Geriatric Rehabilitation & Fall Prevention

Falls are one of the common causes of injuries among the elderly in Singapore. According to the National Registry of Disease Office (NRDO) of Singapore, the incidence rate of unintentional falls in year 2012 was 277.7 per 100,000 for adults aged 60 years and above. This means about one in three older adults above 60 years old falls once a year, and when they age, the chance and risk of fall becomes higher. The common consequences of falls in the elderly include hip fracture, spinal fracture, traumatic head injury and others. Once the elderly loses their mobility, their general condition deteriorates due to prolonged bed lying/immobility which renders mobilization. Hence, fall prevention and management for the elderly is an important public health aspect.

An intervention program to improve balance of the elderly can be carried out based on an accurate assessment of the deficits. Subsequently, balance training activities can be personalized to the individuals according to their needs.

Balance training activities include:

  1. Improving trunk stability, biomechanical alignment, and symmetrical weight distribution.
  2. Improving awareness and control of center of mass and limits of stability.
  3. Improving musculoskeletal responses necessary for balance which includes functional Range of Motion (ROM), strength and synergistic patterns
  4. Promoting use of functional balance strategies during static and dynamic activities in varying environmental conditions.
  5. Improving utilization of sensory system (Somatosensory, visual, vestibular inputs) and Central Nervous System (CNS) sensory integration mechanisms for balance.
  6. Improving safety awareness and compensatory strategies for effective fall prevention.

In addition, life-style counseling is important to help them recognize potentially dangerous situations and reduce the possibility of falls. Falls during daily activities include sit-to-stand transferring, stair climbing, turning, picking things up from the floor, reaching forward and bending over etc. Environment modifications to prevent slippery floors or surfaces, uneven or tripping carpets, chairs and wires can significantly reduce the risk of fall caused by them. Compensatory strategies/training should be advised, for example, use of grab bar for standing whilst brushing teeth, sitting down for showers and using a vertical cane or support for ambulation.

A fall prevention program must also consider other environmental factors, such as:

  1. Sufficient light must be provided to the elderly and the glare should be reduced by using shades or curtains.
  2. Accessible light switches must be installed at the appropriated height for use at night in the bedroom, bathroom and the hallway.
  3. Furniture or any form of the obstruction along the walkways has to be removed.
  4. Loose carpets must be removed.
  5. Grab bars or rails provide the elderly more stability.
  6. Toilet seats can be elevated to facilitate independent use.

For more details regarding geriatric rehabilitation & physiotherapy at MoveFree Physio, please contact us.