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Fall prevention includes any action taken to help reduce the number of accidental falls suffered by susceptible individuals, such as the
elderly Old age refers to ages nearing or surpassing the life expectancy of human beings, and is thus the end of the human life cycle. Terms and euphemisms for people at this age include old people, the elderly (worldwide usage), OAPs (British usage ...
(
idiopathic An idiopathic disease is any disease with an unknown cause or mechanism of apparent spontaneous origin. From Greek ἴδιος ''idios'' "one's own" and πάθος ''pathos'' "suffering", ''idiopathy'' means approximately "a disease of its own kin ...
) and people with
neurological Neurology (from el, νεῦρον (neûron), "string, nerve" and the suffix -logia, "study of") is the branch of medicine dealing with the diagnosis and treatment of all categories of conditions and disease involving the brain, the spinal c ...
(
Parkinson's Parkinson's disease (PD), or simply Parkinson's, is a long-term degenerative disorder of the central nervous system that mainly affects the motor system. The symptoms usually emerge slowly, and as the disease worsens, non-motor symptoms becom ...
,
Multiple sclerosis Multiple (cerebral) sclerosis (MS), also known as encephalomyelitis disseminata or disseminated sclerosis, is the most common demyelinating disease, in which the insulating covers of nerve cells in the brain and spinal cord are damaged. This ...
,
stroke A stroke is a disease, medical condition in which poor cerebral circulation, blood flow to the brain causes cell death. There are two main types of stroke: brain ischemia, ischemic, due to lack of blood flow, and intracranial hemorrhage, hemorr ...
survivors, Guillain-Barre,
traumatic brain injury A traumatic brain injury (TBI), also known as an intracranial injury, is an injury to the brain caused by an external force. TBI can be classified based on severity (ranging from mild traumatic brain injury TBI/concussionto severe traumatic br ...
, incomplete spinal cord injury) or orthopedic (lower limb or spinal column fractures or
arthritis Arthritis is a term often used to mean any disorder that affects joints. Symptoms generally include joint pain and stiffness. Other symptoms may include redness, warmth, swelling, and decreased range of motion of the affected joints. In som ...
, post-surgery,
joint replacement Replacement arthroplasty (from Greek ''arthron'', joint, limb, articulate, + ''plassein'', to form, mould, forge, feign, make an image of), or joint replacement surgery, is a procedure of orthopedic surgery in which an arthritic or dysfunctional ...
, lower limb
amputation Amputation is the removal of a limb by trauma, medical illness, or surgery. As a surgical measure, it is used to control pain or a disease process in the affected limb, such as malignancy or gangrene. In some cases, it is carried out on indi ...
, soft tissue injuries) indications. Current approaches to fall prevention are problematic because even though awareness is high among professionals that work with seniors and fall prevention activities are pervasive among community living establishments, fall
death rates Mortality rate, or death rate, is a measure of the number of deaths (in general, or due to a specific cause) in a particular population, scaled to the size of that population, per unit of time. Mortality rate is typically expressed in units of ...
among older adults have more than doubled. The challenges are believed to be three-fold. First, insufficient
evidence Evidence for a proposition is what supports this proposition. It is usually understood as an indication that the supported proposition is true. What role evidence plays and how it is conceived varies from field to field. In epistemology, evidenc ...
exists that any fall risk
screening Screening may refer to: * Screening cultures, a type a medical test that is done to find an infection * Screening (economics), a strategy of combating adverse selection (includes sorting resumes to select employees) * Screening (environmental), ...
instrument is adequate for predicting falls. While the strongest predictors of fall risk tend to include a history of falls during the past year,
gait Gait is the pattern of movement of the limbs of animals, including humans, during locomotion over a solid substrate. Most animals use a variety of gaits, selecting gait based on speed, terrain, the need to maneuver, and energetic efficiency. ...
, and balance abnormalities, existing models show a strong
