Preventing Falls in Community Dwelling… The Physical Therapist's Role
By Nicole Byers, DPT

In 2005, approximately 1.8 million people age 65 and older were treated in emergency departments for nonfatal injuries from falling. Injuries included: bruising, fractures, and traumatic brain injury. In addition to physical injury, people may also acquire a fear of subsequent falls resulting in a decrease in their overall activity level (CDC 2008). As physical therapists, we have direct contact with people age 65 and older on a daily basis. Our role in working to decrease one's risk of falling involves identifying those at risk and modifying factors within our scope of practice. We may utilize traditional musculoskeletal tests of strength and flexibility as well as quantifiable functional tests and measures to identify those at risk for falling. Traditional tests and measures help physical therapists determine patient specific programs for improved strength and flexibility. Functional tests are helpful in guiding treatment strategies as well as objectively demonstrating progress toward physical therapy goals.

Centers for Rehab Services physical therapists provide customized rehabilitation programs addressing a multitude of potential factors that may contribute to one falling. Physical therapists may also provide recommendations for assistive devices for safe and independent ambulation. With the expertise of physical therapists specializing in the areas of balance/vestibular, neurological, orthopedic, and women's health physical therapy, patients are well served in the area of fall prevention.

In addition to the presence of diagnoses physical therapists typically treat, non-musculoskeletal or neuromuscular factors may also contribute to one's risk of falling. Additional factors may include: visual disturbance, use of multiple prescription medications, poor attention task, and environmental hazards. Consequently, physical therapists may refer patients to other health care practitioners for a multi-factorial approach to fall prevention.

Simple recommendations for improved safety include:

• adequate lighting and clear walkways in the home
• removal of throw rugs
• use of appropriate safety and assistive devices for activities of daily living

Nicole Byers is a Physical Therapist at Centers for Rehab Services. For more information, call 1-888-723-4277 or visit www.upmc.com/crs

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