Post on 26-Dec-2015
transcript
Evidence based geriatric physical therapy
Ahmad Osailan
Falls
• One of the most common incidents and cause for hospital admission for elderly. Even considered one of the leading causes for sudden death.
• What are the risk factors for falls?• - balance impairments • - strength impairments• - difficulty in walking
History of fall prevention
• Most common interventions:• Moderate to high intensity Balance exercise
training• Exercise + multifactorial interventions.• Q: What is the minimum dose of exercise to
prevent falls?• A: 50 Hrs of exercise
Incidence of falls
• Falls are the leading cause of traumatic brain injury and fractures in older adults.
• For individuals aged 65 and older, falls outpace motor vehicle accidents as the leading cause of unintentional death by several thousands
• Falls are the leading cause of emergency department visits by older adults, and the number one cause of hospital admissions due to trauma
Some Definitions
Some Definitions
Falls prevention
• According to Shubert 2011, it is recommended by the American geriatric society to do screening for falls for those Aged 65 and above.
• Effective fall prevention intervention should focus on the contributing risk factor.
• Doing a triage to find the impairments that can lead to fall.
Example
Screening for falls• American geriatric association recommended
screening for balance and immobility. • The screen consist of:• 1- Hx of fall in the past year ( how many times)• 2- any difficutly in walking or in balance (y/n)• 3- observe walking performance and balance
changes by doing tests (Time up and go test, berg balance test)
• If one of these is positive, he/she should be referred for a comprehensive multifactorial assessment
Falls screening
• There are many balance and mobility assessment tests, but most of theses tests do not take into account the medical risk factor.
Examples for studies
What do we learn from this study
• All risk factors must be assessed and triaged properly.
• Physical therapist must use clinical judgement to determine which risk factor should be assessed first.
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Exercise dose
Mode of exercise
Static activities
Dynamic Activities
Dual task training
Strength training
walking
conclusion