bias Bias is a disproportionate weight ''in favor of'' or ''against'' an idea or thing, usually in a way that is closed-minded, prejudicial, or unfair. Biases can be innate or learned. People may develop biases for or against an individual, a group ...
and therefore mostly fail to differentiate between adults that are at low
risk In simple terms, risk is the possibility of something bad happening. Risk involves uncertainty about the effects/implications of an activity with respect to something that humans value (such as health, well-being, wealth, property or the environm ...
and high risk of falling. Second, current fall prevention interventions in the
United States The United States of America (U.S.A. or USA), commonly known as the United States (U.S. or US) or America, is a country Continental United States, primarily located in North America. It consists of 50 U.S. state, states, a Washington, D.C., ...
are limited between short-term individualized
therapy A therapy or medical treatment (often abbreviated tx, Tx, or Tx) is the attempted remediation of a health problem, usually following a medical diagnosis. As a rule, each therapy has indications and contraindications. There are many differe ...
provided by a high-cost physical therapist or longer-term wellness activity provided in a low-cost group setting. Neither arrangement is optimum in preventing falls over a large population, especially as these evidence-based physical exercise programs have limited effectiveness (approximately 25%). Even multifactorial interventions, which include extensive physical
exercise Exercise is a body activity that enhances or maintains physical fitness and overall health and wellness. It is performed for various reasons, to aid growth and improve strength, develop muscles and the cardiovascular system, hone athletic ...
,
medication A medication (also called medicament, medicine, pharmaceutical drug, medicinal drug or simply drug) is a drug used to diagnose, cure, treat, or prevent disease. Drug therapy ( pharmacotherapy) is an important part of the medical field and ...
adjustment, and environmental modification only lower fall
risk In simple terms, risk is the possibility of something bad happening. Risk involves uncertainty about the effects/implications of an activity with respect to something that humans value (such as health, well-being, wealth, property or the environm ...
by 31% after 12 months. Questions around effectiveness of current approaches (physical exercise and multifactorial interventions) have been found in multiple settings, including long-term care facilities and hospitals. The final challenge is adherence. Average adherence in group-based fall prevention exercise programs is around 66%, mostly due to the highly repetitive nature of the programs and the extremely long duration required for noticeable benefits accrue. Adherence to physical therapy can be even lower. When adherence is below 70%, effectiveness of fall prevention physical exercise programs can drop to less than 10%. Practitioners are aware that the most successful approach to fall prevention utilizes a multimodal, motor-cognitive training approach that could be introduced to all adults over 65. The
scientific Science is a systematic endeavor that builds and organizes knowledge in the form of testable explanations and predictions about the universe. Science may be as old as the human species, and some of the earliest archeological evidence for ...
basis of this approach is an understanding of how the
dual-task paradigm A dual-task paradigm is a procedure in experimental neuropsychology that requires an individual to perform two tasks simultaneously, in order to compare performance with single-task conditions. When performance scores on one and/or both tasks are ...
induces
neuroplasticity Neuroplasticity, also known as neural plasticity, or brain plasticity, is the ability of neural networks in the brain to change through growth and reorganization. It is when the brain is rewired to function in some way that differs from how it p ...
in the
brain A brain is an organ (biology), organ that serves as the center of the nervous system in all vertebrate and most invertebrate animals. It is located in the head, usually close to the sensory organs for senses such as Visual perception, vision. I ...
, especially in aging
population Population typically refers to the number of people in a single area, whether it be a city or town, region, country, continent, or the world. Governments typically quantify the size of the resident population within their jurisdiction usi ...
s. This is driving a growing body of research that specifically links the cognitive sub-domains of attention and executive function (EF) to gait alterations and fall risk.


