problem you have. Once you have begun your strengthening and balance program, your physical therapist will know when you’re ready to start aerobic exercise. Depending on your ability, the therapist might have you do three 30-minute walking sessions each week.
Education
Your physical therapist will take the time to explain to you how to best manage your own risks for falling. Your therapist also may talk to you about the best activities for you to do to maintain your quality of life.
Fear management
It will be important for you to talk with your physical therapist about any fear of falling that you have. Your therapist will work with you to determine whether there are activities you should avoid. Your therapist also will work with you to determine whether your fear may be unfounded and whether there are activities that you should be doing to keep strong and help your balance.
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