● Centers for Disease Control and Prevention, National Center for Injury Preventions and Control, Division of Unintentional Injury Prevention. STEADI (Stopping Elderly Accidents, Deaths, and Injuries) Tool Kit for Health Care Providers : https://www.cdc.gov/steadi/materials.html This link provides instructions for functional tests, measuring orthostatic blood pressure, and many other materials for healthcare providers. offered to all participants in a program (population approach). ● Multifactorial fall risk assessment : Assessment of known predisposing factors within the person and in the environment that increase the risk for falling. ● Multifactorial intervention : An intervention made up of a subset of interventions that are selected and offered to an individual to address the specific risk factors identified through a multifactorial fall risk assessment. ● Postural control : Controlling the body’s position in space for the dual purposes of stability and orientation. ● Postural orientation : Ability to maintain an appropriate relationship between body segments, the body, and environment for a task. ● Postural stability : Ability to control the center of mass relationship to the base of support. ● Single intervention : An intervention in one of the preceding categories, such as balance and strength exercise program, medication adjustment, vision improvement, home/environmental modification, footwear adjustment, educational programs. ● Stepping strategy : Maintaining upright posture by stepping when the center of mass cannot be maintained over the current base of support. ● Suspensory strategy : Flexing at the ankle, knee, and hip to lower the center of gravity toward the base of support. Delbaere K., Close JC., Mikolaizak AS., et al. (2010). The falls efficacy scale international (FES-I). A comprehensive longitudinal validation study. Age Ageing, 39 (2):210–216. Dite, W. and Temple, V. A. (2002). A clinical test of stepping and change of direction to identify multiple falling older adults. Archives of Physical Medicine and Rehabilitation, 83 (11): 1566-1571. Duncan, P. W., Weiner, D. K., Chandler, J., & Studenski, S. (1990). Functional reach: a new clinical measure of balance. J Gerontol, 45 (5), M190-197. Ensrud, K. E., Ewing, S. K., Taylor, B. C., Fink, H. A., Stone, K. L., Cauley, J. A., … & Study of Osteoporotic Fractures Research Group. (2007). Frailty and risk for falls, fracture, and mortality in older women: The study of osteoporotic fractures. Journal of Gerontology, Series A: Biological Sciences, 62 (7), 744-751. Faber, M. J., Bosscher, R. J., Marikje, J., Paw, C. A., & van Wieringen, P. C. (2006). Effects of exercise programs on falls and mobility in frail and pre-frail older adults: A multicenter randomized controlled trial. Archives of Physical Medicine and Rehabilitation, 87 (7), 885-896. Falls Free. (2015). Falls Free: 2015 National Falls Prevention Action Plan . 2015. Retrieved from https://www. ncoa.org/resources/2015-falls-free-national-falls-prevention-action-plan/ . Fitzharris, M. P., Day, L., Lord, S. R., Gordon, I., & Fildes, B. (2010). The Whitehorse NoFalls trial: effects on fall rates and injurious fall rates. Age and Ageing, 39 (6), 728-733. Folstein, M., Folstein, S. E., & McHugh, P. R. (1975). “Mini-Mental State” a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12 (3), 189-198. Franchignoni F., Horak F., Godi M., Nardone A., Giordano A. (2010). Using psychometric techniques to improve the Balance Evaluation Systems Test: the mini-BESTest. J Rehabil Med. 42 (4):323-31. Fried L.P., Tangen C.M., Walston J., Newman A. B., Hirsch C., Gottdiener J., Seeman T…& McBurnie M.A. (2001). Frailty in older adults evidence for a phenotype. Journal of Gerontology, Series A: Biological Science and Medical Sciences, 62 (7), 744-751. Fritz, S., & Lusardi, M. (2009). White paper: “Walking speed: the sixth vital sign.” Journal of Geriatric Physical Therapy, 32 :2-5. Hennie, V., Janssen, C. J. P., Samson, M. M., & Verhaar, H. J. J. (2002) Vitamin D deficiency, muscle function, and falls in elderly people. American Journal of Clinical Nutrition, 75 (4), 611-615. Garmendia, M. L., Dangour, A. D., Albala, C., Eguiguren, P., Allen, E., & Uauy, R. (2013). Adherence to physical activity intervention among older adults in a post-transitional middle income country: A quantitative and qualitative analysis. Journal of Nutrition, Health & Aging, 17 (5), 466-471. Gillespie, L. D., Robertson, M. C., Gillespie, W. J., Sherrington, C., Gates, S., Clemson, L. M., … & Lamb S. E. (2012). Interventions for preventing falls in older people living in the community. Cochrane Database of Systematic Reviews, 9 , CD007146. Doi:10.1002/14651858.CD007146.pub3. Gleason, K. M., McDaniel, M. R., Feinglass, J., Baker, D. W., Liss, D., & Noskin, G. A. (2010). Results of the medications at transitions and clinical handoffs (MATCH) study: An analysis of medication reconciliation errors and risk factors at hospital admission. Journal of General Internal Medicine, 25 (5), 441-447. Groot, M. H. D., Jagt-Willems, H. C. V. D., Campen, J. P. V., Lems, W. F., Beijnen, J. H., & Lamoth, C. J. (2014). A flexed posture in elderly patients is associated with impairments in postural control during walking. Gait & Posture, 39 (2), 767-772. Gunther, J., Kolodziej, T., Bish, C., & Tiberi, J. (2005). Test retest and interrater reliability of two postural measures in postmenopausal women with osteoporosis. Journal of Geriatric Physical Therapy, 28 (3), 122. Guralnik, J. M., L. Ferrucci, et al. (2000). Lower extremity function and subsequent disability: consistency across studies, predictive models, and value of gait speed alone compared