Cost of falls

Falls and fall-related injuries are among the most common but serious medical problems experienced by older adults. Nearly one-third of older people fall each year, half of which fall more than once per year. Over 3 million Americans over the age of 65 visited hospital emergency departments in 2015 due to fall-related injuries, with over 1.6 million being admitted. Because of decreased bone density due to
osteoporosis Osteoporosis is a systemic skeletal disorder characterized by low bone mass, micro-architectural deterioration of bone tissue leading to bone fragility, and consequent increase in fracture risk. It is the most common reason for a broken bone a ...
, mobility, and reflexes, falls often result in hip fractures and other fractures,
head injuries A head injury is any injury that results in trauma to the skull or brain. The terms ''traumatic brain injury'' and ''head injury'' are often used interchangeably in the medical literature. Because head injuries cover such a broad scope of inju ...
, and
death Death is the irreversible cessation of all biological functions that sustain an organism. For organisms with a brain, death can also be defined as the irreversible cessation of functioning of the whole brain, including brainstem, and brain ...
in older adults. Accidental injuries are the fifth most common cause of death in older adults. 75% of hip fracture patients do not recover completely and show signs of overall health deterioration.


Strategies and interventions

Motor-cognitive training is increasingly viewed as the gold standard for healthy aging and fall prevention. One approach that has been researched is the introduction of semi-immersive
virtual reality Virtual reality (VR) is a simulated experience that employs pose tracking and 3D near-eye displays to give the user an immersive feel of a virtual world. Applications of virtual reality include entertainment (particularly video games), edu ...
simulation A simulation is the imitation of the operation of a real-world process or system over time. Simulations require the use of Conceptual model, models; the model represents the key characteristics or behaviors of the selected system or proc ...
during
treadmill A treadmill is a device generally used for walking, running, or climbing while staying in the same place. Treadmills were introduced before the development of powered machines to harness the power of animals or humans to do work, often a type o ...
training Training is teaching, or developing in oneself or others, any skills and knowledge or fitness that relate to specific useful competencies. Training has specific goals of improving one's capability, capacity, productivity and performance. I ...
. Initially conceptualized by the
Tel Aviv Sourasky Medical Center Tel Aviv Sourasky Medical Center ( he, המרכז הרפואי תל אביב ע"ש סוראסקי; commonly referred to as Ichilov Hospital) is the main hospital complex serving Tel Aviv, Israel and its metropolitan area and the second-largest hos ...
with funding from the Michael J Fox Foundation and the
European Commission The European Commission (EC) is the executive of the European Union (EU). It operates as a cabinet government, with 27 members of the Commission (informally known as "Commissioners") headed by a President. It includes an administrative body ...
, V-TIME projects a real-time image of participants' feet onto a large screen at eye-level while the participants are walking on a treadmill. The virtual environment introduces multiple physical and cognitive challenges while the participant is in dynamic motion. This one approach to motor-cognitive training was found to repeatedly reduce falls by 50% after 5
week A week is a unit of time equal to seven days. It is the standard time period used for short cycles of days in most parts of the world. The days are often used to indicate common work days and rest days, as well as days of worship. Weeks are of ...
s of 15 sessions across multiple
clinical trial Clinical trials are prospective biomedical or behavioral research studies on human participants designed to answer specific questions about biomedical or behavioral interventions, including new treatments (such as novel vaccines, drugs, diet ...
s and multiple indications (idiopathic, Parkinson's, Multiple sclerosis). The biological manifestations of this improvement were identified through functional MRI, which showed changes in brain activity patterns for patients that were exposed to combined motor-cognitive training, as opposed to exclusively physical training. Other preventative measures with positive effects include strength and balance training, home risk assessment, the withdrawal of psychotropic medication,
cardiac pacing An artificial cardiac pacemaker (or artificial pacemaker, so as not to be confused with the natural cardiac pacemaker) or pacemaker is a medical device that generates electrical impulses delivered by electrodes to the chambers of the heart eit ...
for those with
carotid sinus hypersensitivity In human anatomy, the carotid sinus is a dilated area at the base of the internal carotid artery just superior to the bifurcation of the internal carotid and external carotid at the level of the superior border of thyroid cartilage. The carotid s ...
, and tai chi. Resistance exercise two or three times a week with ankle weights or elastic bands has been proven in tests to rebuild lost muscle mass and reduce falls in adults of all ages: it was first tested in New Zealand by the Otago Medical School in four controlled trials, in which about 1,000 older adults with an average age 84 participated. Falls among a test group that did the Otago routines three times a week for 12 months was 35% fewer than a control group that did not use the routines. Two similar 12-month tests were conducted in the US using residents in assisted and skilled nursing facilities with one group showing a 54% reduction in falls. After the age of 50, adults experience a decrease in muscle mass ( sarcopenia) by approximately 2% every year. A systematic review concluded that resistance training can slow down the rate of loss in muscle mass and strength. It has been recommended that older adults participate in resistance training two to three times a week to weaken the effects of sarcopenia.
Assistive technology Assistive technology (AT) is a term for assistive, adaptive, and rehabilitative devices for Disability, people with disabilities and the elderly. Disabled people often have difficulty performing activities of daily living (ADLs) independently, ...
can also be applied, although it is mostly reactive in case of a fall. Exercise as a single intervention has been shown to prevent falls in community-dwelling older adults. A systematic review suggests that having an exercise regimen that includes challenging balance workouts for three or more hours per week results in a lesser chance of falling. Resistance training has been shown to be beneficial beyond fall prevention, as it also helps improve functional mobility and activities of daily living such as walking endurance, gait speed, and stair climbing. Research explains that this significant increase in performance can be accomplished after the age of 90. For older adults to gain confidence in resistance training, which may ultimately lead to falling prevention effects, they must obtain the recommended amount of daily activity. The aim of medical management is to identify factors that can contribute to falls and fracture risk such as osteoporosis, multiple medications, balance and
gait Gait is the pattern of movement of the limbs of animals, including humans, during locomotion over a solid substrate. Most animals use a variety of gaits, selecting gait based on speed, terrain, the need to maneuver, and energetic efficiency. ...
problems, loss of vision and a history of falls.
Beers Criteria The Beers Criteria for Potentially Inappropriate Medication Use in Older Adults, commonly called the Beers List, are guidelines published by the American Geriatrics Society (AGS) for healthcare professionals to help improve the safety of prescribi ...
is a list of medications that are potentially inappropriate for use in the elderly and some of them increase the risk of falls. Falls are well known amongst community-dwelling individuals ages 65 and older. The risk of fall-related incidents nearly doubles when individuals are institutionalized. The impact on different falls in certain situation of fall prevention programs on the rate differences of falls in elderly population has not been reported. As well as cognitive impairment, functional impairment, gait, and balance disorders, certain medications can increase fall risk factors for patients. At an advanced age, these risk factors are double and more likely to occur. It's important to identify the risk factors that increase the likelihood of injurious falls. State-level fall prevention strategies can also mitigate fall risk for community-dwelling older adults.


