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Evidence-Based Intervention for Balance and Falls Prevention

Evidence-Based Intervention for Balance and Falls Prevention
Kathleen Weissberg, OTD, OTR/L
February 9, 2016
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Review

We talked about last week that 78% of falls were anticipated physiologic falls, meaning that if we did a risk assessment tool, there would be some factor on that tool that would indicate the individual is at risk for falls. In a normal individual, cognitive processes, the musculoskeletal system, and the sensory motor system (vestibular, somatosensory, and the visual systems) all work together in order to give a person good balance control. It is when one of these are not functioning well that we have an increased fall risk and balance issues. 

Evidence from the AGS/BGS

I want to jump right into treatment. A lot of what we are going to talk about today is based on the evidence-based practice guidelines that have been developed by the American Geriatric Society (AGS) and the British Geriatric Society (BGS). They came forward and said that we need to do a multifactorial fall risk assessment, which we talked about before, and this needs to be followed by direct interventions tailored to the individual and to the identified risk factors, so very individualized type of program. Now the interventions that they found strong evidence for included exercise, environmental modification, management of hypotension, medication management, and management of foot problems and footwear. We are going to review each of those in turn, starting with exercise.

Evidence Related to Exercise

The American Geriatric Society says that we should be developing an exercise program that includes balance, gait, and strength. They also suggest that we also include flexibility and endurance in the exercise program, but those would not be sole components. While it is nice to have them, they are not going to prevent falls. The strongest evidence they have is related to Tai Chi. I do not know if any of you use Tai Chi in your practice, but we are going to pull up a study here in just a second that will show that it is incredibly effective for reducing falls.


kathleen weissberg

Kathleen Weissberg, OTD, OTR/L

Dr. Kathleen Weissberg, (MS in OT, 1993; Doctoral 2014) in her 25+ years of practice, has worked in rehabilitation and long-term care as an executive, researcher and educator.  She has established numerous programs in nursing facilities; authored peer-reviewed publications on topics such as low vision, dementia quality care, and wellness; has spoken at numerous conferences both nationally and internationally, for 20+ State Health Care Associations, and for 25+ state LeadingAge affiliates.  She provides continuing education support to over 17,000 therapists, nurses, and administrators nationwide as National Director of Education for Select Rehabilitation. She is a Certified Dementia Care Practitioner and a Certified Montessori Dementia Care Practitioner.  She serves as the Region 1 Director for the American Occupational Therapy Association Political Affairs Affiliates and is an adjunct professor at both Chatham University in Pittsburgh, PA and Gannon University in Erie, PA. 



Related Courses

Multisensory Stimulation Rooms for Persons with Dementia: Design on a Dime
Presented by Kathleen Weissberg, OTD, OTR/L
Video
Course: #5180Level: Intermediate1 Hour
This session reviews the benefits and limitations of sensory stimulation for persons with dementia and design factors to consider when designing a multi-sensory space. This session will offer a “design on a dime” approach to a sensory room and demonstrates to occupational therapists how they can assist communities in designing a space to impact the quality of life without relying on pharmacology.

Tools to Optimize Quality Alzheimer’s and Dementia Care: Tackling Loneliness and Social Isolation
Presented by Kathleen Weissberg, OTD, OTR/L
Video
Course: #4961Level: Intermediate1 Hour
This session will review practical and cost-effective strategies care providers can implement to impact these areas. Following the framework of person-centered care, providers will hear about meaningful and purposeful activity, sensory, technology, and wellness strategies they can implement to mitigate the potentially harmful effects of isolation.

A Montessori-Based Approach for Aging and Dementia
Presented by Kathleen Weissberg, OTD, OTR/L
Video
Course: #4525Level: Intermediate1 Hour
In this course, participants will learn about the Montessori principles of independence according to one’s ability and the benefits of the prepared environment. Specifically, participants will learn about the fundamental principles of the Montessori method, how to conduct a Montessori-based session, Montessori-based steps to engagement that reduce unwanted behaviors, issues that may arise with this approach, and using case studies and video examples, how to set up activities/tasks for individuals with dementia using a Montessori Approach.

Fall Management: Evidence-Based Interventions for Screening and Intervention
Presented by Kathleen Weissberg, OTD, OTR/L
Video
Course: #9453Level: Intermediate2 Hours
This session will review evidence-based screening and intervention strategies applicable to a balance and falls management program including research-based exercise programs, environmental modification, patient and caregiver education and balance retraining activities. Falls management program rationale and implementation is also discussed as well as interdisciplinary techniques and strategies to reduce fall risk in the elderly.

Interdisciplinary Approach to Continence Improvement
Presented by Kathleen Weissberg, OTD, OTR/L
Video
Course: #2830Level: Intermediate2 Hours
All healthcare disciplines have a role in skilled intervention to treat continence. This seminar provides an overview of anatomy and physiology of normal voiding as well as normal function related to continence. Different types of incontinence are identified and assessment/treatment strategies are offered for each. This course takes an interdisciplinary approach to continence improvement and demonstrates roles of each team member. Emphasis is placed on completing an assessment of voiding, identifying triggers and bladder stimulants, voiding habits and patterns, and implementing individualized care approaches. This course is open captioned.

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