April Falls – Falls risk awareness
Falls risk increases with age and age related co-morbidities. April is a month dedicated to raising awareness about falls risks and their contributing factors. Some of the factors that contribute to the increased risk of falls, especially in the elderly population, include:
1. Muscle Weakness/ decrease in reflexes:
Degenerative loss of skeletal muscle mass and decline in strength of skeletal muscles (especially in lower extremities) is associated with increased likelihood and risk in falls (Tonner et al 2003).
As we grow older, our muscles lose fast twitch motor units, which increase the number and percentage of slow twitch fibers, meaning a decrease in strength and power.
Changing directions and trying to catch balance may increase risk of falls due to a decrease in reaction time.
2. Balance and gait:
Poor balance and difficulty walking (due to pain or other co-morbidities such as osteoarthritis, lack of exercises, neurological causes, diabetes, medications, stroke) lead to an increased risk of falls.
3. Postural hypotension:
A decrease in blood pressure when standing after sitting will increase the risk of falls due to feeling “dizzy”.
4. Unsafe footwear:
Backless shoes, slippers, high heels and any footwear not deemed appropriate can increase the risk of falls.
5. Poly-pharmacy:
Many medications and drugs can have interactions and contraindications that can cause dizziness, drowsiness or sedation. The half-life of drugs is increased in some people due to decrease in normal body functions.
Liverpool Podiatry assessment, management and falls risk:
As a Liverpool podiatrist, routine assessment is undertaken to understand subjective and objective findings that may contribute to an increased risk of falls, this includes;
Medical history, medication and surgical history
Social history
Gait and posture: Best observed in an environment that is familiar to the patient (home), walking speed; base of gait; stride length; barefoot & in shoes
Footwear assessment: 50-80% of older people wear ill-fitting shoes
Biomechanical assessment: Muscle strength, Joint range of motion, Foot posture, Foot deformity
Measurement of foot pressure distribution: Identify anatomical foot deformities, guide diagnosis and treatment of gait disorders and falls, consider strategies to prevent pressure ulcerations
Neurological assessment: Foot sensation and pain, sensory loss, loss of protective sensation, presence of neuropathy (that affects autonomic control, peripheral nervous system and central nervous system)
Treatment may include: general podiatric care, footwear advice, health promotion and putting in place programs to aid falls prevention, strength exercise programs.
Key things to look out for:
Trouble getting out of a chair
Shorter step length or height (shuffling steps)
Slower pace
Difficulty managing uneven surfaces
Reduced balance
If you or one of your friends/family members are exhibiting any of these features, get in contact with us today!
Call - 8798 8987