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Jun 8

Physical therapist’s guide to falls – Journal Advocate

Exercise Programs Comments Off on Physical therapist’s guide to falls – Journal Advocate

By Dr. Pete Stucchi

ApexNetwork Physical Therapy

Falls can diminish your ability to lead an active and independent life. About one third of people over the age of 65 and almost half of people over the age of 80 will fall at least once this year. There usually are several reasons for a fall. Physical therapists can help you reduce your risk of falling by:

Assessing your risk of falling

Helping you make your home as safe as possible

Educating you about the medical risk factors linked to falls

Designing individualized exercises and balance training

Working with other health care professionals and community services to create programs for people who want to reduce their risk of falling

What Are Falls?

Dr. Pete Stucchi ApexNetwork

The reasons for falls are complex and include:

Being 80 years old or older

Leg muscle weakness

Difficulty with balance or walking

Vision problems (cataracts, macular degeneration, wearing bifocals)

Medical conditions that limit your ability to get around, such as Parkinson disease, stroke, or diabetes

Conditions that cause confusion, such as dementia and Alzheimer disease

Depression

Taking more than four medications at the same time or psychoactive medications (such as sedatives or antidepressants)

Using a cane or other walking device

Home hazards (throw rugs, pets underfoot)

Low blood pressure

The more risk factors you have, the greater your risk. The factors associated with the greatest fall risk are:

A history of previous falls

Balance problems

Leg muscle weakness

Vision problems

Taking more than four medications or psychoactive medications

Difficulty with walking

How can a physical therapist help?

If you are worried about falling or if you recently had a fall, your physical therapist can conduct a brief check ("screening") of your fall risk. If the screening shows that you are at risk, the therapist will perform a thorough evaluation, including:

A review of your medical history

A review of your medications

A simple vision tests

A home safety assessment

A simple screen of your thinking abilities

A check of your heart rate

Blood pressure measurements while you change positions (from sitting to standing)

Feet and footwear assessment

Assessment of any nervous system disorders, such as stroke or Parkinson disease

The therapist also will:

Measure your leg strength, using simple tests such as timing how long it takes you to risk from a chair

Determine how quickly and steadily you walk

Assess your balance for instance, by having you stand on one leg or rise from a chair and walk

Use special tests to measure your balance

Based on the evaluation results, your physical therapist will design an exercise and training program to improve your balance and strength. A recent systematic review of many published studies found that exercise-based programs in the home or in group settings are effective in preventing falls. These programs are especially effective when balance exercises are performed in a standing position without using much arm support.

Balance Training

Balance training has been shown to be an important and effective part of falls prevention. Your physical therapist will design exercises that challenge your ability to keep your balance, including such exercises as single-leg standing.

Walking and Moving

When people walk very slowly or are unsteady, they are at risk of falling. Your physical therapist can improve your walking ability by having you do such activities as:

Dance steps

Walking in circles

"Figure 8" exercises to strengthen the core abdominal muscles that help stabilize your body

Obstacle courses

Doing More Than One Thing at the Same TimeSafely

Older adults who have difficulty walking and talking at the same time are at a higher risk of falling. To help increase your safety during daily activities, your physical therapist can design a "dual-task" training program. This kind of training will challenge you to maintain walking speed while you do another task, such as counting backwards, engaging in a conversation, or carrying a bag of groceries.

Strength Training

Strengthening exercises are a key element of fall prevention when they are done in conjunction with balance training. Your physical therapist will design strengthening exercises that focus on your leg and the muscles used in maintaining posture.

Aerobic Training

Aerobic exercise is physical exercise of relatively low intensity and long duration; it can help improve almost every aspect of your health. Walking is one of the safest forms of aerobic exercise, no matter what kind of problem you have. Once you have begun your strengthening and balance program, your physical therapist will know when you're ready to start aerobic exercise. Depending on your ability, the therapist might have you do three 30-minute walking sessions each week.

Education

Your physical therapist will take the time to explain to you how to best manage your own risks for falling. Your therapist also may talk to you about the best activities for you to do to maintain your quality of life.

Fear Management

It will be important for you to talk with your physical therapist about any fear of falling that you have. Your therapist will work with you to determine whether there are activities you should avoid. Your therapist also will work with you to determine whether your fear may be unfounded and whether there are activities that you should be doing to keep strong and help your balance.

Community Programs

Several fall prevention programs are being promoted by the Injury Prevention and Control Center of the Centers for Disease Control and Prevention in collaboration with the Administration on Aging. These programs help people:

Reduce their fear of falling

Set goals for increasing their physical activity

Make their homes more safe

Do more exercise to increase strength and balance

Your physical therapist may be involved in setting up one of these programs and can help you find programs in your area that would be best for you. #choosePT

Dr. Pete Stucchi, PT, DPT is the physical therapist and clinic manager at ApexNetwork Physical Therapy in Sterling. Dr. Pete is a Doctor of Physical Therapy and has a bachelor's degree in athletic training. He has been practicing physical therapy for the last 11-plus years, dry needling for the last five years, and working with athletes for over 18 years. Pete uses evidence based treatments that include manual therapy and exercise to help expedite recovery. He has a passion for advocating for the physical therapy profession, and enjoys treating a variety of neurologic/sports/orthopedic conditions. His particular interests are in chronic pain, concussion management, fall prevention, movement disorders and how to help patients continue activity while managing their pain. In addition to patient care, Pete oversees daily operations of the clinic, marketing, and community/event planning. He currently resides in Sterling with his wife and two sons. Contact Dr. Pete at ApexNetwork Physical Therapy 970-425-7272, 126 N. Second St., Sterling to set up an appointment for a complimentary discovery session to see how PT can help you meet your goals. Colorado is a direct access state and no referral is required to begin your physical therapy care. Call today to make an appointment. For healthy tips and ways to help getting back to living life, Like and Share "Dr. Pete Stucchi, Physical Therapist" on Facebook. @DrPetePT. Check out @ApexNetworkSterlingCo on Facebook as well!

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Physical therapist's guide to falls - Journal Advocate

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