Assessing Mobility and Preventing Falls:
How Physiotherapy Makes a Difference
Physiotherapy plays a critical role in assessing and managing mobility and falls risk, particularly for older adults or individuals with certain health conditions.
Physiotherapists are at the forefront of identifying risk factors,
preventing falls, and enhancing overall mobility to improve quality of life.
Contact us today to find out how Wellbeing Physio can make a difference.
Key Falls Risk Factors
Several factors can increase an individual’s risk of falling, including:
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Age
- Age is a significant risk factor for falls. Older adults are more prone to falling, and their falls often result in serious injuries or even death.
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Muscle Weakness or Impaired Balance
Conditions - like general muscle weakness, recovery from fractures, or impaired balance can significantly raise the risk of falls.
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Medication Side Effects -
The use of three or more medications, especially sleeping tablets, tranquilizers, or antidepressants, can increase fall risk due to side effects such as dizziness or drowsiness.
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Health Conditions
Certain medical conditions—such as diabetes, arthritis, Parkinson’s disease, a history of stroke, cardiac or circulatory problems, and cognitive impairment—can elevate the risk of falling.
Importance of Physiotherapy Assessment
A comprehensive physiotherapy assessment is crucial for identifying falls risk factors and creating an effective management plan.
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Falls History and Medical Review
- A detailed evaluation of previous falls, medical history, and specific risk factors such as osteoporosis, bone health, urinary incontinence, and cardiovascular disease.
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Physical Examination
- A thorough physical examination evaluates gait (walking pattern), balance, lower limb strength, visual acuity, feet and footwear, and overall functional mobility. Additionally, assessments of neurological and cognitive function are performed to determine any contributing factors to falls risk.
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Outcome Measures
- Evidence-based tools, such as the Timed Up and Go Test (TUG) and Berg Balance Scale, are utilized to objectively measure an individual’s risk of falling and track progress over time.
Physiotherapy in Falls Management
Structured physiotherapy is a key component of a fall prevention program. The goals of physiotherapy interventions include:
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Preventing Further Falls
- Focusing on improving mobility, balance, and strength—the most effective interventions for fall prevention.
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Training to Cope with Falls
- Educating individuals on how to handle falls and reduce the consequences of a "long lie" (being on the floor for an hour or more), which is a marker of frailty, illness, and social isolation.
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Ensuring a Safe Living Environment
- Assessing and modifying the individual's living environment to minimize fall hazards.
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Restoring Confidence and Self-Esteem
 - Building confidence and self-esteem to enhance quality of life and reduce the fear of falling.
Physiotherapy Interventions for Fall Prevention
Several specific physiotherapy interventions have proven effective in reducing falls rates:
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Strength and Balance Exercises
- Targeted exercise programs focusing on strength and balance are the most effective at reducing fall rates. These programs are tailored to the individual's needs and can be performed at home, in the community, or in outpatient settings.
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Reactive Balance Training (RBT)
- RBT involves exercises designed to improve the body's ability to react to sudden losses of balance. This type of training includes whole-body movements, such as reactive stepping and other exercises that simulate real-life situations like slips and trips.
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Otago Exercise Program
- Developed by the New Zealand Falls Prevention Research Group, this program includes 17 strength and balance exercises and a walking routine, proven to reduce falls in older adults. It can be performed three times a week in various settings.
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Tai Chi-Based Exercise Programs
- Tai Chi has been shown to improve strength, balance, and coordination, making it a beneficial exercise for fall prevention in older adults.
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Training to Get Up Safely from the Floor
- Teaching individuals how to safely get up from the floor is a vital part of fall prevention. The step-by-step training helps build confidence and reduces the fear of falling again.
