Have you fallen lately? What can you do?

As the weather turns cold and the first snowflakes hit the ground, the thoughts and fears of slipping and falling are on the minds of many elderly individuals. Long periods of cold and inclement weather can lead to a reduction in activity level resulting in loss of strength and cardiovascular endurance, which contribute to balance problems.

 

Slipping and falling is not isolated to the winter season. It occurs throughout the year, at home and in the community. More than one third of adults 65 and older fall each year in the United States. According to the Center for Disease Control and Prevention (CDC), falls are the leading cause of injury death in older adults. This number is on the rise over the past decade.

 

 

Not only is falling dangerous, it is very costly. The need to find affective treatments is vital for the protection of the elderly and to contain health care costs. Treatment including physical therapy and exercise has been shown to be of significantly less cost than treating the average result of falls. It has also been found that a simple exercise routine may reduce fall risk, which is of minimal health care cost.

 

 

Falls are a result of a combination of underlying issues. Musculoskeletal changes such as leg and core weakness, flexibility deficits, and reduced endurance are correlated with an increase in fall risk. Body position sense, called proprioception, reduces as we age, which equates to slower reaction time for the body to right itself when forced off balance. Other medical conditions such as Parkinson’s disease, neurological conditions, spine disorders, and infection may cause imbalance. Orthostatic hypotension, rapid drop in blood pressure with change in position from back to sitting, can cause falls.

 

 

In research studies, it has been shown that those individual who have previously fallen are at significantly higher risk of falling in the future. A study completed by Fletcher et al. 2002 demonstrated that nearly 1/3 of seniors surveyed had experienced a fall, of those individuals, half had fallen previously. If you feel imbalanced with reaching overhead, looking over your shoulder, going up or down stairs, negotiating curbs, bending forward and walking on the grass/gravel, you may be at a greater risk of falls. 

 

 

A thorough evaluation completed by a physical therapist can give an accurate assessment of an individual’s fall risk. After reviewing a complete medical history the physical therapist will evaluate strength, flexibility, coordination, and balance. This is done to determine what the cause of balance dysfunction is and then to design an appropriate treatment plan. This may include strengthening, balance exercises, a walking program, Tai Chi, and recommendations for home exercises. The physical therapist works with the medical health care team such as neurologists and orthopedic doctors.

 

 

Since a significant number of falls occur in the home, a home safety assessment is a quick 3600 way to immediately reduce your fall risk. Making the following modifications can improve safety by removing obstacles.

• Improve lighting in poor lit areas, most importantly in the hallway and stairs. The use of night lights can reduce falling at night in the bedroom, hallway, and bathroom. 
• Remove traditional rugs in the bathroom and add non-slip rugs.
• If you have difficulty getting in/out of the tub and on/off the toilet, consider adding support bars. Ask your physical therapist for recommendations.
• Remove all cords and cables from areas of walking traffic. 

Simple balance exercise can improve balance. If you think you are at risk of falling, please contact your physical therapist for an evaluation. Trying balance exercises without proper assessment may lead to falls. Your physical therapist and medical team can assist in an appropriate and safe exercise program. The reduction of falls takes a multifaceted approach. Individuals with balance dysfunction, their family members, physicians, and physical therapists must work together to effectively administer the evidence-based treatments. If you think that you or a loved one is at risk of falling, please call 856-396-2250 for a free balance screen.