Don't Get Tripped Up! Prevent Falls Before They Happen

Don't Get Tripped Up!

Prevent Falls Before They Happen



Did you know that 30% of adults aged 65+ experience falls? 

People can be pretty reluctant to report falls, so this may actually underestimate the problem.  

With our aging population, falls are becoming more and more common and can have serious consequences. This means falls prevention is more important than ever before! 

The good news - preventing falls isn't complicated, but there are some crucial pieces that need to be in place to make sure it's effective. 


What Can You do to Prevent Falls?


The first step to preventing falls is knowing your risk!

Why is it important to know your risk?

Because most falls are preventable! They are NOT a normal and inevitable part of aging.

It's important to understand your risk of sustaining a fall so you can take the necessary steps to prevent it. 


To determine your risk, or the risk of the older adult in your life, start by asking these 3 questions: 

1. Do you ever worry about falling?

Fear of falling is an important risk factor for falls. It involves a lack of confidence in your balance which can lead to reduced physical activity and avoidance of tasks and recreation. Being insufficiently active contributes to muscle weakness and balance issues, making a fall more likely! The fear of falling and lack of activity become a viscious cycle. 

We can use the Short Falls Efficacy Scale International (Short FES-I) to asses the level of fear, or concern an individual has about falling. The questionnaire was developed as part of the Prevention of Falls Network Europe (ProFaNE) project from 2003 to 2006 and has been demonstrated to have good reliability and validity.

Click here to fill out the Short FES-I questionnaire 


2. Do you ever feel unsteady when walking?

Reduced balance and slow walking speed is a risk factor for falling. 

3.Have you fallen in the past year?

Falling within the last year is one of the most important risk factors to consider because those who have fallen once within the last year have a 70% chance of falling again!   


If you answered YES to any of these questions you may be at risk of falling.




So You Answered the Falls Risk Self Assessment Questions... What Comes Next? 


The self assessment is a good start, and brings your awareness to some important risk factors,  but things require a deeper look. If you answered YES to any of the questions in the self assessment, you would benefit from a falls risk assessment with one of our physiotherapists.

Your physiotherapist will take a thorough look at all the factors that play into your falls risk. Researchers have developed 3 categories for falls risk. Each category has specific criteria, and recommendations for what can be done to reduce the risk of falls for folks in that category. 

Falls Risk Categories 

 Level of Risk   

 Criteria   

 Recommendation      

Low Risk of Falling

The older adults who fit into this caterogy have had no falls, or one non-severe fall and have no balance issues. Continue to stay active and sure you are meeting Exercise Guidelines

Intermediate Risk of Falling

Those who have one non-severe fall and also have problems with their balance fall into this category. Balance and strength intervention

 High Risk of Falling

Had one fall in the last 12 months and one or more of the following: multiple falls in the last 12 months, injuries from the fall, frailty, inability to get up after the fall and/or loss of consciousness after the fall.

Multifactorial risk assessment from multiple health professionals - there may be a number of factors influencing falls risk (medications, loss of strength and balance, medical conditions etc) and multiple interventions may be needed. 

Exercise and Falls Prevention 



Now that you have an idea of your falls risk, it's time to take steps to prevent them!   

Exercise has so many benefits, and is key in preventing falls. 

Exercise programs for falls 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. (3) Therefore, balance exercises in combination with strength training should be done as much as possible, at least 3 hours/week. By doing this you can reduce your risk of falling by up to 39%!(3) 

It bears repeating that to get the most out of your falls prevention exercise program, the exercises need to be challenging, and progressive. If standing on one foot and holding onto the counter is easy, it's not going to improve your balance, and it's time to work on a more challenging balance exercise. That brings us to progression - as your exercises become easy, you'll need more challenge! 

  
    



Two people with the same falls risk, may need different exercises to be working at an appropriate level of challenge. Individualized programs are the perfect solution, and make sure you continue to progress. 

Falls prevention isn't a sprint, it's a marathon... these are long term strategies that need the become part of your day to day! 

Falls, Fractures, and Osteoporosis


People with osteoporosis and low bone density are at greater risk for fractures, and fractures are the most common injury sustained after a fall. This means that preventing falls (which can lead to fractures!) is vitally important for anyone with osteoporosis or low bone density.  Preventing falls helps prevent fractures. 

Those with a moderate to high falls risk should have an assessment of their bone health to see if they are at  risk of fragility fractures (fractures that are a result of a low energy impact such as a fall from standing height or lower, sneezing, or coughing). 

Similarly those who have a diagnosis of osteoporosis or osteopenia should undergo a falls risk assessment to get the necessary treatment according to their falls risk.

Fragility fractures  are  associated with high a high level of disability and healthcare costs so proper intervention as early as possible is key.

Click here to learn more about osteoporosis and fracture risk. 

If you have been diagnosed with osteoporosis, or are concerned about your bone health, our BoneFit™️ trained clinicians are here to help! Learn more about how Physiotherapy can help you manage osteoporosis here

Physiotherapy and Falls Prevention

The latest guidelines on falls prevention and management for older adults recommend that all community dwelling older adults take part in a falls risk assessment so appropriate intervention, including exercise programming can take place. 

Physiotherapy is one of the first line treatments recommended for falls prevention and Physiotherapists are uniquely positioned to not only assess risk for falls but to provide treatment and implement exercise programming to help prevent falls.


That's why our physiotherapists have developed a Falls Risk Assessment that is based on the latest global guidelines for falls prevention.

During the assessment you will be asked questions about your falls history, medical history and medications you are currently taking.

Your physiotherapist will also assess your mobility, walking speed, strength and balance, and make recommendations based on their findings. 

The findings of the assessment will help direct your individualized Falls Prevention Program which will include balance, strength and mobility exercised tailored to your needs. 


We hear all the time from older adults that they are afraid of falling, and it's not just those who've experienced a fall who are worried. The rhetoric around falls can make it feel like they're an inevitable part of aging, but they're not! Sure, there's no perfect, 100%  way to guarantee you won't have a fall, but there's A LOT that can be done to reduce your risk. 


Falls don't have to be a normal part of aging. It's time to be proactive and prevent falls before they happen. Book in your Falls Assessment today, and a take a step towards better balance and keeping your independence! 


References:

1. https://academic.oup.com/ageing/article/51/9/afac205/6730755

2. 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

3. 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.