Posts Tagged ‘prevention’

Physical Therapy & Fall Prevention

MediLodge of Taylor

MediLodge of Taylor Physical Therapy

by Ebony Rice, DPT, MediLodge of Taylor

Falls and fall-related injuries, such as fractures, are a growing problem among older adults, often causing longstanding pain, functional impairments, reduced quality of life and mortality. Falls are one of the leading causes of accidental death among people older than 65 years. According to the Centers for Disease Control and Prevention, each year one in every three adults age 65 and older falls. Among the elderly, most falls occur indoors during usual activities of daily living such as transfers into or out of bed and walking. Age related factors contributing to falls include but are not limited to: changes in postural control; changes in gait; and declining visual abilities.

With increasing age, muscle tone, strength, and proprioception (our internal sense of body position) are all decreased which may cause slower righting reactions. Ambulation is slower and older adults demonstrate a lower swing height which leads to catching of the toe or tripping. Visual conditions such as cataracts, glaucoma, age-related macular degeneration and health related vision changes; all contribute to declines in depth perception, clarity, visual field, dark adaptation and color sensitivity which increases the risk of falling over unseen objects. Fall prevention is a multidimensional process. Physical therapy aides in the prevention of falls by assessing falls risk and addressing the impairments related to advanced aging. Physical therapists design and implement individualized regimens that include strengthening, gait and balance activities.

Exercises that focus on strengthening core/postural muscles along with those needed for ambulation (hip, knee and ankle muscles) can increase stability when performing functional mobility. Gait training with or without assistive devices is also a major component of physical therapy. Therapists may assess and recommend assistive devices, such as canes and walkers, which may be beneficial for older adults at high risk for falls. If not used properly, assistive devices can become a fall hazard. Choosing the appropriate assistive device, the appropriate height and gait training which focuses on safety and sequencing are all aspects of skilled therapy that should be performed by a physical therapist. The use of an assistive device will allow for the highest level of independence while increasing safety.

MediLodge of Taylor

MediLodge of Taylor Physical Therapy

Standing dynamic balance activities, such as throwing and catching a ball, facilitates balance reactions which are needed to correct yourself when loss of balance occurs. Physical therapy also implements balance activities that simulate functional activities performed daily, for example, reaching up into a cabinet.

Therapists educate patients and caregivers on ways to adapt or compensate for a deficit in the visual field. For example, a person who recently had a stroke may neglect the visual field on one side. Physical therapy focuses on training that individual to turn the head to increase the visual field and ensure safety when walking and/or performing functional mobility.

Physical therapists educate and instruct patients on fall recovery; the safest and most effective way of getting up after a fall occurs. Physical therapists also perform home evaluations to assess the possible hazards and adaptations needed to increase safety in the home while performing activities of daily living.

Falls are often unreported due to fear of losing ones independence. Repeated falls can be a sign of a change in medical status. There are many health conditions that may contribute to falls: stroke, heart attacks, diabetes, brain injuries, etc. Additionally, some medications that treat certain health conditions have possible side effects that may increase the chance of fall occurrence. Falls can be a sign of a more serious problem and should always be reported to a medical doctor. While physical therapy does not prevent falls, physical therapy may improve the impairments related to falls which in turn, decreases the risk of falls.

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MediLodge of Taylor

MediLodge of Taylor

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MediLodge Wellness: Preventing Falls in the Elderly

Written by K.R. Tremblay and C.E. Barber MediLodge of Port Huron

 

Here are a few quick facts about falling in the elderly:

  • The risk of falling increases with age and is greater for women than for men.
  • Two thirds of those experience a fall will fall again with six months.
  • A decrease in bone density contributes to falls and resultant injuries.
  • Failure to exercise regularly results in poor muscle tone, decreased strength, and loss of bone mass and flexibility.
  • At least one third of all falls in the elderly involve environmental hazards.

 

Causes and Prevention:

The causes of falls are known as “risk factors.”  Many of these risk factors are preventable.  As obvious as it may sound, a lack of knowledge about risk factors and how to prevent them contributes to many falls.  Some people believe that falls are a normal part of aging and are not preventable.  Lack of knowledge leads to lack of preventative action, resulting in falls.

