Falls in

Elderly
Physiothera
pist
Perspective
An 85 year old lady fell down while draping her 7 year old Grand Daughter with a
blanket and didnt have pain or discomfort in her body immediately. After couple of
days she was having pain in her back for which she went for an orthopedics consult
followed by !" which revealed multiple crush fracture in the lumbar and dorsal
spine. #he had complete rest with back brace for few weeks followed by
comprehensive physiotherapy. $verall it took si% months for her to recover from the
day of fall and a&ected her 'uality of life especially to lead an active and
independent life.
About one third of people over the age of (5 and almost half of people over the age
of 8) will fall at least once a year. Doctors* +urses* para, medical persons* family
member * friend etc can identify fall risk person in their life and refer them to
-hysiotherapist for further management.
Physiotherapists can help reduce a persons risk of falling by
Assessing a persons risk of falling.
.elping his home as safe as possible.
/ducating that person about the medical risk factors linked to fall
Designing individuali0ed e%ercises and balance training.
1orking with other health care professionals and community services to create
programs for people who want to reduce their risk of falling.
Physiotherapist can do a thorough evaluation which includes
A review of ones medical history
A review of ones medication
A simple vision test
A home safety assessment
A simple screen of ones thinking abilities.
A check of ones hear rate.
2- measurements while changing position from sit to stand. 3eet and footwear
assessment.
Assessment of any nervous system disorders such as stroke* -arkinsons* etc
easure ones leg strength using simple tests such as timing how long it takes
you to rise from a chair. Determine how 'uickly and steadily one can walk.
Assess ones balance 4 for instance * by having one stand on one leg or rise from
a chair and walk 5se special test to measure the balance
2ased on the evaluation results* -hysiotherapist will design an e%ercise and training
program to improve ones balance and strength. A recent systematic review of
many published studies found that e%ercise based programs in the home or in group
settings are e&ective in preventing falls. 6hese programs are especially e&ective
when balance e%ercises are performed in a standing position without using much
arm support.
I Balance Exercises
2alance training has been shown to be an important and e&ective part of falls
prevention. $nes -hysiotherapist will design e%ercises that challenge his ability to
keep his balance including such e%ercises as single leg standing
II Walking and Moving
1hen people walk very slowly or unsteadily* they are at risk for falling. .is
-hysiotherapist can improve his walking ability by making him do such activities as7
Dance steps
1alking in circles
83igure 89* e%ercise to strengthen the core abdominal muscles that help stabi0e
ones body
$bstacle course
III oing !ore than one thing at the sa!e ti!e safely
$lder adults who have di:culty walking and talking at the same time are at high
risk of falling. 6o help increase their safety during activities ones -hysiotherapist
can design a*9dual task9* training program. 6his kind of training will challenge one
to maintain a walking speed while he do another task such as counting backwards*
engaging conversation or carrying a bag of groceries.
I" #trength $raining
#trengthening e%ercises are a key element of fall prevention when they are done in
con;unction with balance training. $nes -hysiotherapist will design strengthening
e%ercises that focus on his leg and the muscles used in maintaining posture.
" %erobic $raining
1alking is one of the safest way of aerobic training. -hysiotherapist will formulate
walking program according to the patients capacity.
"I Education& Fear Manage!ent
-hysiotherapist will talk to the patient how best to manage his own risk of falling
and to build his self esteem to overcome the fear of falling.
"II 'o!!unity Progra!
-hysiotherapist can participate with local groups in organi0ing di&erent fall
prevention activities at the community level like in the malls* senior citi0en centres*
clubs etc.
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