Provide opportunities for the growth of knowledge and quality of practice for physical therapists in relation to older persons with balance deficits and an increased risk for falling.
A new CDC publication, “The Potential to Reduce Falls and Avert Costs by Clinically Managing Fall Risk,” has been published in the American Journal of Preventive Medicine. This report is the first to show that evidence-based fall prevention interventions delivered by U.S. healthcare providers have the ability to prevent thousands of falls, thereby improving the health and well-being of older Americans. In addition, these interventions could substantially lower healthcare costs currently estimated at $50 billion annually.
Using a two-step process, the authors calculated the population-level impact of 7 evidence-based interventions on reducing falls and lowering direct medical costs. In step one, they used the prevalence of seven fall risk factors among American’s age 65 and older to calculate the number of older adults who would be eligible for and willing to reduce their risk by adopting an evidence-based fall prevention intervention. The interventions included 1) Tai Chi exercise program, (2) Otago Exercise Program, (3) medication management, (4) vitamin D supplementation, (5) expedited first eye cataract surgery, (6) single-vision distance lenses for outdoor activities, and (7) home modifications led by occupational therapist. In step two, the authors estimated the expected number of falls that would occur if the intervention had not been implemented and the medical costs of these falls. Lastly, the direct medical costs averted were calculated based on the known effectiveness of the intervention.
The study found that implementing single interventions could prevent between 9,563 and 45,164 medically treated falls and avert between $94 and $442 million in direct medical costs annually.
Preventing falls can benefit older adults significantly by improving their health, independence, and quality of life. Healthcare providers are in a unique position to educate and empower their older patients on how to reduce fall risk. The CDC’s Stopping Elderly Accidents, Deaths, and Injuries initiative (STEADI) includes resources and tools to help members of the healthcare team (e.g., physicians, nurses, pharmacists, and physical therapists) integrate fall prevention into their clinical practice.
Monograph: The Balance and Falls Monograph written for the AGPT has been completed, please visit the APTA Learning Center for more details.
Outcome Measure Resource Toolkit: We are currently working on a Balance and Falls Outcome Measure Table. The table will include cut-off values, psychometric properties, and other clinically useful information. We have completed the initial search and are now reviewing each others work prior to putting it together in an easy to digest manner for clinicians to use in clinic.
Monthly Challenge: Each month we are highlighting a different aspect of clinical practice to integrate to promote and grow our management of balance and falls within the older adult community. We highly recommend active participation- the more individuals participate the more we all get out of it. If you are not participating and would like to please contact Heidi Moyer at [email protected].
National Council On Fall Prevention and Awareness: Our SIG chair is going down to DC to represent the SIG and the profession. She will be meeting with other healthcare team members, to work towards creating a companion document to the STEADI with a concentration on lower extremities.
Home Safety & Home Modification Work Group: Members of the SIG are part of a Research Subcommittee for the Home Safety and Home Modification Work group. It is a project organized by the NCOA and the mission is to implement Home Safety Recommendations, which is part of the 2015 National Falls Prevention Action Plan.
Inter-SIG Journal Club: The next Journal Club will be on May 29th at 8 PM eastern time zone. The Journal Club will be moderated by Jennifer Vincenzo, PT, PhD, GCS and Cynthia Gibson-Horn, PT, BS and the article discussed will be “Four months of Wearing a Balance Orthotic Improves Measures of Balance and Mobility Among a Cohort of Community-Living Older Adults.” Look for a follow up e-mail with more information.
Public Liaison: Our SIG is looking for a public liaison to assist with managing our Twitter account, our Listserve, as well as other opportunities to volunteer and be involved with the SIG. It is a very supportive environment with assistance every step of the way. If you are interested please contact Mariana at [email protected]
Other opportunities: The Clinical Liaison and Research Liaison are looking for assistance for many great projects that they do not have the man power/time to achieve. If you are interested please contact Mariana at [email protected]
Article 1: Mortazavi H, Tabatabaeichehr M, Golestani A, Armat MR, Yousefi MR. The Effect of Tai Chi Exercise on the Risk and Fear of Falling in Older Adults: a Randomized Clinical Trial. Materia Socio-Medica. 2018;30(1):38-42.