 

Here is a list of risk factors that contribute to falls:

  • Osteoporosis:  Osteoporosis is a condition wherein bones become more porous, less resident to stress, and more prone to fractures.  Eating calcium rich foods such as milk, yogurt, fish/shellfish, broccoli, soybeans, collards, tofu, and almonds help replenish the body’s need for calcium. Vitamin D enhances the absorption of calcium. Weight-bearing exercises are also beneficial.St Hts New Therapy
  • Lack of Physical Activity:  Failure to exercise regularly results in poor muscle tone, decreased strength, and loss of bone mass and flexibility.  Even simple wheelchair exercises can help you keep your joints flexible and strong. Take time to recover balance when rising from chair or bed.  Keep items within reach to minimize overextending and losing your balance.
  • Impaired Vision:  Cataracts and glaucoma alter older people’s depth perception, visual acuity, peripheral vision, and susceptibility to glare.  Add contrasting color strips to first and last steps to identify depth and changes of level.  Clean glasses often to improve visibility.
  • Medications:  People that take multiple medications are at greater risk for falls. Sedatives, antidepressants, and anti-psychotic medications can contribute to falls by reducing mental alertness, worsening balance/gait, and effecting blood pressures.  Know the common side effects of your medications.  Talk with your physician about ways to reduce your chances of falling by reviewing medications.
  • Environmental Hazards:  The most common hazard for falls is tripping over objects on the floor.  Poor lighting, loose rugs/bed covers, lack of grab bars, and unstable furniture contribute to the risk for falls.  A walk through of your home by the occupational therapist prior to discharge will help identify fall hazards and get your home safe for your return.  A night light along the path to the bathroom can also be useful.

 

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Cold vs. Flu: Beating Them Both With MediLodge Wellness

Upper respiratory infections are very common, especially in the colder months and when seasons are changing.  The cold and the flu (influenza) are caused by many different types of viruses.  The common cold usually affects your nose, throat and lungs.  Influenza brings fever,aches and pains in addition to the typical cold symptoms.  Influenza is not the same as the “stomach flu” which are viruses that make you experience nausea, diarrhea and vomiting.cold v flu

Head Cold Symptoms

Cold symptoms start gradually.  You may feel slight chills, occasional sneezing, watery eyes or scratchy throat.   It may take at least two to three days before you realize you actually have a cold.

Treating A Head Cold

Drink plenty of water or broth, but avoid soda, Gatorade or fruit juices.  The fluids high in sugar may give you diarrhea.  Use steam from the shower or a cool room vaporizer to sooth and help clear your stuffy nose.  Lotion or Vaseline can be used on the outside of the nose.  Saline nasal spray can relieve soreness inside the nose.  If you use oxygen, only use a water-soluble gel (KY) both inside and outside the nose.

Check with your doctor before using any over the counter antihistamines or cold/cough remedies as these medications will increase your heart rate for several days after using them.

If you have a cough and sore throat, gargle with salt water (¼ teaspoon salt to ½ cup water), use cough lozenges and cough medication as directed.  Too much cough medication may cause increased heart rate, dizziness and nausea.

Most colds will resolve in seven to ten days after symptoms first occur.  If symptoms last longer, you develop a temperature greater than 100.4 Fahrenheit, are coughing up yellow-green sputum, have a severe sore throat, earache or shortness of breath and chest pain, see your physician.

Signs Of Influenza (Flu)

Flu causing viruses attack your nose, throat and lungs.  The symptoms come on very suddenly, such as fatigue and coughing.  Other symptoms are fever, headache, tiredness, sore throat, runny nose and muscle aches.  The acute symptoms last for a week, but the after effects can linger for over two weeks.  You  are unable to perform any normal daily activities with the flu because you feel completely worn out.

Treating The Flu

When flu symptoms first start, stay at home and call your doctor’s office.  The doctor may be able to prescribe medication that will help resolve the symptoms faster.  It is fine to take acetaminophen (Tylenol) or ibuprofen (Motrin) for fever reduction and aches and pains, but remember not to give children aspirin as it can cause Reye’s Syndrome.

Drink at least six to eight full glasses of water daily, rest in bed and eat small frequent meals.  If your fever is over 101 Fahrenheit, you are dizzy, light-headed or short of breath, call the doctor immediately.handwashing

Influenza is spread through droplets from your lungs.  It can spread when someone with the flu coughs, sneezes, laughs or even talks.  If you are in a weakened state it can easily cause bronchitis or pneumonia with very serious consequences.

Prevention:  Colds and Flu

Proper hand washing with soap and water by scrubbing with a generous lather for 15 to 30 seconds, rinsing with the fingers held down, drying with clean paper towel and turning the tap off and opening the door with the towel are the first steps to preventing the spread of germs of any kind.  Covering your mouth and nose when coughing or sneezing with a tissue, handkerchief or even the crook of your arm are other steps you can take to stop the spread of germs.  Avoid touching your eyes, nose and mouth as well.

It is okay to use alcohol-based cleanser that is at least 60% alcohol ( most are 68%) when soap and water are not available.  Avoid using the alcohol-based hand cleanser more than three times in a row before washing with soap and water.  Limit your exposure to crowds and use judgment on whether or not to shake hands with someone.

At the end of September get a flu vaccination as soon as it is available.  Flu vaccines are usually given from September through January, but check with your physician for exact details.  If you have chronic health conditions or are over 65 years of age, consult your physician about the pneumonia vaccine as well.

Remember, the cold and flu can be very dangerous.  Prevention and prompt attention if you become ill will keep you and those around you safe and healthy.

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