Risk factors of falls


Older adults

Studies have shown that adults over the age of 65 are more prone to falls than younger, healthy adults. Most
falls in older adults Falls in older adults are a significant cause of morbidity and mortality and are a major class of preventable injuries. Falling is one of the most common accidents that cause a loss in the quality of life for older adults, and is usually precip ...
are due to: * Gait deviations – These are the main changes that occur in the gait patterns of older adults, which may contribute to the incidence of falls. Older adults may experience a 10–20% reduction in gait velocity and reduction in stride length, an increase in stance width and double support phase, or a bent posture. Studies show that a wider stride does not necessarily increase stability, and may instead increase the likelihood of experiencing falls. *Limitations in mobility – Loss of mobility increases the risk of falls in situations which, under normal circumstances, would pose a low risk of falling (such as walking up/down stairs). *Reduced muscle strength, especially in the lower body, which leads to difficulties standing up. *Poor reaction time – Aging is associated with the gradual slowing of an individual's reaction time. *
Accidents An accident is an unintended, normally unwanted event that was not directly caused by humans. The term ''accident'' implies that nobody should be blamed, but the event may have been caused by unrecognized or unaddressed risks. Most researcher ...
/environmental factors – Falls may occur due to dangerous or unstable surfaces, such as wet surfaces, ice, stairs, or rugs; or inappropriate footwear. * Balance disorders
vertigo Vertigo is a condition where a person has the sensation of movement or of surrounding objects moving when they are not. Often it feels like a spinning or swaying movement. This may be associated with nausea, vomiting, sweating, or difficulties w ...
, syncope, unsteadiness, ataxias * Visual, sensory, motor, and cognitive impairment * Medications and alcohol consumption – Dizziness, drowsiness and confusion can occur as side effects of some medications. Alcohol consumption causes a delay in reflexes and diminishes balance and fine motor control via its inhibitory effects on nerve pathways in the
cerebellum The cerebellum (Latin for "little brain") is a major feature of the hindbrain of all vertebrates. Although usually smaller than the cerebrum, in some animals such as the mormyrid fishes it may be as large as or even larger. In humans, the cerebe ...
. * Acute and chronic infections * Dehydration


