FALL PREVENTION
                     FALL 
PREVENTION
http://www.virtualphysicaltherapists.com/
Falls are the leading cause 
of injury death for 
Americans 65 years and 
older.
Every 20 minutes, an older adult dies 
from a fall in the US, and many more 
are injured, costing $50 billion a year. 
 Approximately a third of older adults 
who live at home, and half of those 
living in nursing homes, fall at least 
once a year.
Only 37 percent of elderly patients are asked about falls in 
the primary care setting. 
Most falls are preventable, and many common causes can easily be corrected.  
The Centers for Disease Control and Prevention (CDC) and the American 
Geriatric Society recommend a yearly fall assessment screening for all adults 65 
years of age and older, but for most, this is NOT done.
Seniors are prone to underreporting falls, usually out of denial, fear of losing 
their independent living status, or because of memory and recall difficulty.
Fall Risk Assessments should 
be part of regular check-ups 
for our seniors and performed 
every six months.  
Anyone who falls outside of sports 
activity should undergo a gait and 
balance assessment. Those who have had 
multiple falls within a year should be 
evaluated more thoroughly to determine 
their fall risks and identify and mitigate 
them. Falls are rarely due to a single 
cause or risk factor and are often the 
accumulated effect of impairments in 
multiple domains.
1. Perform a Fall Risk Assessment to Identify Risk 
Factors
Our Fall Prevention Program is based on the CDC’s STEADI program.
VPT’s Fall Prevention Program is based on the CDC’s STEADI program. 
 A questionnaire to identify risk factors, including medications, home 
hazards, visual impairment, cognition, feet/footwear issues, Vitamin 
D deficiency, and comorbidities, is reviewed with our trained 
therapists.
Our therapists then perform an extensive assessment, including range of 
motion and strength of the lower extremities and specific balance testing.  
Multiple studies have shown an association between walking speed and 
survival, so many of our screening tests for falls involved timed movement. 
(*Extreme caution is taken by our clinicians when testing patient’s 
remotely. Patients with moderate to high fall risk must have someone 
assisting them during our screening.)
Individuals with a “low fall risk” are provided with educational materials on 
fall prevention and an Otago exercise program and are advised to have a 
yearly follow-up. Those individuals with “moderate” and “high fall risk” are 
recommended for further evaluation to determine the root cause of the 
balance deficit.  This includes a comprehensive vestibular assessment, gait 
analysis, strength, range of motion, neurological screen, and specific balance 
tests, including Sit to Stand, Single Leg Stance, and Timed Up and Go.  Those 
with a “high fall risk” require physical assistance to complete the assessment.
 Five Times Sit to Stand (5X STS): This test assesses strength. Have 
the patient start seated in an armless chair with a firm seat, ask him 
or her to stand up and sit down five times as quickly as possible, and 
record the time required to complete the five repetitions.
 Single Leg Stance (SLS): This test assesses balance. Have the patient 
stand on one leg with arms crossed. Time how long the patient can 
remain in this position without touching the suspended foot to the 
ground, moving the hands away from the chest, or displacing the 
weight-bearing foot.
 Time Up and Go (TUG): This test assesses gait. Have the patient start 
in a seated position, rise to a stand, walk three meters and return to 
a seated position in the chair, and record the time required to 
complete the exercise.
*Patients who take more than 10 seconds to do the 
5X STS and TUG tests and those who can balance for 
less than 10 seconds during the SLS probably require 
further scrutiny.
The underlying physical condition determines the 
individualized treatment plan, which may include 
vestibular, neurological, strength, and/or specific 
balance exercises.  Each exercise program is provided 
with a video demonstration. The focus of the 
treatment plan is to educate and empower to 
remove any risks, improve any deficits and reduce 
their overall risk of a fall.  Follow-up appointments 
are based on individual patients’ needs.
Eliminate Risk Factors
1.  Improve your Balance.   Exercise is critical to improving your strength and 
balance. Exercises should include strength, balance, and proprioceptive training.
2.  Vestibular Assessment: Our balance center is actually in our inner ear. Any 
disturbances can cause balance problems, make you dizzy, and make the room 
feel like it is spinning. Having a specialist assess your vestibular system is 
essential in eliminating potential risk factors.
3.  Medications: Some medicines have side effects that cause dizziness,      
drowsiness, or confusion, so changing or reducing the dose of medicines that may 
affect your gait or balance is important.
4.  Footwear: Look at your footwear to see if any of your shoes might increase your 
risk of falling. Make sure to wear nonskid soles.
5.  Reviewing your home for potential hazards. These may include poor lighting, 
loose rugs, and/or cords on the floor. This review may be done by yourself, a 
partner, or a healthcare provider.
6.  Vision: Getting your vision checked by an eye doctor.
7.  Vitamin D:  Take Vitamin D to strengthen your bones.
VIRTUAL 
PHYSICAL 
THERAPISTS
[email protected]
HTTP://WWW.VIRTUALPHYSICALTHERAPISTS.COM/
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