Various risk factors make older adults more susceptible to falls. Some of these risk factors include visual deficits, sensation deficits, vitamin deficiencies, polypharmacy, joint replacements, and generalized lower extremity weakness. According to the Center for Disease Control and Prevention, one in every four adults over the age of 65 fall each year, while less than half report falls to their doctor. These numbers are staggering considering your risk for falls can be substantially reduced by addressing risk factors early. Physical therapy can have a significant role in reducing your risk of falls while also providing strategies to remain safe and independent in the most unpredictable environments.
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OCTOBER ISSUE: • Life-Changing Benefits of Fall Risk Prevention & Balance Training • Are You At Risk of Sustaining a Fall-Related Injury? • Patient Spotlight • What Are You Doing for You This Month? • Specialist Spotlight: Welcome Dr. Jamie Coon! FALL RISK PREVENTION & BALANCE TRAINING LIFE-CHANGING BENEFITS OF
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Life-Changing Benefits of FALL RISK PREVENTION & BALANCE TRAINING by Dr. Jamie Coon, PT, DPT Various risk factors make older adults more susceptible to falls. Some of these risk factors include visual deficits, sensation deficits, vitamin deficiencies, polypharmacy, joint replacements, and generalized lower extremity weakness. According to the Center for Disease Control and Prevention, one in every four adults over the age of 65 fall each year, while less than half report falls to their doctor. These numbers are staggering considering your risk for falls can be substantially reduced by addressing risk factors early. Physical therapy can have a significant role in reducing your risk of falls while also providing strategies to remain safe and independent in the most unpredictable environments. The impact of falls can cause a cascade effect not only for the adult, but also for the family members/caregivers and the overall health care system. It was estimated that approximately 95% of hip fractures are the result of falls. Falls are also the most common cause of traumatic brain injuries and concussions in older adults. Additional injuries such as broken bones, bruises, and a debilitating fear of future falls can also substantially limit movement and quality of life. Physical therapy can provide a safe environment in which adults can gain confidence, improve their coordination and return to their prior level of activity. Aging in Place Addressing balance impairments in adults can also help to promote the concept of aging in place. This idea came about as a result of the Baby Boomer generation pushing back against the norm to transition to nursing home or assisted living care. This transition has encouraged adults to plan ahead for aging and make the necessary preparations to reduce risk of falls and promote independent living for as long as safely possible. Pleaseseewww.aginginplace.org formore informationon thisgrowing trend. Benefits of Fall Risk Prevention/Balance Training • Improved quality of life to do the things you love! • Reduced risk and fear of future falls. • Promoted aging in place. • Increased independence at home and community. • Gained confidence to navigate indoor and outdoor surfaces. • Improved walking speed. Our skilled therapists at VCSST can perform a thorough assessment of what risk factors may be impeding your safety with daily tasks. Some of these tasks may include standing on one foot, picking objects off the floor, or rising from a chair without the use of your arms. Balance assessments can range from basic day to day tasks to high level assessments that target coordination, inclined surfaces and unexpected movements. Formal assessments may include:
• Functional Gait Assessment • Timed Up and Go • Mini-BESTest
What to Expect When Being Treated for Balance Impairments In order to truly effect the bodily systems involved in balance (visual, vestibular, and somatosensory), our systems must be challenged in isolation as well as in conjunction with one another. Your physical therapist will likely ask you to perform tasks with your eyes closed or while standing on unsteady surfaces. He/she may also ask you to perform cognitive tasks while completing challenging activities. Although these may feel like unlikely and unrealistic daily activities, your therapist is simply challenging your ability to multi-task in a variety of situations so that you can feel confident to tackle any situation. Once you have become safe with balance tasks, your therapist may also provide you with a home exercise program to further facilitate balance training at home. Fear of Falling A fear of falling is defined as a natural fear or anxiety surrounding the potential for falls. This phenomenon can occur in adults with or without a history of falls. Developing a fear of falling can have a significant impact on the health and independence of an adult. Although developing a fear of falling is a natural response to what some adults may consider a dangerous task, the overall effect can have significant consequences. In many cases, this psychosocial component can lead to avoidance of social and functional tasks, decreased quality of life and increased disability. Conversely, there can be just argument to say that some adults with impulsive behaviors may benefit from a more cautious approach to balance related tasks. Tips for Reducing Risk of Falls at Home • Ensure proper lighting throughout rooms and hallways (even at night). • Make a clear path between furniture. • Avoid “furniture walking” (using furniture to stabilize yourself). • Remove throw rugs or use double sided tape to ensure non-slip surface. • Remove lose electrical cords that may be obstructing pathways. • Ensure handrails are securely fastened. • Consider use of non-slip surfaces in shower/bathroom. • Wear shoes both inside and outside the home. Dr. Jamie Coon, PT, DPT graduated with honors from James Madison University, with a Bachelor of Science degree and a minor in Gerontology. Following her undergraduate studies, she received her Doctor of Physical Therapy degree fromMary Baldwin University. Jamie is local to the Midlothian area and enjoys treating across the lifespan but has a special interest in working with older adults and runners of all ages.