Conclusion: “The results of the present study showed that Tai Chi exercise significantly reduced the risk and fear of falling in the elderly. It seems that, Tai Chi exercise, is a harmless intervention and complication-free intervention, can play a significant role in improving balance and motor function in elderly and increasing their independence power and enable enjoyable and dynamic elderly.”
Article 2: Lavedán A, Viladrosa M, Jürschik P, et al. Fear of falling in community-dwelling older adults: A cause of falls, a consequence, or both? Glasauer S, ed. PLoS ONE. 2018;13(3):e0194967.
Conclusion: The prevalence of the fear of falling was 41.5% at baseline. Logistic regression analysis showed a significant association between a history of falls and the fear of falling. Other factors associated with the fear of falling were female gender, comorbidity, depressive symptoms, and disability. In total, 41.7% of the subjects who had reported a fear of falling at baseline had suffered at least one fall 24 months later. Unadjusted Cox regression analysis revealed that the fear of falling was a risk factor for falls. According to the final model adjusted for other covariates, the only reliable predictor was female gender. The Cox model stratified by gender failed to show a crude association between fear of falling and falls.
If you would like to be involved with our efforts of providing growth of knowledge and ensuring high quality of practice please contact our chair. Mariana’s E-mail is [email protected].
The Academy of Geriatric Physical Therapy is pleased to announce Management of Falls and Fall Prevention in Older Adults written by Mariana Wingood, DPT, PT, GCS, CEEAA and edited by Barbara Billek-Sawhney, PT, EdD, DPT, GCS is now available in the APTA Learning Center.
Falls are major concern for older adults! Physical therapists play a key role in fall prevention, as well as treating falls and fall related injuries. With evidence-based practice the functional mobility and quality of life of older adults may be improved, while decreasing the national fall related statistics. This information will provide clinicians with the appropriate multi-factorial assessment and interventions to set their patient up for success!
As the clinical liaison for the AGPT Balance and Falls SIG, it is my plan that we continue with the monthly challenge into 2018. We will be exploring a few familiar topics, as well as a few new ones to keep us all up to date on our falls management skills.
I once again, personally invite you to partake in a 12-month clinical skills development challenge, dubbed "The Monthly Challenge", through the year of 2018. Each month, we will be sending out information related to a different aspect of managing balance and falls risk in our older adult population.
Topics for the year are as follows:
All members of the AGPT are invited to partake, but if you are interested in being included on a separate email list where you can communicate with other professionals, please email me at [email protected] to get connected with our support group to help ensure your success in this endeavor. This year we will be engaging members through Twitter (totally voluntary, not mandatory to participate) in addition to our monthly emails. You can follow the Balance and Falls SIG on twitter @AGPT_BF_SIG. Clinicians of all skill levels, from students to expert clinicians, and from all settings are welcome and exuberantly encouraged to participate.
12 months, 12 essential skills, 12 simple and EASY changes to your current clinical practice habits, one simple way to create lasting impact on those we serve.
Please join me in welcoming another year with good cheer, a good attitude, and good clinical practice!
Looking forward to growing with you,
Heidi Moyer, PT, DPT
Occurs on a bi-monthly basis- the last Tuesday of the Month at 8pm eastern time.
Click here for past Journal Clubs.
Every month, we send out an email to interested members with a quick summary of an aspect of balance and falls management. This email thread allows members to have topic specific communication as well as share experiences/ideas. We will also be posting the materials to our google drive which you can access at any time. Emails are sent out at the beginning of each month. If you wish to join the email chain and get the information before anyone else, email us at [email protected] .