Management of Falls in Community-Dwelling Older Adults: Clinical Guidance Statement From the Academy of Geriatric Physical Therapy of the American Physical Therapy Association

Avin, Keith G.; Hanke, Timothy; Kirk-Sanchez, Neva; McDonough, Christine M.; Shubert, Tiffany E.; Hardage, Jason; Hartley, Greg

doi:10.2522/ptj.20140415

Cited by 135 publications

(146 citation statements)

References 26 publications

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“…This is why the use of multidimensional measures has been advocated for the assessment of balance and risk of falls in older adults. The Clinical Guidance Statement on Management of Falls [44] recommends the screening of different risk factors for falls and interventions, such as foot assessment and footwear correction, with level two evidence. It is important to highlight that other variables associated with postural changes may influence balance impairment and risk of falls in older adults, such as visual and proprioceptive muscle response [31], paravertebral muscle weakness [21 -24], decreased spinal mobility [21] and low physical function [8].…”

Section: Resultsmentioning

confidence: 99%

Postural changes versus balance control and falls in community-living older adults: a systematic review

et al. 2018

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Introduction: Since falls are considered to be a public health problem, it is important to identify whether postural changes over time contribute to the risk of falls in older adults. Objective: To investigate whether postural changes increase fall risk and/or postural imbalance in healthy, community-dwelling older adults. Methods: In April 2016, two reviewers independently searched the PubMed, Web of Science, SPORTDiscus, and CINAHL databases for studies in English published in the previous 10 years, using the following combined keywords: "posture" or ("kyphosis","lumbar lordosis","flexed posture","spinal curvature","spinal sagittal contour") AND "elderly" AND "fall". Study quality was assessed according to the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines for observational studies. Results: The search retrieved 1,734 articles. Only observational studies that assessed posture, balance, and/or falls in older adults were considered eligible for review. The final sample included 17 articles: reliability and reproducibility of the instruments were not reported in five studies, while two studies offered a questionable description of the instruments used. Fourteen

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Section: Resultsmentioning

confidence: 99%

Postural changes versus balance control and falls in community-living older adults: a systematic review

et al. 2018

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“…Health care direct costs associated with this phenomenon are high [13], and reaches 25 billion euros/year in the European Union [2]. The evidence shows that falls can be prevented by screening to detect risk factors and by the prescription of tailored interventions [14]. The screening process should review a different number of items.…”

Section: Introductionmentioning

confidence: 99%

Multifactorial Screening Tool for Determining Fall Risk in Community-Dwelling Adults Aged 50 Years or Over (FallSensing): Protocol for a Prospective Study (Preprint)

Martins¹,

Moreira²,

Silva³

et al. 2018

Preprint

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Background: Falls are a major health problem among older adults. About a third of community-dwelling adults aged 65 years or over fall each year. The risk of falling can be increased by polypharmacy, vision impairment, high blood pressure, environmental home hazards, fear of falling and changes in function of musculoskeletal and sensory systems, associated with aging. Moreover, individuals who experienced previous falls are at higher risk. Nevertheless falls can be prevented by screening to detect risk factors. Objective: To understand if FallSensing screening tool is able to determine the fall risk of community-dwelling adults aged 50 years or over. Methods: FallSensing screening tool is a technological solution for fall risk screening, including a software, a pressure platform and two inertial sensors. The screening software includes questions about sociodemographic and health and lifestyle behaviors, a detailed explanation about procedures to accomplish six functional tests (Grip Strength, Timed Up and Go, 30 seconds Sit-to-Stand, Step test, 4 Stage Balance test "modified" and 10 meters Walking Speed) and three questionnaires concerning environmental risk, activities and participation profile related to mobility and self-efficacy for exercise. The questions registers information about demographic and anthropometric data (age, sex, height and weight), Fear of Falling, history of fall (previous 12 months), health conditions, medication, sedentary lifestyle, upper extremities assistance to stand from a chair, living settings, alcohol habits, self-perceived health and unintentional or involuntary weight lost. We will recruit community-dwelling adults aged 50 years or over, independent to be standing and walking with or without walking aids in different regions of continental Portugal. In order to be a representative sample of Portuguese population, a minimum of 385 participants is needed. Results: The development of the FallSensing screening tool started in October 2015, and the screening of participants started in June 2016 and continues by the time of submission. A set of seniors' university, parish councils, physical therapy clinics and other community facilities have consented to participate in the study. Conclusions: In order to develop a multifactorial screening tool for fall risk in community-dwelling adults, it is essential to identify key risk factors for falls and select the best method to evaluate them. FallSensing screening tool, gathers a multifactorial assessment, designed and studied through the best evidence, which seek to identify factors that influence the fall risk. Understanding these factors, will allow that preventive strategies could be implemented and decrease falls rates.

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“…Inadequate ground foot positioning (22), increased of both musculoskeletal effort and intrinsic mechanisms of balance control explain cadence and speed variability increases, in order to keep gait stability and minimize the fall risk among the elderly (23).…”

Section: Discussionmentioning

confidence: 99%

“…Os consensos científicos de Gerontologia e de Fisioterapia recomendam a avaliação de marcha no estudo do processo de senescência (8,23,24).…”

Section: Velocidade Da Marchaunclassified

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Medidas têmporo-espaciais da marcha relacionadas com queda em mulheres saudáveis

Gervásio¹

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Tridimensional da Marcha" objetivou determinar, dentre as medidas têmporo-espaciais, quais apresentam precocidade de risco de queda, quando comparadas à literatura.Amostra composta por dois grupos: jovens (20-39 anos) e adultas idosas (50-69 anos).Considerou-se a média de 46 medidas têmporo-espaciais, lados direito (D) e esquerdo (E), para análise tridimensional. Houve diferença estatística significativa para comprimento da passada D (p=0,003) e E (p=0,002); passo D (p=0,008) e E (p=0,001); período do apoio E (p=0,008); período do passo D (p=0,049); duplo suporte E (p=0,003); largura da base E (p=0,005); resposta à carga E (p=0,001); pré-balanço D (p=0,001) e E (p=0,001), bem como para as seguintes medidas em percentil do ciclo de marcha: apoio E (p=0,001); balanço E (p=0,001); simples suporte E (p=0,025); resposta à carga E (p<0,001); pré-balanço E (p=0,001) e pré-balanço D (p=0,014 swing. Linear regression indicates that step and stride length change 18% and gait velocity changes 20% with age variation. These findings suggest that fall risk begins from the age of 50 and expand knowledge about gait changes in an age group still considered fall risk-free and offer informtions to preventive programs.

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Management of Falls in Community-Dwelling Older Adults: Clinical Guidance Statement From the Academy of Geriatric Physical Therapy of the American Physical Therapy Association

Abstract: This CGS provides recommendations to assist physical therapists in the identification and management of fall risk in older community-dwelling adults.

Cited by 135 publications

References 26 publications

Postural changes versus balance control and falls in community-living older adults: a systematic review

Postural changes versus balance control and falls in community-living older adults: a systematic review

Multifactorial Screening Tool for Determining Fall Risk in Community-Dwelling Adults Aged 50 Years or Over (FallSensing): Protocol for a Prospective Study (Preprint)

Medidas têmporo-espaciais da marcha relacionadas com queda em mulheres saudáveis

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