• Berg Balance Scale • Tinetti Balance Test • Dynamic Gait Index
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ARE YOU AT RISK OF SUSTAINING A FALL- RELATED INJURY? Mostpeopledon’t thinkaboutkeeping theirbalance in shape until it is too late and they suffer a harsh fall.Thegoodnews is thatmost fallscaneasilybe prevented, simply by the regular exercising of your balance system. If you have recently sustained a balance-related injury, it is important to seek the helpofaphysical therapist immediately, inorder to avoidadditional injuries in thefuture. It is important to note that you should also contact a physical therapist ifyouhaveanyof thefollowingsymptoms: • Dizzinessorvertigo(“spinning”sensations,even when remaining still). • Nausea or vomiting. • Arm or leg weakness. • Abnormal eye movements. • Difficulty standing up from a seated position or standing for prolonged periods of time. Do you frequently notice an imbalance, dizziness, or unsteadiness that makes you feel as if you may falloveratanygiven time?Haveyousuffered from afall in thepast?Areyouworried thatyoumaybeat riskofsustainingafall-related injury? Ifso,contact VirginiaCenterforSpine&SportsTherapy todayso wecanhelpyoufigureout the rootofyourproblem and treat it accordingly. Am I at Risk of Falling? Some people have a higher risk of falling than others. Certain risk factors include: • Inability to focus or remain alert. • Double vision or tunnel vision.
• Living a sedentary life. • Previous history of falls. • Vertigo or dizziness. • Parkinson’s disease. • Alzheimer’s disease. • Heart disease. • Diabetes.
reduces both the rate of falls…and the number of people experiencing falls.” At Virginia Center for Spine & Sports Therapy, your initial physical evaluation may consist of several parts to better determine what your most problematic factors are.These may include vision tests,thinkingtests,restingheartratechecks,active heart rate checks, and evaluations of your gait, balance, range of motion, and strength. Basedontheresultsofthisevaluation,yourphysical therapist will design a treatment plan around your specific needs. These plans are aimed first and foremost at reducing your risk of falling, but they will also aid you in improving balance, strength, flexibility, endurance, and overall movement. Are you ready to get back on your feet by improving your balance and decreasing your risk of sustaining a fall-related injury? Contact us at (804) 249-8277 or visit our website at www.vcsst.com to schedule a consultation and get started today!
• Previous stroke or heart attack. • Arthritis or alternative joint pain. • Problems with vision. • Problems with walking or staying balanced. • Fatigue. • Overall poor health. Your physical therapist will assess your medical history todeterminehowmany risk factors toward fallingyoumayhave.Theywilleducateyouonwhat these factors mean, as well as steps you can take to decrease your risk. After this, they will perform a thorough physical evaluation to figure out what the best treatment plan for you will be. How Will Physical Therapy Help Reduce My Fall Risk? ArecentlypublishedsystematicreviewbyCochrane, comprisedofover100randomizedcontrolled trials, supports exercise interventions as an effective treatment method for patients with an increased risk of falling. The average age of patients in this reviewwas76,and77%ofthepatientswerewomen. Results concluded that those who participated in exercise interventions had a 23% decrease in falls as compared to the control group. Fall risk was also reducedat21-24%,dependingon if treatments were done in individual or group settings. The risk of fall-related fractureswasdecreasedby27%and thenumberof falls that requiredmedicalattention wasdecreasedby39%.Concludingstatementsfrom the authors demonstrated how overall, “Exercise
• Advanced age. • Being female.
“I am in my mid-seventies and I observed that many of my peers were having falls. A temporary loss of balance was often the cause. My primary care doctor referred me to VCSST for balance training. The staff and especially my therapist were all very pleasant and professional. After 6 weeks of treatment, I have regained the confidence to do activities that were becoming difficult. I also have a substantial list of home exercises that I am using to continue improving my balance. I had a great experience which yielded great results.” - D. L. (5 Star Review via Google.com) Patient Spotlight
Specialist Spotlight
“status quo.” Do you know that normal body temperature can actually range between 97.2° and 99.5°? So, if you typically run low, then a temperature of 99° may be a moderate fever for you. Do you know that normal blood pressure range can vary greatly depending on your age or even ethnicity? Become aware of your own typical measures and note variations. At the end of each day, reflect on your IOAF - Inputs (vegetables, fruits, fiber, fats, etc), your Outputs (any changes in urine or stool), your Activity level (were you stuck at a desk more than usual), and FUN (did you laugh or smile). Simply taking stock daily of your IOAF can help you know your body and make adjustments, if needed. Singular changes may have little meaning but by monitoring your own “normals,” you can spot subtle trends or changes that would be key pieces of information to your physician in the event of illness. Get to know your own body! Jamie graduated with honors from James Madison University, receiving her Bachelor of Science Degree in Health Sciences and a minor in Gerontology. Following her undergraduate studies, she received her Doctor of Physical Therapy degree fromMary Baldwin University. Jamie completed research studying the use of visual feedback for gait training in runners during her time at MBU. Jamie is local to the Midlothian area and grew up in competitive dance and running. She is passionate about serving the community she grew up in through community outreach and therapeutic relationships. Jamie enjoys treating across the lifespan but has a special interest in working with older adults and runners of all ages. Jamie is currently pursuing advanced manual therapy certifications through the Functional Manual Therapy Institute and The McKenzie Institute. To request an appointment with Dr. Coon, Call us today at (804) 249-8277 or request an evaluation online at www.vcsst.com. Welcome Dr. Jamie Latta Coon PT, DPT
WHAT ARE YOU DOING FOR YOU THIS MONTH?
Each month, we make suggestions for ways to improve your life. This month, we suggest you really get to know your own body numbers.
Why rely only on annual visits with your doctor to monitor your health? Your baseline indicators may vary slightly from average or “normal” even in healthy individuals,
and regularly documenting yours can provide useful data trends to your physician. While we certainly advocate continuing regular checkups by your physician, we suggest you also perform your own weekly or even daily checkups. Many of us step on the scale regularly and take note of small (or large) fluctuations in our weight as one indicator of our body’s
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