Falls in the elderly – risk assessment and procedding

Marta Podhorecka, K. Kędziora–Kornatowska, Jadwiga Główczewska, Dominika Gębka, Marta Sucharska-Szymkowiak, Natalia Ciesielska, Remigiusz Sokołowski, Magdalena Weber-Rajek
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Abstract

The aging of society was an incentive to the development of many fields of medicine including geriatric physiotherapy. Rehabilitation in geriatrics involves a range of issues connected with the involutional and/or disease related changes in the organism of an elderly person. To highlight the most important ones, so called ‘great geriatric problems’ were distinguished. One of them are falls. The risk of falls rises significantly after the age of 65. Among people older than 65 the chances of falls are 40% higher than among younger people. The article aims at showing the issues connected with the role of physiotherapy in falls prophylaxis in the elderly. The problem of falls in the elderly is mainly connected with the consequences of falls. Falls may lead to injuries, disability and even death. Falls prophylaxis should start with complex geriatric assessment. To assess the risk of falls a physiotherapist may use special scales: the stand up and go and the Tinetti test. After thorough analysis of the state of health of the elderly person appropriate prophylaxis measures may be chosen: removal of the environmental threats, appropriate selection of shoes as well as the assisting equipment, acute and chronic diseases treatment, pharmacotherapy modification, physiotherapy. Anti-fall rehabilitation usually focuses on balance training, expanding the range of motion, gait re-education and analgesic measures. In some medical centres special anti-fall programs are being developed, where physical activities and appropriate assisting equipment play the most important role. Modern physiotherapy methods enable individual anti-fall prophylaxis adjustment to the elderly person’s needs. The use of rehabilitation to diminish the risk of falls in the elderly is more and more common.
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老年人跌倒-风险评估和处理
社会的老龄化促进了包括老年物理治疗在内的许多医学领域的发展。老年病学中的康复涉及一系列与老年人机体的无意识和/或疾病相关的变化有关的问题。为了突出最重要的问题,我们区分了所谓的“老年大问题”。其中之一是瀑布。65岁以后跌倒的风险显著上升。在65岁以上的人群中,跌倒的几率比年轻人高出40%。这篇文章的目的是显示与物理治疗在老年人跌倒预防中的作用有关的问题。老年人跌倒的问题主要与跌倒的后果有关。跌倒可能导致受伤、残疾甚至死亡。预防跌倒应从复杂的老年评估开始。为了评估跌倒的风险,物理治疗师可能会使用特殊的量表:站立和行走测试和蒂内蒂测试。在深入分析老年人的健康状况后,可以选择适当的预防措施:消除环境威胁、适当选择鞋子以及辅助设备、急慢性疾病治疗、药物治疗修改、物理治疗。防跌倒康复通常侧重于平衡训练、扩大活动范围、步态再教育和镇痛措施。一些医疗中心正在制定特别的防跌倒方案,其中体育活动和适当的辅助设备发挥着最重要的作用。现代物理治疗方法使个体抗跌倒预防调整到老年人的需要。利用康复来降低老年人跌倒风险的方法越来越普遍。
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