Vertigo and Dizziness by Jaydip Ray

Author:Jaydip Ray [Ray, Professor Jaydip]
Language: eng
Format: epub
Publisher: John Murray Press
Published: 0101-01-01T00:00:00+00:00

Falls assessment, treatment and therapies

By now you will appreciate how maintenance of posture, balance and gait is essential to safe independent living. Loss of balance causes falls and fractures resulting in loss of activity, earning and productivity. With an active ageing population, falls pose a huge challenge to society and health care and is described as one of the six ‘giants of geriatrics’. The human cost of falling to the individual includes distress, pain, injury, loss of confidence and loss of independence, as well as affecting relatives and carers.

Polypharmacy (the use of a large number of medications) is one of the major contributory factors towards falls in older people. Common culprits are antidepressants, sleeping pills, tranquillizers, antipsychotics, blood pressure tablets and anticonvulsants.

It is therefore essential that healthcare professionals are aware of the possible risks of falls in older people and actively enquire about and record the falls episodes in the previous twelve months. They should also enquire about any changes in posture, gait, balance and stability.

As part of your multifactorial falls assessment your doctor would normally assess gait, balance, mobility, muscle strength, neurology, cognition, environment, activities of daily living, functional ability and fear of falls.

If you experience falls, you may be referred to the local falls service. They may address strength and balance training, home hazard assessment and intervention, vision correction and medication review and modification. Increasingly ‘gamification of therapy’ with ‘exergames’ – video game-based balance and stability exercises – are being recommended as an enjoyable, engaging home or community-based therapeutic regime.

Awareness, advice, reduction of modifiable risks and exercise- based strength and balance training are proven to be most beneficial in falls prevention.

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