September 22nd is the National Fall Prevention awareness day. I want to take this opportunity to talk about falls and how we can prevent it.
Some Statistical Data on Falls:
As per Central of Disease Control, more than 1/3 of adults over 65 years, falls every year in the United States. Falls are a leading cause of injury-related deaths in the US. In 2007, 18,334 people 65 and older died from injuries related to falls. In 2009, 2.2 million people 65 and older were treated in emergency departments for nonfatal injuries from falls, and more than 581,000 of these patients were hospitalized. By 2020, the cost of fall injuries is expected to reach $54.9 billion (in 2007 dollars). One out of five falls causes a serious injury such as broken bones or a head injury. Each year, 2.8 million older people are treated in emergency departments for fall injuries. Over 800,000 patients a year are hospitalized because of a fall injury, most often because of a head injury or hip fracture. Falls are the most common cause of traumatic brain injuries (TBI).
Causes of falls:
- Poor vision
- Poor balance
- Muscle weakness
- Improper use of assistive devices like wheelchair, walker or cane
- Improper posture
- Cluttered house
- Medication
- Vertigo
- History of falls or frequent falls
- Fear of falling
- Poor sensation, especially in the sole of feet
- Certain medical conditions like Diabetes, stroke, arthritis, osteoporosis, cardiovascular disease
Prevention of falls:
A fall is basically a loss of balance when an individual will either touch/hit the ground/surface unexpectedly or involuntarily. To prevent falls, we need to find out why it happens. Above I discussed some major causes of falls. Below are some prevention strategies.
Exercises:
Exercise can help strengthen the muscles and improve balance which are two important factors to prevent falls. The following are some examples of balance exercises that a physical therapist may prescribe. Do not begin any exercise program without consulting with your physical therapist. Do not attempt to do the exercises alone—make sure that you have someone next to you to decrease the potential risk of falling.
Heel Rises:
Stand straight; hold onto a sturdy table or chair for balance. Slowly stand on tiptoe, as high as possible. Hold the position for 1 second. Slowly lower heels all the way back down. Pause.
Repeat 10 to 15 times.
Hip Bending:
Stand straight; hold onto a sturdy table or chair for balance. Slowly bend your right knee toward your chest—do not bend at the waist. Hold the position for 1 second. Slowly lower the leg all the way back down. Pause.
Repeat with the left leg. Alternate legs so you have repeated 10 to 15 times on each leg.
Side leg raise:
Stand straight, feet slightly apart; hold onto a sturdy table or chair for balance. Slowly lift your right leg straight out to the side—keep your back straight and your toes pointing forward. Hold the position for 1 second. Slowly lower the leg all the way back down. Pause.
Repeat with the left leg. Alternate legs so you have repeated 10 to 15 times on each leg.
Few more Exercises:
Stand up and sit down from a chair without using your hands and keeping your back straight.
Stand on 1 leg while waiting in line (you can use a counter or other stable object for balance).
Environmental changes :
This is mainly home modification to make the environment you live in as safe as possible. It can also include your office, your vehicle, your garden, etc. You can install some adaptive equipment in your car etc to make the vehicle safe for transfers. Here are some examples of home modifications:
- Make sure home, bathroom, stairways are well lit. Use night lights to help light the areas for night time hours.
- In Bathroom, install grab bars, nonslip bath mats, etc. If you have breathing problems, then having a shower chair or tub bench helps. Using a small step stool to get in and out of bath also helps to prevent loss of balance.
- Home should be clutter-free in all areas.
- loose rugs are the culprit of many falls in older adults so please remove loose rugs. A foot or adaptive equipment can get caught in a corner of loose rugs, causing falls.
- Install a handrail on both sides of stairs to give extra support while going up and down the steps.
Education to prevent Falls:
Educating your patient on causes of falls, risk factors, on participating exercise program etc can help. Also educating on medication management, home modification, asking for help when needed are a huge component on fall reduction.
References:
The American Physical Therapy Association: http://www.moveforwardpt.com/
Centers for Disease Control and Prevention: http://www.cdc.gov/Homeandrecreationalsafety/Falls/adultfalls.html/
Home Safety Council: http://www.homesafetycouncil.org/SafeSeniors/sen_safeseniors_w001.asp