PTs and PTAs have long understood the role physical therapy can play in reducing the risk of falls, and APTA offers important resources to help strengthen that role.
Many of those resources are available on the association's Balance and Falls webpage and include a clinical summary on fall risk in community-dwelling older adults, links to recent APTA research reviews such as this one on falls and emergency department visits, a handout on research supporting physical therapy's role in falls prevention, and connections to online courses in management of falls, home health interventions for falls, and vestibular physical therapy.
APTA resources also include a recording of a two-day APTA Centennial Lecture Series presentation, available for purchase, on the latest advances in the management of benign paroxysmal positional vertigo and peripheral vestibular hypofunction, the most common causes of vertigo and imbalance.
Over the past year, research on falls has expanded to include investigations into the effect the coronavirus pandemic is having on the issue. In recognition of National Falls Prevention Awareness Week Sept. 21-25, here's a roundup of some of the latest research on the effects of COVID-19 on falls and falls prevention.
From social isolation to inactivity to falls: the pandemic's domino effect. A national survey of 2,006 U.S. adults ages 50-80 conducted earlier this year found that 36.9% reported reduced activity levels and 45.9% said they are experiencing social isolation due to the pandemic — two factors that authors of a related analysis say are associated with increased falls risk and worsened fear of falling. "Public health actions to address reduced physical activity and social isolation are needed," authors write. (Journal of the American Geriatrics Society)
Falls as a possible indicator of COVID-19. A meta-analysis of studies on COVID-19 symptoms reveals that falls could be an "atypical" symptom of COVID-19 in older patients, along with delirium, confusion, and dizziness. Authors of the study call for further research but say that for now, atypical presentations of COVID-19, such as falls, "should be considered when screening and testing people at increased risk (of COVID-19) due to their age." (Geriatric Orthopaedic Surgery & Rehabilitation)
Falls (and fractures from them) dropped in Israel during the pandemic. But what does that mean? A study from Israel analyzed the incidence of hip fracture surgeries during 2020, focusing on those patients whose fractures were due to falls. They compared rates with 2019 data and found that fewer falls-related fractures surgeries took place during the pandemic, and that overall rates of falls dropped as well. For those who were hospitalized due to a fall, length-of-stay dropped too. Authors theorize that the differences could be due to more caution among older adults during the pandemic — but a reluctance to seek care may also be at work. (IMAJ: Israel Medical Association Journal)
In New Zealand, the pandemic lockdown changed injury patterns (although falls were still the most prevalent cause for hospitalization). Much like the study from Israel described above, an analysis of hospital admissions for injury during pandemic lockdowns in New Zealand saw an overall decrease, but a change in cause patterns: while admissions due to injuries incurred on roads, schools, and sports areas decreased, injuries occurring at home and on footpaths increased. Despite the shift, falls still remained the most frequent source of injury (39%). Authors say the decline was "short-lived" once restrictions were lifted in the country. (New Zealand Medical Journal)
Falls risk remains high for individuals with MS and may have worsened during the pandemic. Researchers surveyed 239 individuals with multiple sclerosis and 133 without MS and found that during the pandemic those living with MS had a higher frequency of falls compared with the non-MS group (58.5% compared with 21.8%). The group with MS also reported higher rates of falls recurrence (45.3% vs 9.8%), in-home falls (83.9% vs 54.2%), and fractures (5.7% vs 0.8%). Lower physical activity levels were similar for both groups — 49.1% for those with MS, and 52.2% for those without. (Multiple Sclerosis and Related Disorders)
Did the pandemic spark a resistance to ED visits among older adults, resulting in "excess mortality" not related to COVID-19? Researchers looked at ED admissions for falls, sepsis, acute myocardial infarction, stroke, and hip fracture, and investigated the possible reasons why, during the pandemic's height in 2020, emergency department visits declined while excess mortality not associated with COVID-19 grew. Their conclusion: compared with other age groups, the decline in ED visits has been "more persistent" among older adults, who experience incidents "that are amenable to time-sensitive ED diagnosis and treatment." (Journal of the American Geriatrics Society)
A foggy notion behind a fall-related fracture. Authors of a case study of a falls-related olecranon fracture sustained by a 70-year-old female point fogged glasses as the likely cause. The reason for the fog? The patient was wearing a mask at the time. The researchers hope that their study will help clinicians and other providers avoid overlooking the possibility that glasses and masks could add up to yet another risk factor for falls. (Case Reports in Orthopedics)