Falls: Prevention, Assessment, and Intervention
Description
Falls are a common problem for older adults, and fall-related morbidity and mortality are on the rise in the U.S. In this course, Rehab professionals will learn the epidemiology of falls among older adults in the U.S., fall risk factors, consequences of falls, how to assess for fall risk, and how to create an individualized intervention plan. A focus on assessment and modification of the home environment is included. Appropriate Rehab professionals treatment options for these patients are discussed, with an emphasis on evidence-based intervention through exercise. The course covers both inpatient and outpatient fall risk management, but focuses primarily on interventions with community-dwelling older adults. Therapist Tips, sample exercises, and case studies help reinforce the clinician’s application of the material. This course is a must for every therapist and therapist assistant who works with older patients.
Available Course Credits
| Alaska State PT & OT Board | 9.00 | ||
| Arizona State Board of Physical Therapy | 9.00 | ||
| Arkansas State Board of Physcial Thearpy | 9.00 | ||
 |
BOC | 9.00 | |
| California Physical Therapy Board | 9.00 | ||
| Colorado Division of Professions and Occupations | 9.00 | ||
| Connecticut Department of Public Health | 9.00 | ||
| Delaware Examining Board of Physical Therapists and Athletic Trainers | 9.00 | ||
| District Of Columbia Department of Health | 9.00 | ||
| FPTA | 9.00 | ||
| Georgia State Board of Physical Therapy | 9.00 | ||
| Hawaii Board of Physical Therapy | 9.00 | ||
| Idaho Physical Therapy Licensure Board | 9.00 | ||
| Illinois Department of Professional Regulation | 9.00 | ||
| Indiana Physical Therapy Board | 9.00 | ||
| Iowa Board of Physical Therapy and Occupational Therapy | 9.00 | ||
| Kansas State Board of Healing Arts | 9.00 | ||
| Kentucky Board of Physical Therapy | 9.00 | ||
| Louisiana Physical Therapy Board | 9.00 | ||
| Maine Board of Physical Therapy | 9.00 | ||
| Maryland Board of Physical Therapy | 0.90 | ||
| Massachusetts Board of Allied Health Professionals | 9.00 | ||
| Michigan Board of Physical Therapy | 9.00 | ||
| Minnesota Board of Physical Therapy | 9.00 | ||
| Mississippi State Board of Physical Therapy | 9.00 | ||
| Missouri Advisory Commission for Physical Therapists | 9.00 | ||
| Montana Board of Physical Therapy Examiners | 9.00 | ||
| Nebraska Department of Health and Human Services | 9.00 | ||
| New Mexico Physical Therapy Board | 9.00 | ||
| New York State Education Department | 9.00 | ||
| North Carolina Board of Physical Therapy Examiners | 9.00 | ||
| North Dakota Board of Physical Therapy | 9.00 | ||
| Oklahoma Physical Therapy Board | 9.00 | ||
| Oregon Board of Physical Therapy | 9.00 | ||
| Pennsylvania State Board of Physical Therapy | 9.00 | ||
| Physical Therapy Governing Board New Hampshire | 9.00 | ||
| South Carolina Board of Physical Therapy | 9.00 | ||
| South Dakota Physical Therapy License Board | 9.00 | ||
| State of Alabama Board of Physical Therapy | 9.00 | ||
| State of Rhode Island Department of Health | 9.00 | ||
| Tennessee Board of Physical Therapy | 9.00 | ||
| Texas Physical Therapy Association | 9.00 | ||
| Utah Physical Therapy Licensing Board | 9.00 | ||
| Virginia Board of Physical Therapy | 9.00 | ||
| Washington State Board of Physical Therapy | 9.00 | ||
| West Virginia Board of Physical Therapy | 9.00 | ||
| Wisconsin Physical Therapy License Board | 9.00 | ||
| Wyoming Board of Physical Therapy | 9.00 |
Course Content
| 209 Falls: Prevention, Assessment, and Intervention | Module | ||
| Course Evaluation | Module |
Sarah R.Stillings, MA, PT, MPT, CHT
Sarah R. (Sally) Stillings is a PT and Certified Hand Therapist in Texas. She received her physical therapy degree from the University of North Carolina at Chapel Hill. Prior to becoming a therapist, Sally taught university-level writing courses and was assistant editor of The Journal of Craniomandibular Practice. In her extensive career as a PT, she has held a variety of clinical, teaching, administrative, and business roles, including general PT practitioner, upper extremity specialist, clinic manager, hand therapy clinic coordinator, continuing education (CE) instructor, and CE course administrator. She has also served as Executive Director of the Kellermann Foundation, a U.S. nonprofit organization supporting healthcare and community development in Uganda, East Africa. Her work now focuses on creating evidence-based CE materials for rehab professionals. Sally is a lifelong runner who celebrates all those who cover the ground.