Stroke

Individuals who have had a
stroke A stroke is a disease, medical condition in which poor cerebral circulation, blood flow to the brain causes cell death. There are two main types of stroke: brain ischemia, ischemic, due to lack of blood flow, and intracranial hemorrhage, hemorr ...
have higher fall rates. Approximately 30% fall at least once a year and 15% fall twice or more. Risk factors for falls in stroke survivors are: * Gait deviations – Disturbance of gait is a common problem post-stroke and a common contributor of falls, predicting a continual functional decline. Velocity, cadence, stride time, stride length, and temporal symmetry index are reduced and result in significant gait deterioration. Reduced propulsion at push-off, decreased leg flexion during the swing phase, reduced stability during the stance phase, and reduced automaticity of walking occur. * Reduced
muscle tone In physiology, medicine, and anatomy, muscle tone (residual muscle tension or tonus) is the continuous and passive partial contraction of the muscles, or the muscle's resistance to passive stretch during resting state.O’Sullivan, S. B. (2007). ...
and weakness * Side effects of drugs *
Hypoglycemia Hypoglycemia, also called low blood sugar, is a fall in blood sugar to levels below normal, typically below 70 mg/dL (3.9 mmol/L). Whipple's triad is used to properly identify hypoglycemic episodes. It is defined as blood glucose bel ...
*
Hypotension Hypotension is low blood pressure. Blood pressure is the force of blood pushing against the walls of the arteries as the heart pumps out blood. Blood pressure is indicated by two numbers, the systolic blood pressure (the top number) and the di ...
* Communication disorders * Hemianopia * Visuospatial agnosia


Parkinson's disease

Most people with
Parkinson's disease Parkinson's disease (PD), or simply Parkinson's, is a long-term degenerative disorder of the central nervous system that mainly affects the motor system. The symptoms usually emerge slowly, and as the disease worsens, non-motor symptoms beco ...
(PD) fall and many experience recurrent falls. A study reported that over 50% of persons with PD fell recurrently. Direct and indirect causes of falls in patients with PD: * Gait deviations – Decreased gait velocity and stride length due to hypokinetic movement, decreased cadence due to bradykinetic movements. Affected individuals also exhibit flat foot strike. * Sudden falls * Freezing and festination episodes * Postural instability * Intensified
dyskinesia Dyskinesia refers to a category of movement disorders that are characterized by involuntary muscle movements, including movements similar to tics or chorea and diminished voluntary movements. Dyskinesia can be anything from a slight tremor of ...
* Autonomic system disorders –
orthostatic hypotension Orthostatic hypotension, also known as postural hypotension, is a medical condition wherein a person's blood pressure drops when standing up or sitting down. Primary orthostatic hypertension is also often referred to as neurogenic orthostatic hyp ...
, neurocardiogenic syncope, postural orthostatic tachycardia syndrome * Neurological and sensory disturbances – muscle weakness of lower limbs, deep sensibility impairment, epileptic seizure, cognitive impairment, visual impairment, balance impairment *
Cardiovascular disease Cardiovascular disease (CVD) is a class of diseases that involve the heart or blood vessels. CVD includes coronary artery diseases (CAD) such as angina and myocardial infarction (commonly known as a heart attack). Other CVDs include stroke, hea ...
* Drugs


Multiple sclerosis

There is a high prevalence of falls among persons with
multiple sclerosis Multiple (cerebral) sclerosis (MS), also known as encephalomyelitis disseminata or disseminated sclerosis, is the most common demyelinating disease, in which the insulating covers of nerve cells in the brain and spinal cord are damaged. This ...
(MS), with approximately 50% reporting a fall within the past six months. About 30% of those individuals report falling multiple times. * Gait deviations – Gait variability is elevated in individuals with MS. Stride length, cadence, and velocity decrease, while stance duration and cycle duration increase. *
Foot drop Foot drop is a gait abnormality in which the dropping of the forefoot happens due to weakness, irritation or damage to the deep fibular nerve (deep peroneal), including the sciatic nerve, or paralysis of the muscles in the anterior portion of t ...
* Ataxia – vestibular ataxia results in loss of balance. Symptoms are exacerbated when the eyes are closed and the base of support is reduced. * Reduced
proprioception Proprioception ( ), also referred to as kinaesthesia (or kinesthesia), is the sense of self-movement, force, and body position. It is sometimes described as the "sixth sense". Proprioception is mediated by proprioceptors, mechanosensory neurons ...
* Improper or reduced use of assistive devices * Vision – blurred vision, double vision, loss of peripheral vision * Cognitive changes – Approximately 50% of affected individuals experience difficulty with their cognition over the course of the disease, which affects planning, organizing, problem-solving, and the ability to accurately perceive the environment. When these problems interfere with walking, it may result in a fall. * Neurological medications – causes fatigue, weakness, dizziness


