The Science of Fall Prevention
APDM partner Mike Studer, PT, discusses the science of Fall Prevention in a recent article.
Studer highlights the advances that have come to fruition in the last 5 years, in research, policy, and technology, and discusses the “why, who, what, and how” of Fall Prevention. Below is a summary of his thoughts.
Why: Also found in past APDM articles, Studer points out the staggering costs of Falls in our healthcare system. The current estimation is that one-third of the American population age 65 or older will fall each year. This costs on average at least $35,000 per hospital visit, leading to an annual $30+ billion dollar price tag. Studer also points out that medical costs are not the only pitfall – fear of falling and lack of activity work together in a vicious cycle, intensifying comorbidities and causing even more of an impact in socioeconomic costs.
Who: Studer points out that resources should be allocated effectively, as not every person over age 65 needs physical therapy for Fall Prevention. Performing accurate screening helps to identify possible fallers by filtering patients in at-risk communities like those with Parkinson’s, vertigo, stroke, and dementia. This accurate screening includes things like functional assessment and a medical and pharmaceutical review. Accurate identification of potential fallers preserves valuable resources in a more effective manner.
What: Advances in Fall Risk Assessment have allowed us more individualized care, delivering a more accurate dosage of therapy based on a patient’s abilities and goals. Studer briefly touches on more recent studies using virtual reality, posturography, and wearable sensors (like APDM Opals) that have shown to accurately detect and treat a patient’s visual dependence – which is often heightened after sensory impairment. Therapists mimic lifelike circumstances that could lead a patient to fall, such as creating dual-task or crowded environments to train reaction time, for example. Policy and community-based programs have also provided potential fallers with a more involved exercise and activity outlet.
How: Studer highlights the advances we have seen in Fall Prevention in recent years. Tools and equipment have been shown to help therapists more accurately measure standardized tests with simple instrumentation. He speaks about the ability of tools like APDM Mobility Lab to provide more detailed information on the relative sensory contributions in balance, showing pin-point data that subjective testing does not. Technology has provided therapists with evidence-based means to help improve patient outcomes.
Studer concludes by saying “Given the importance that fall prevention is being given, and the advances being made, this is the best decade to age yet. We should encourage those at risk to keep moving, and be better than ever at supporting their efforts to do so.”
Mike Studer, PT, is owner of Northwest Rehabilitation Associates in Salem, Ore, where he is also a treating physical therapist. Studer was honored by the American Physical Therapy Association as recipient of the organization’s 2014 award for Geriatric Clinical Excellence, and recognized with the APTA’s 2011 Neurology Section Award for Clinical Excellence, which the APTA presents to its Clinician of the Year. Currently, Studer serves as Chair of the APTA Geriatric Section Balance and Falls Special Interest Group.
