Physical Therapy for Fall Prevention

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Physical Therapy & Fall Prevention

WHAT IS PHYSICAL THERAPY’S ROLE IN FALL PREVENTION?

Falls are a major contributor to injury and high medical costs, especially in older adults. Helping to prevent these falls is an important role that physical therapists play in patient care. As part of their evaluation, your physical therapist will perform a fall risk assessment which allows them to create a comprehensive treatment plan to address the identified risk factors.

WHAT CAN BE DONE TO PREVENT FALLS?

There is a lot that my team of physical therapists and I can do to help prevent falls. We start by performing a subjective interview to find out if you are already experiencing falls, near falls or feelings of unsteadiness. We will ask you about the circumstances in which you feel unsteady or have led to a fall in the past. Questions about the activities you are involved in and your level of functional mobility are also helpful.

We will likely ask you about your home environment, devices that you use to help you balance or walk and measure your balance confidence. Finally, a physical examination of strength, range of motion, balance, coordination and motor control, endurance, posture and more is used to round out the evaluation. Each piece of information gathered provides your therapist with a list of targets towards which to focus their intervention.

By addressing lifestyle, environmental and personal factors that increase your risk for falls, we can help prevent them in the future.

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ADDRESS RISK FACTORS TO PREVENT FALLS…

Making a plan to address risk factors for falls is an important step in fall prevention. While physical therapists are not licensed to address all of them ourselves, we can address many of them and refer you to the right professional to address the others. Some of the important risk factors addressed in fall prevention are as follows:

Environmental Factors:

Home set-up: Many falls happen in the home. Physical therapists can make recommendations for home modifications that can lower your risk for falls such as:

Eliminate throw rugs
Place visible tape lines at the edges of the stairs to delineate each one
Move the primary bedroom downstairs if possible
Install a railing on both sides of the stairs
Utilize a shower or bath chair
Install grab bars throughout the house
Install nightlights for better illumination at night

Outdoor environment: By understanding the outdoor spaces you regularly or occasionally work, walk and recreate in, we can make suggestions on assistive devices or equipment to reduce your fall risk and prescribe exercises to improve your safety in these environments.

Personal Factors:

Polypharmacy: Polypharmacy refers to the simultaneous use of multiple drugs to treat the same or different conditions. The use of multiple medications, especially if it includes psychoactive drugs, muscle relaxers or antihistamines can increase one’s risk for falls. If a physical therapist identifies polypharmacy in their interview as a potential fall risk factor they may recommend you discuss this issue with your physicians.

Low vision: If you have visual impairments, it is important to see your optometrist or ophthalmologist regularly. When this is the case your therapist will help strengthen your other balance systems and teach you how to compensate for the visual deficit.

Impaired strength, range of motion or motor control: Muscle weakness, loss of coordination and motor control and impairments in joint range of motion can all contribute to feelings of instability.

Impairments in memory or cognition: Either of these conditions can increase risk for falls and physical therapists can help advise the patient and family members on strategies for decreasing fall risk in these scenarios.

Medical conditions: while your physical therapist will not be managing your medical conditions, they may identify one or more conditions that may be contributing to your fall risk and encourage you to consult with your physician to make sure it is being optimally managed.

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End Injury Progression

Physical therapy for falls has proven to prevent injury, slow and even stop pain issues, improve performance, and reverse injury progression in many cases.

**Relieve Pain**
The movements used in this technique can target your entire body helping you to manage discomfort and pain during the course of your physical therapy treatments.

**Improve Range of Motion**
Posture awareness is an important area to focus on due to the fact that certain positions may cause you further discomfort and pain.

**Restore Mobility**
You can regain mobility and flexibility by taking part in the stretches and exercises as prescribed by your physical therapist.

How Long Will Fall Prevention Physical Therapy Treatments Last?

If you decide to work with a physical therapist to help with fall prevention related issues, your entire treatment plan could consist of around 8-20+ different physical therapy sessions that will each last 60-90 minutes. Once you complete your customized physical therapy treatment plan, you will be able to continue to do the prescribed stretches and exercises utilized during your PT sessions yet in the comfort of your own home.

WHAT INTERVENTIONS DO PHYSICAL THERAPISTS PRESCRIBE TO PREVENT FALLS?

Aside from giving advice on modifying risk factors, a personalized exercise plan to address patient impairments is an important step in preventing falls.

Strengthening exercises: adequate strength around the muscles in the trunk, hips, knees and ankles that help us balance or catch our balance is very important.

Flexibility and range of motion exercises: exercises like stretching, mobility exercises and joint mobilizations may all be prescribed to improve range of motion and flexibility.

Vestibular rehab: If dizziness or feelings of disequilibrium are contributing to your falls or feelings of unsteadiness then vestibular physical therapy may be needed to either restore the function of the vestibular system or help the brain compensate for any weaknesses.

Balance exercises: practicing balance is an essential component of a physical therapy program for balance disorders. These exercises are highly individualized to address specific patient impairments and to help address limitations in function. They are also progressive and begin with easier exercises and progress to more challenging ones over time.

Assistive device training: sometimes using an assistive device like a cane or walker is the best step to prevent falls. Your PT can advise you on which device is best and help you learn how to use it safely.

Fall recovery: Despite our best efforts, sometimes falls happen and practicing how to fall safely and to get back up after a fall is very important.

While physical therapists often treat patients after a fall, let’s work together to prevent them in the first place. If you are feeling unsteady or want to minimize your risk for falls, call us today to schedule a physical therapy evaluation.