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A physical therapy evaluation can help determine the multiple risk factors for falls in older adults.

A physical therapy evaluation can help determine the multiple risk factors for falls in older adults.
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Publish Date: 12/30/10
Media Contact: Katy Cosse, 513-556-2635
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UC HEALTH LINE: Stay Active, Know Risks to Avoid Falls

CINCINNATI—Winter’s snow and ice aren’t the only things that are causing us to slip lately. For older adults, many factors can combine to make them to feel off-balance.

"Falls in older adults can be caused by multiple things,” says Kari Dunning, PhD, physical therapist and University of Cincinnati rehabilitation sciences assistant professor. "Risk factors include weakness, vision problems, low blood pressure, medications and balance problems."

Certain diagnoses also increase the risk of falls, says Dunning; for example, adults who have experienced a stroke fall more often than persons without a neurological diagnosis.

While some slips trigger only embarrassment, others can result in moderate to severe injuries, from hip fractures to traumatic brain injury. According to the Centers for Disease Control and Prevention, U.S. emergency departments saw 2.2 million nonfatal fall injuries among older adults in 2009. More than one-quarter of those patients were hospitalized.

But Dunning cautions that older adults shouldn’t assume these falls are just part of aging—the majority of them are preventable.

"If someone falls, they should be evaluated,” she says. "There’s usually something going on that made them fall. The correct intervention can prevent future falls and injury.”

A multi-factorial evaluation by a physical therapist (PT) can help point to reasons behind stability problems, including, Dunning says, the fear of falling itself.

"A lot of people haven’t fallen but are still afraid of falls,” she says. "That fear, by itself, can contribute to risk. The person stops moving and then they lose strength.”

Strength has been shown to be a key element of fall prevention. Dunning says strength training of the lower extremities has been shown to be one of the few factors that can decrease falls by itself—something not shown with balance training.

A PT evaluation will include assessments of strength, balance, flexibility and mobility, including specific balance tests to determine if a person is at risk for falls. Based on that assessment, a PT will develop a treatment program to help prevent falls and injury. PTs can also refer clients to a physician for care of medical risk factors including medication, incontinence and impaired vision.

For those worried about falling, Dunning recommends an evaluation with a PT or primary care physician, basic strength exercises and, above all, continued activity.  

"One of the most important things to prevent falls is to stay active,” she says. "Inactivity leads to weakness and fear of falling. Keep walking, keep exercising, keep moving! There are many activity programs for older adults at local hospitals, senior centers and through the health departments. There is also a program perfect for persons who have fallen or are afraid of falling titled ‘Matter of Balance’ that is offered  throughout the Greater Cincinnati and Northern Kentucky area.”

For more information about fall prevention and to find a Matter of Balance class near you, Dunning recommends the Hamilton County Fall Prevention Task Force’s website, which includes information for older adults, their family and health care providers. The site also features steps older adults can take to reduce risk factors inside their home—improving the lighting and installing handrails and non-slip mats where needed.

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