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Physical therapy can help prevent falls, keep older patients active

Every year, 1 in 4 Americans age 65 or older falls, according to the National Council on Aging. For older Americans, falls are the leading cause of fatal injuries and of nonfatal trauma-related hospital admissions. By 2020, the cost of treating fall injuries in the United States is expected to top $67 billion annually.

However, suffering a fall-related injury does not have to be part of aging. Physical therapists can help their senior citizen patients lessen their risk of falling through simple, painless exercises. As a result, patients can live safer, more active lives for years to come.

Why are seniors at risk?

As we age, we are more at risk for falls, due to several health-related conditions:

▪ Chronic illnesses can lead to overall frailty or specific physical impairments. For example, diabetes can cause nerve problems in the feet and legs, making it easier for someone to stumble.

▪ Dementia can make it more difficult to pay attention to environmental factors, such as a step down when moving from one room to another.

▪ Cataracts and other age-related vision problems make it more likely to trip over hard-to-see objects.

▪ Cardiac conditions can cause dizziness or muscle weakness.

▪ Reaction time slows with age, making it more challenging to prevent a small stumble from turning into a major fall.

▪ Long-term medications can cause dizziness, lessen alertness or impair the connection between brain and muscles.

All of these factors can lead to fear of falling, which can make a person restrict activity, leading to decreased fitness, thus an increased risk of falling. It’s a vicious circle, but one that can be managed through physical therapy and coordination among medical providers.

Physical therapy to reduce fall risk

Physical therapy often is prescribed following a fall-related injury. This is critical, since a person who already has fallen once is at highest risk for another fall. However, physical therapy can help prevent a fall from occurring at all. A physical therapist can help patients improve strength, balance and overall confidence.

First, a physical therapist assesses the patient’s current abilities. Can the patient walk in a straight line? Are the patient’s steps equal in length? How long does it take the patient to stand up, walk 10 feet, turn around and go back to sitting in a chair? These measurements help the therapist develop a strategic, individualized program to build the patient’s strength, balance and endurance.

A patient’s PT program could include exercises, such as building leg muscles through work with resistance bands, gaining balance by standing heel-to-toe or increasing endurance in standing up from a seated position. Many of these exercises can be continued at home with a trained spotter to ensure safety.

It’s important, though, for the exercise plan to begin with a professional physical therapist who can prescribe the correct activities for the individual patient. Choosing the wrong exercises or doing them incorrectly can actually increase a person’s risk of falling.

Physical therapy is best coordinated with a patient’s overall medical care, because more than one factor can influence risk of falling. A physician can investigate whether a chronic medical condition, such as Parkinson’s disease, might be worsening. A pharmacist can help determine whether medications prescribed might be impairing balance. An eye doctor can assess vision loss.

In some cases, a change in treatment or medications could be all that’s needed to improve the patient’s condition and lessen the risk of falling. In other cases, physical therapy — alone or in combination with other measures — can improve a person’s stability. That can mean a safer, more active and independent life, both now and in the future.

Dean Plafcan is a physical therapist with Penn State Sports Medicine.

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