209 Falls: Prevention, Assessment, and Intervention—Course Objectives
After successfully completing this continuing education course, the learner should be able to:
- Recognize the epidemiology of falls among older adults in the U.S.
- Differentiate modifiable and non-modifiable intrinsic and extrinsic fall risk factors
- Identify fall risk screening principles
- Identify components of a comprehensive fall risk assessment for an older adult
- Choose and apply appropriate fall risk functional measures in case studies
- List interventions appropriate for inpatient and outpatient fall risk management
- Identify universal fall risk precautions
- Differentiate the factors involved in developing a patient-specific fall risk plan of care
- Identify and assess environmental fall risk factors using case studies
- Identify modifications to the home environment to decrease fall risk
- Recognize the research evidence supporting exercise intervention for fall management
- Identify and apply, using case studies, exercise-based fall prevention interventions for older adults
- Identify comprehensive evidence-based approaches to decrease patients’ fall risk
209 Falls: Prevention, Assessment, and Intervention—Table of Contents
Page #
HOUR 1
Course Instructions 2
About the Author / Course Description 3
Course Objectives 4
Table of Contents 5
Introduction 8
Chapter 1: Understanding Falls—Definitions & Epidemiology 9
Demographics: An Aging Population
Definitions 11
Incidence of Falls 13
Morbidity 15
Injury 16
Psychosocial Effects 21
Mortality 24
HOUR 2
Costs 27
Risk Factors 28
Intrinsic Risk Factors
Extrinsic Risk Factors 30
Chapter 2: Clinical Screening and Assessment 33
Screening for Fall Risk
When Fall Risk Screening Is Positive 40
AGS/BGS Algorithm
NICE Guidelines
STEADI Algorithm
Academy of Geriatric PT/APTA Guideline
Screening for Fear of Falling and Depression 43
HOUR 3
Choosing Fall Risk Assessment Functional Measures 44
Berg Balance Scale 46
Single Limb Stance, Eyes Open 47
Five Times Sit-to-Stand Test 48
Timed Up and Go Test 48
Self-Selected Walking Speed 50
Dynamic Gait Index 51
Four Square Step Test 52
Fullerton Advanced Balance Scale 52
Short Physical Performance Battery 53
Completing the Fall Risk Clinical Assessment 54
Completing the Post-Fall Clinical Assessment 55
Chapter 3: Reducing Fall Risks—Creating the Plan of Care 57
Inpatient Risk Reduction Interventions 58
Universal Fall Precautions 59
HOUR 4
Individual Patient Strategies 60
Outpatient Risk Reduction Interventions 63
Patient Education
Muscle Strengthening and Endurance
Range of Motion/Flexibility Exercises 64
Gait Training 65
Balance Training 66
Special Considerations for Frail Older Adults 68
Chapter 4: Addressing the Environment 70
Lighting Conditions 72
Floor Surfaces 74
Hard Flooring Surfaces
Carpet
Throw Rugs
HOUR 5
Trip Hazards 77
Beds 79
Seating 80
Handrails and Grab Bars 82
Stairs 84
Indoors
Outdoors
Bathroom 87
Kitchen 89
Other Modifiable Extrinsic Risk Factors 89
Clothing and Footwear
Assistive Devices
HOUR 6
Chapter 5: Exercise-Based Fall Prevention Strategies 92
Evidence for Exercise Intervention
Multifactorial Intervention vs. Exercise Alone
Recommendations for Exercise Intervention 94
U.S. Preventive Services Task Force
AGS/BGS
National Inst. for Health and Care Excellence
Academy of Geriatric PT/APTA
AOTA
STEADI
Intervention Focus Areas 99
Evidence-Based Fall Prevention Programs 100
A Matter of Balance
Bingocize
CAPABLE
Enhance® Fitness
HOUR 7
FallsTalk 104
Fallscape
Fit and Strong!
Healthy Steps for Older Adults
Healthy Steps in Motion 106
The Otago Exercise Program
Stay Alive and Independent for Life (SAIL) 107
Stepping On
Tai Chi for Arthritis
Tai Ji Quan: Moving for Better Balance
YMCA Moving For Better Balance 109
Individualized Exercise Intervention 111
Gait Training 112
ROM/Flexibility Exercises 114
Strength Training 120
HOUR 8
Balance Training 128
Conclusion 133
Case Studies 134
Appendix A: Patient Education Resources 137
Appendix B: Provider Resources 138
HOUR 9
Appendix C: Exercise Instructions 140
References 154
Examination 165
Evaluation 176
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Educational Level: Intermediate
Target Audience: PT, PTA, OT, OTA, ATC
Course Completion Requirements: Passing an online exam with 70% or greater will be required to earn continuing education credit
This course is approved for 0.9 CEUS. 9 contact hours
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