Physiotherapy Management for Falls

Falls can be common, especially among elderly people, and can result in serious injuries.

Falls are a significant public health concern, with one in three adults over 65 experiencing a fall yearly. The consequences of falls can be severe, including fractures, head injuries, and even death.

Did you know that physiotherapy can help prevent falls and manage their aftermath?

Physiotherapy is a non-invasive and effective approach to fall prevention and management. By addressing strength, balance, and mobility, physiotherapists can help reduce the risk of falls and improve outcomes for those who have experienced a fall.

Physiotherapy can play a critical role in preventing falls and helping those who have experienced a fall recover and prevent future falls.

Facts about falls

Approximately one-third of all people aged over 65 years fall every year, and more than half of the population aged 80 years or above suffer from falls. Falls are the second leading cause of unintentional injury deaths over the world. 

Each year worldwide: more than 600 000 people die from falls; 37.3 million incidents are required to seek medical attention due to the severity of falls. Adults older than 60 suffer the most significant number of fatal falls.

It has been shown that physiotherapists can play an essential role in preventing falls in the old population. There is strong evidence that appropriately prescribed interventions can prevent falls.

The key risk factors of falls

•  Age

It is more likely to have increased frequency and severity of falls in the older population, and the risk increases with age. There are components in aging that increase the fall risk, including physical, sensory and cognitive changes.

•  Gender

It is suggested that older women and children are more likely to have more severe injuries from falls. However, higher death rates occur in males due to occupations and higher risk-taking behaviours.

• Other risk factors

• • Occupation
  • Cognitive impairment
  • Substance abuse
  • Undying medical conditions
  • Side effects of medications
  • Sedentary lifestyle
  • Unsafe environment

Falls management

The management of falls is complex, and multiple factors should be considered.

A combination of interventions can target the risk factors, including regular medical review, home assessment and exercise programs for balance and falls.

It is expected that there are multiple factors leading to falls. Hence, creating a tailor-made program for individuals with a high risk of falls is crucial. The goal of the management is to minimise and prevent any future incidents of falls for each individual.

Physiotherapy assessment for falls

• Gather relevant information.
• History of falls medical history (e.g. osteoporosis and bone health, urinary incontinence and cardiovascular disease).
• Medication.
• Physical examination.
• Gait and balance neurological and cognitive function-lower limb strength
• Feet and footwear.
• Home environment (e.g. Identify hazards and declutter the environment).
• Equipment (e.g. gait aid, rails, shower chair).

Physiotherapy interventions for falls

Physiotherapy management for falls prevention should involve an individual assessment to determine risk factors for falling and then develop an exercise program tailored to address those risk factors. This includes activities to improve strength, balance, and mobility.

• Individualised and progressive program: Including balance exercises, strength-training exercises and postural-challenging exercises.
• Falls education: To prevent falls and restore confidence in mobility. We teach individuals how to get off the floor or call for help.
• Gait aid assessment and practice: We prescribe appropriate equipment for your mobility and transfers. With the gait analysis we did in the assessment, we can identify your gait problems and how you can correct them.
• Optimise the home environment: While health and lifestyle issues are essential to reduce your risk of falls, we could minimise any risk factors in your everyday environment with home modifications.
• Liaise with other health professionals: Clients are referred to services as appropriate if we think more contributing factors need to be targeted by other professionals.

Exercise interventions for falls

Falls are a major public health concern for older people. Substantial evidence has shown that exercise programs can reduce the chance of falls and the number of people experiencing falls in community-dwelling older people.

Benefits of individualised exercise programs

• Reduce falls rate by 23%.
• Reduce the risk of fractures by 27%.
• Have a fall prevention effect in community-dwelling older people with Parkinson’s disease or cognitive impairment.
• More significant outcomes are seen when more than 3 hours/week of balance components are involved in the exercise program.

Final thoughts on physiotherapy management for falls

Falls can be a scary and dangerous experience, but with the help of physiotherapy, they can be prevented.

Taking the necessary steps to improve balance, strength, and mobility can reduce the risk of falls and improve your overall quality of life.

Remember, it’s always possible to start taking care of yourself, and with the proper support, you can stay on your feet and keep doing the things you love for years to come.

Book an appointment with us today! Our team of experts will lead you down the best treatment path for your condition.

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References:

• Hamed A, Bohm S, Mersmann F, Arampatzis A. Follow-up efficacy of physical exercise interventions on fall incidence and fall risk in healthy older adults: a systematic review and meta-analysis. Sports medicine-open. 2018 Dec;4(1):56.Available from:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6292834/

• Sherrington C, Fairhall NJ, Wallbank GK, Tiedemann A, Michaleff ZA, Howard K, Clemson et al.  Exercise for preventing falls in older people living in the community. (Cochrane Review) Cochrane Database Syst Rev 2019; (1): CD012424 (https://www.cochrane.org/CD012424/MUSKINJ_exercise-preventing-falls-older-people-living-community)

• Public Health England. Falls and fracture consensus statement. Public Health England, 2017: [PDF File]