FALLS: KNOW YOUR RISK, AND WHAT YOU CAN DO TO PREVENT THEM. 

Did you know that each year, approximately 30% to 40% of people aged 65 years and older who live in the community fall? Half of these falls result in an injury which is creating a burden on our health care system.1 Not only do they effect the aging population, but they are also the leading cause of hospital admissions for children aged 0-14. (2)

What is usually injured during a fall? The following body parts, from are most often injured (4): Shoulders/upper arm (15%) Knees (13%) Ankles/feet (12%) Head (11%) Fractures (39%) are the most common injury to sustain after a fall followed by sprains/strains (27%). The majority of fall (61%) occur from walking (4).

Injuries sustained from falls can limit physical activity, but even just the fear of falling can restrict activity level. Fear of falling involves having a lack of confidence in your balance throughout the day. This may lead to leaving the house less often and taking fewer steps a day, in turning having negative consequences on your health such as heart disease, diabetes and more(3). Being insufficiently active can also cause muscle weakness and balance issues making it even more likely to fall! It becomes of vicious cycle.

Who is at risk for falls?

Having risk factors for falls, increase a person’s likelihood for falling. Risk factors can be intrinsic meaning they are within a person or extrinsic meaning related to the environment a person is in.

1/3 of individuals who fall do not seek medical attention within the first 48 hours after falling.4 Also, many older adults do not recognize their falls risk and tend to under-report their falls. However, falls are NOT a normal part of aging, and most are preventable. (5) 

Many of these risk factors discussed above can be modified with interventions, such as physiotherapy!

Role of Physiotherapy in Fall Prevention

Physiotherapists can target risk factors for falling by doing home assessments to give recommendations on how you can increase your safety in the home, can look at your footwear and your foot health and can target reduced strength and balance with an exercise program.

Exercise programs for fall prevention focus on strength training and balance training, all while improving confidence in your ability to move around and therefore reducing fear of falling.

Studies suggest that you need to be working on activities that challenge your balance 120 mins/week.(6) Therefore, balance exercises in combination with strength training should be done has much as possible, at least 3 hours/week. By doing this you can reduce your risk of falling by up to 39%!(6)

This can be time consuming so incorporating these balance exercises into your day can help you stay on top of it. For example, do your balance exercises when you are talking on the phone, standing in line at a grocery store, in the elevator or during TV commercials!

Specific balance exercises you can incorporate into your day:

Talk to your physiotherapist to learn more about what types of balance exercises you should be doing!

A team-based approach is better to manage falls, efforts should be coordinated.

Other professions that can help with falls prevention:

• Physicians: Your physician can look at what medicine you are taking and see if anyone of them (or a combination) may be contributing to falls.
• Ophthalmologist/optometrist: Can help with vision correction
• Podiatrist: Can help with foot care
• Occupational therapist: Can perform home assessments to minimize risk of falls from environmental hazards
• Home and community care support workers: Can help you get the support you need at home

References

1. Phelan EA, Mahoney JE, Voit JC, Stevens JA. Assessment and management of fall risk in primary care settings. Med Clin North Am. 2015 Mar;99(2):281-93. doi: 10.1016/j.mcna.2014.11.004. PMID: 25700584; PMCID: PMC4707663. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4707663/
2. Parachute. Retrieved from: http://www.parachutecanada.org/child-injury-prevention/item/fall-prevention
3. Jefferis, B.J., Iliffe, S., Kendrick, D. et al. How are falls and fear of falling associated with objectively measured physical activity in a cohort of community-dwelling older men?. BMC Geriatr 14, 114 (2014). https://doi.org/10.1186/1471-2318-14-114
4. Gouvernement of Canada. (2022, June 8). Surveillance Report on Falls Among Older Adults in Canada 2021–2030 Surveillance Report on Falls Among Older Adults in Canada. Canada.ca. Retrieved October 26, 2022, from https://www.canada.ca/en/public-health/services/publications/healthy-living/surveillance-report-falls-older-adults-canada.html
5. BCGuidelines.ca: Falls: Prevention, Risk Assessment and Management for Community-Dwelling Older Adults (2021) https://www2.gov.bc.ca/assets/gov/health/practitioner-pro/bc-guidelines/fall_prevention_guideline_final.pdf
6. Sherrington C, Michaleff ZA, Fairhall N, Paul SS, Tiedemann A, Whitney J, Cumming RG, Herbert RD, Close JCT, Lord SR. Exercise to prevent falls in older adults: an updated systematic review and meta-analysis. Br J Sports Med. 2017 Dec;51(24):1750-1758. doi: 10.1136/bjsports-2016-096547. Epub 2016 Oct 4. PMID: 27707740.