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Caring for people with impaired mobility
Published in Nicola Neale, Joanne Sale, Developing Practical Nursing Skills, 2022
Rowena Slope, Katherine Hopkinson
Additionally, the following interventions can be effective in preventing falls: Call bell within reachSuitable footwearMuscle strengthening, gait and balance training and exercise (Halvarsson et al. 2011)Home hazard assessment and modifications such as handles and rails to a person’s home (While 2020b)Review and possible withdrawal of medications where appropriate (Anderson 2008)Cardiac pacing where appropriate (NICE 2013)Full eye examination and ensure wearing glasses appropriately (Windsor and Dix 2017)Continence management (Anderson 2008)Hip protectors may be provided to prevent hip fractures in older people who have a high risk of falling; research evidence to support this function is equivocal (Parker et al. 2006).
Falls
Published in Henry J. Woodford, Essential Geriatrics, 2022
Strength and balance training are common components of falls prevention programmes. The exact nature of the most effective format is unclear. Interventions tend to focus on balance and functional exercises, possibly combined with resistance training. Tai Chi may be beneficial too. Sessions can be done at home alone or in group settings. The Otago Exercise Program is an example of a formalised system that has been shown to improve balance and physical function in older people.41
Trauma in the Elderly
Published in Ian Greaves, Keith Porter, Jeff Garner, Trauma Care Manual, 2021
Ian Greaves, Keith Porter, Jeff Garner
Patients over 75 are now the second-most common group to experience major trauma in the UK.3 Elderly patients with equivalent Injury Severity Scores (ISS) are more likely to require admission, will spend longer in hospital and are more likely to die as a result of their injuries.4 The mechanism and spectrum of injury differ in the elderly. In the over-75-year-olds, falls of <1 m are overwhelmingly the leading cause of death.5 The causes of falls are often multifactorial, but known risk factors include below-average general health, male sex, perceived insufficient sleep, health problems requiring assistive devices, alcohol consumption, increasing body mass index and history of stroke.6
Frequency and characteristics of falls, fall-related injuries, and fear of falling among wheelchair users with spinal cord injury
Published in The Journal of Spinal Cord Medicine, 2023
Falls are a major health concern in this population. It is estimated that approximately 69% (95% CI 60%–76%) of non-ambulatory individuals with SCI experience at least one fall over a period of 6–12-month.4 Falls may result in physical injuries, including minor injuries such as bruising or more serious injuries such as fractures or head concussions. For example, in an individual with SCI, a fall might result in a 4 to 8-week hospital stay with significant time on bed rest which often leads to immobilization, loss of strength, and blood clots.5 In addition to physical injuries, falls may lead to fear of falling (FOF) that can affect the performance of activities of daily living (ADLs), quality of life, and restrict the social participation of non-ambulatory individuals with SCI.6,7
A theoretical framework for addressing fear of falling avoidance behavior in Parkinson’s disease
Published in Physiotherapy Theory and Practice, 2023
Merrill R. Landers, Maria H. Nilsson
Some degree of FOF avoidance behavior is theoretically protective and beneficial, especially for those who have poor gait and balance. By avoiding risky activities, falls can be prevented and this may be beneficial in the short term. However, eventually, the consequences of avoidance may hasten deconditioning and further functional decline. Thus, the more avoidance, the faster the progression into deconditioning and disability. Therefore, activity avoidance should be addressed in rehabilitation treatment plans because of the potential for negative downstream consequences. Specifically, it is important to determine if the activity avoidance is adaptive or maladaptive as that will help provide guidance for clinical reasoning. This can be done by measuring gait/balance performance and FOF avoidance behavior concurrently to see if the avoidance behavior is proportional to the current level of gait/balance function.
Stability and Falls Evaluations in AMPutees (SAFE-AMP 1): Microprocessor knee technology reduces odds of incurring an injurious fall for individuals with diabetic/dysvascular amputation
Published in Assistive Technology, 2023
Shane R. Wurdeman, Taavy A. Miller, Phillip M. Stevens, James H. Campbell
The current analysis is limited in its ability to quantify the types of injuries that individuals incurred. However, data from the 2008 National Health Interview Survey showed the most common non-fatal fall-related injuries were sprains and strains of joints, followed by fractures, contusions, and lacerations (Verma et al., 2016). This is concerning given that downtime for recovery can reduce mobility (e.g., a fracture even of the wrist can prevent the ability to don a lower limb prosthesis for 8 weeks or more). A reduction in mobility would likely further reduce quality of life beyond the immediate impact of injury (Wurdeman et al., 2018a). Further work is needed to determine if injurious falls among lower limb prosthesis users have similar long-term effects as in the general population, such as increased mortality and poorer quality of life (Ayoung-Chee et al., 2014; Hartholt et al., 2011).