Falls & Balance Flashcards
Over what age is the prevalence of falls over 50%? Are falls more common in residential aged care facilities or community living?
From 85yo.
Residential aged care.
How common is a minor injury, a serious injury and a fracture after a fall? How common is fear of falling among fallers?
Minor: 50%. Serious: 10-15%. Fracture: 5%.
Fear: 50%.
What are the 3 classes of risk factors for falls?
Intrinsic, extrinsic and behavioural.
Intrinsic risk factors for falls - name at least 3.
Balance impairment, muscle weakness, vision impairment, postural hypotension. (Drugs can affect these)
Extrinsic risk factors for falls - name at least 3.
Gait aids, uneven/slippery surfaces, footwear, stairs and rails, poor lighting, clutter. Medications (esp more than 4)
What 3 sensory systems are involved in obtaining information about body position for balance?
Visual system, vestibular system and somatosensory system (touch, pressure, proprioception)
What are tests of balance? Which are static and which dynamic?
Static: Romberg’s test, Standing on heels/toes, Dynamic: Timed Up & Go, Sternal push/Shoulder tug, functional reach
What scale do physiotherapists use to assess balance? How many components and what is the total score?
Berg Balance Scale. 14 tests with total score of 56.
What are some extra questions to ask in the context of a fall history?
Witnesses, impact on lifestyle and fear of falling, ability to get up, rule out syncope - remember falling?
Apart from balance tests, what physical examinations are common for a faller?
Musculoskeletal for joints, gait assessment, vision, postural BP, footwear assessment, neurological - central and peripheral.
What areas may be useful to address intrinsic factors for a faller? What professionals are usually involved?
Medical interventions for vision, balance, hypotension, foot/joint conditions, manage syncope. Exercise programs.
Doctor and physio.
What are 3 areas that may be useful to address extrinsic factors for a faller? Which professionals may be involved?
Foot care and footware. Gait aids. Home hazard assessment.
Podiatry, OT and physio.
Which professionals may address behavioural factors in falls?
Who may be useful for severe fear of falling?
ALL health professionals can advise about appropriate behaviour.
Clinical psychology may be useful for fear.
What are 5 singlular interventions which may reduce the risk of having a fall?
Balance training (eg. Tai chi); Cataract surgery; Home hazard assessment; Vitamin D +/- Ca; Reduce psychotropic medications (eg. Benzos)
What are 3 interventions which may be useful to reduce the risk of injury in fallers?
Osteoporosis assessment/treatment. Strength & Balance training.
Hip protectors.