Dementia

Studies suggest that men are twice as likely to fall as women. Common causes of falls in
dementia Dementia is a disorder which manifests as a set of related symptoms, which usually surfaces when the brain is damaged by injury or disease. The symptoms involve progressive impairments in memory, thinking, and behavior, which negatively affe ...
include: * Gait deviations – Slower walking speed, reduced cadence, and step length, increased postural flexion, increased double support time * Postural instability – Gait changes and impaired balance. People with balance deficits are at more risk of falling than those with a normal gait and intact balance. * Lack of physical exercise * Visual impairment - Blurry vision, low vision, and loss of peripheral vision. Eyesight cannot be fixed or corrected by glasses. * Fatigue * Medications – psychotropic drugs have effects on balance, reaction time and other sensorimotor functions, orthostatic hypotension, and extrapyramidal symptoms.


Fear of falling (basophobia)

Basophobia is a term used in many circumstances to describe the fear of falling in either normal or special situations. It refers to uncomfortable sensations that may be experienced by older people. These sensations can include lower-body weakness or loss of balance, which can induce a frightening sensation of falling that can lead to serious and potentially fatal injuries.


Healthy young individuals

Accidents are the most common cause of falls involving healthy adults, which may be the result of tripping on stairs, improper footwear, dark surroundings, slippery surfaces, uneven ground, or lack of exercise. Studies suggest that women are more prone to falling than men in all age groups. The most common injuries among younger patients occur in the hands, wrists, knees, and ankles.


Environmental modification

The home environment can present many hazards. Common places for injurious falls include the
bathtub A bathtub, also known simply as a bath or tub, is a container for holding water in which a person or animal may bathe. Most modern bathtubs are made of thermoformed acrylic, porcelain-enameled steel or cast iron, or fiberglass-reinforced pol ...
and
stairs Stairs are a structure designed to bridge a large vertical distance between lower and higher levels by dividing it into smaller vertical distances. This is achieved as a diagonal series of horizontal platforms called steps which enable passage ...
. Changes to the home environment are aimed at reducing hazards and help support a person in daily activities; they include minimizing clutter, installing
grab bar Grab bars are safety devices designed to enable a person to maintain balance, lessen fatigue while standing, hold some of their weight while maneuvering, or have something to grab onto in case of a slip or fall. A caregiver may use a grab bar to a ...
s in the bathroom, and installing non-slip
decal A decal (, , ) or transfer is a plastic, cloth, paper, or ceramic substrate that has printed on it a pattern or image that can be moved to another surface upon contact, usually with the aid of heat or water. The word is short for ''decalc ...
s to slippery surfaces. Stairs can be improved by installing
handrail A handrail is a rail that is designed to be grasped by the hand so as to provide safety or support. In Britain, handrails are referred to as banisters. Handrails are usually used to provide support for body or to hold clothings in a bathroom o ...
s on both sides, improving lighting, and adding colour contrast between steps. Improvement in lighting and
luminance Luminance is a photometric measure of the luminous intensity per unit area of light travelling in a given direction. It describes the amount of light that passes through, is emitted from, or is reflected from a particular area, and falls with ...
levels can aid elderly people in assessing and negotiating hazards. Occupational therapists can help clients improve fall prevention behaviours. In addition, they can instruct clients and their family members on factors that contribute to falls, and implement environmental modifications and strategies to decrease the risk of falls. There is currently insufficient scientific evidence to ensure the effectiveness of modification of the home environment to reduce injuries. Evidence suggests that pre-discharge home assessments are associated with a reduced risk of falling.


Safety technology

Important improvements to prevent falls include
handrail A handrail is a rail that is designed to be grasped by the hand so as to provide safety or support. In Britain, handrails are referred to as banisters. Handrails are usually used to provide support for body or to hold clothings in a bathroom o ...
s and grab bars, which should be easy to grip or grasp and should be near any stairs or change in floor level. Floors should always be flat and level, with no exposed corners or edges. Patterned floors can be dangerous if they create misleading or distorted images of the floor surface, and should be avoided. There are special handles and closed handgrips available in
bathroom A bathroom or washroom is a room, typically in a home or other residential building, that contains either a bathtub or a shower (or both). The inclusion of a wash basin is common. In some parts of the world e.g. India, a toilet is typically ...
s and lavatories to help users bend down or over. For example, extra support for users when moving include
walking stick A walking stick or walking cane is a device used primarily to aid walking, provide postural stability or support, or assist in maintaining a good posture. Some designs also serve as a fashion accessory, or are used for self-defense. Walking st ...
s, crutches, and support frames, such as a
walker Walker or The Walker may refer to: People * Walker (given name) *Walker (surname) * Walker (Brazilian footballer) (born 1982), Brazilian footballer Places In the United States *Walker, Arizona, in Yavapai County *Walker, Mono County, California ...
. Flexible handles such as hanging straps can also be useful supports.


Eyeglasses selection and usage

Bifocal
spectacles Glasses, also known as eyeglasses or spectacles, are vision eyewear, with lenses (clear or tinted) mounted in a frame that holds them in front of a person's eyes, typically utilizing a bridge over the nose and hinged arms (known as temples o ...
and trifocal eyeglasses are used to provide refractory correction ideal for reading (12–24 inches (30–60 cm) when the wearer looks downward through them. Reading glasses are not ideal for safe walking, where correction for 4.5–5 feet (137–152 cm) would be more appropriate.


Occupational and physical therapy

Studies show that balance, flexibility, strength, and motor-cognitive training not only improve mobility but also reduce the risk of falling. This may be achieved through group and home-based exercise programs or engagement with
physical therapy Physical therapy (PT), also known as physiotherapy, is one of the allied health professions. It is provided by physical therapists who promote, maintain, or restore health through physical examination, diagnosis, management, prognosis, pat ...
clinics with the appropriate equipment. The majority of older adults do not exercise regularly and 35% of people over the age of 65 do not participate in any leisurely physical activities.


Older adults

In older adults, physical training and perturbation therapy is directed to improving balance recovery responses and preventing falls. Gait-related changes in the elderly provide a greater chance of stability during walking due to slower speed and greater base of support, but they also increase the chance of slipping or tripping and falling. Appropriate joint moment generation is required to create sufficient push-off for balance recovery. Age-related changes in muscles, tendons, and neural structures may contribute to slower reactive responses. Interventions involving resistance training along with perturbation training may prove to be beneficial in improving muscle strength and balance recovery.


Stroke recovery

Stroke exercises help patients regain mobility and strength in their bodies, and must be done regularly in order to regain muscle tone that helps prevent falls.


Exercises for prevention

One of the most important things for fall prevention in elderly populations is to stay physically fit. Specialized facilities and programs like seniors' parks are a good place to keep the elderly in shape and increase their resistance to falling. These facilities contain specialized equipment and training stations where elderly people can exercise. The parks usually have an extended amount of space and different stages reserved for different body exercises. Research suggests that participation in such programs successfully mitigates fall risk in the majority of attendees.


See also

* Morse Fall Scale * Falling (accident) *
Falls in older adults Falls in older adults are a significant cause of morbidity and mortality and are a major class of preventable injuries. Falling is one of the most common accidents that cause a loss in the quality of life for older adults, and is usually precip ...
* Fall Prevention Center of Excellence * Light ergonomics * Lighting for the elderly * Safety engineering * Safety equipment * Home modifications * Home automation for elderly and disabled people *
Assisted living An assisted living residence or assisted living facility (ALF) is a housing facility for people with disabilities or for adults who cannot or who choose not to live independently. The term is popular in the United States, but the setting is si ...
*
Assistive technology Assistive technology (AT) is a term for assistive, adaptive, and rehabilitative devices for Disability, people with disabilities and the elderly. Disabled people often have difficulty performing activities of daily living (ADLs) independently, ...


References


Further reading

*


External links


Fall prevention
NHS Choices
Fall prevention for older adults
US Centers for Disease Control and Prevention
Fall Prevention in the Workplace
US Centers for Disease Control and Prevention,
National Institute for Occupational Safety and Health The National Institute for Occupational Safety and Health (NIOSH, ) is the United States federal agency responsible for conducting research and making recommendations for the prevention of work-related injury and illness. NIOSH is part of the C ...
{{DEFAULTSORT:Fall Prevention Geriatrics Patient safety Prevention