with the short physical performance battery. J Gerontol A Biol Sci Med Sci, 55 (4): M221-31. Hamacher, D., Singh, N. B., Van Dieen, J. H., Heller, M. O., & Taylor, W. R. (2011). Kinematic measures for assessing gait stability in elderly individuals: a systematic review. Journal of the Royal Society Interface, 8 (65), 1682-1698. Harwood, R. H. (2009). Slow walking speed in elderly people. BMJ, 339 , b4236. Hartikainen, S., Lonnroos, E., & Louhivuori, K. (2007). Medication as a risk factor for falls: critical systematic review. Journal of Gerontology, Series A: Biological Science and Medical Sciences, 62 (10), 1172-1181. Haynes, M, League, P, & Neault, G. (2014). A matter of balance: Older adults taking control of falls by building confidence. Frontiers in Public Health, 27 , 274. Healy, T., Peng, C., Haynes, M., McMahon, E., Botler, J., & Gross, L. (2008). The feasibility and effectiveness of translating a Matter of Balance into a volunteer lay leader model. Journal of Applied Gerontology, 27 (1), 34-51. Herdman, S. J., & Clendaniel, R. (2014). V estibular rehabilitation . 4th ed. Philadelphia, PA: FA Davis. Hofheinz, M., & Schusterschitz, C. (2010). Dual task interference in estimating the risk of falls and measuring change: A comparative, psychometric study of four measurements. Clinical Rehabilitation, 24 (9), 831-842. Holland, G.J., Tanaka, K., Shigematsu, R., & Nakagaichi, M. (2002). Flexibility and physical functions of older adults: A review. Journal of Aging and Physical Activity, 10 (1), 169-206. Hornyak, V., Brach, J., & VanSwearingen, J. (2013). What is the relation between fear of falling and physical activity in older adults? Archives in Physical Medicine and Rehabilitation, 94 (12), 2529-2534. Howe, E. (2007). Initial screening of patients for Alzheimer’s disease and minimal cognitive impairment. Psychiatry, 4 (7), 24-27. Institute of Medicine. (2011). Clinical practice guidelines we can trust . Washington, DC: National Academies Press.
● Canadian Fall Prevention Community of Practice : http://www.fallsloop.com/( http://www.fallsloop.com/). ● Fall Prevention Awareness: Advanced Training for Home Health Aides : https://phinational.org/resource/fall-prevention-awareness- enhanced-training-curriculum-for-home-health-aides/ ● Community Powerpoint: Take a Stand to Prevent Falls- AOTA/AGPT Fall Risk Presentation : http://geriatricspt.org/pdfs/AOTA-APTA-Falls-Prevention.pdf Glossary Definitions important to understanding course content include the following terms used by the American Geriatrics Society, the British Geriatrics Society, and the American Academy of Orthopedic Surgeons in “Prevention of Falls in Older Person: AGS/BGS Clinical Practice Guideline” (AGS/BGS CGG, 2010): ● Ankle balance strategy : Balance adjustments made at the ankle joint as the person sways much like an inverted pendulum in the anterior/posterior or medial/lateral directions. ● Cross-over strategy : Lateral step of one lower extremity over and across the other leg in order to prevent a loss of balance. ● Fall : An event whereby an individual unexpectedly comes to rest on the ground or another lower level without known loss of consciousness. ● Hip balance strategy : Adjustments made at the hip in the anterior and posterior planes, involving hip flexion and extension in order to remain upright. The challenge to postural control that elicits a hip strategy is typically stronger than that for an ankle strategy (a stronger push or larger shift in the support surface). ● Intervention domains (categories) : Medication, exercise, vision postural hypotension, heart rate and rhythm, vitamin D, foot and footwear, home environment, education. ● Multicomponent intervention : A set of interventions addressing more than one intervention domain or category Abizanda, P., Romero, L., & Sanchez-Jurado, P. M. (2012). Association between functional assessment instruments and frailty in older adults: The FRADEA study. Journal of Frailty & Aging, 1 (4), 162-168. American Geriatrics Society (AGS) and British Geriatrics Society (BGS) Panel on the Clinical Practice Guideline for the Prevention of Falls in Older Persons. (2010). AGS/BGS clinical practice guideline: prevention of falls in older persons . Retrieved from http://www.geriatricscareonline.org/ProductAbstract/updated-american- geriatrics-societybritish-geriatrics-society-clinical-practice-guideline-for-prevention-of-falls-in-older-person-and- recommentdations/CL014. American Hospital Association. (2007). Baby boomers to challenge and change tomorrow’s health care system . Press Release, https://www.aha.org/system/files/content/00-10/070508-boomerreport.pdf; accessed July 12, 2018. Annweiler, C., Montro-Odasso, M., Schott, A. M., Berrut, G., Fantino, B., & Beauchet, O. (2010). Fall prevention and vitamin D in the elderly: An overview of the key role of the non-bone effects. Journal of Neuroengineering and Rehabilitation, 11 , 50. Avin, K. G., Hanke, T. A., Kirk-Sanchez, N., McDonough, C. M., Shubert, T. E., Hardage, J., … & Hartley, G. (2015). Management of falls in community-dwelling older adults: Clinical guidance statement from the Academy of Geriatric Physical Therapy of the American Physical Therapy Association. Physical Therapy 95 , 815-834. Barusch, A. S. (2013). The aging tsunami: Time for a new metaphor? Journal of Gerontological Social Work, 56 , 181-184. DOI: 10.1080/01634372.2013.787348. Bauman CA, Milligan JD, Patel T, Pritchard S, Labreche T, Dillon-Martin S, et al. (2014). Community-based falls prevention: lessons from an interprofessional mobility clinic. J Can Chiropr Assoc . Sep;58(3):300-311. Belza, B., Snyder, S. J., Thompson, M., & LoGerfo, J. P. (2010). From research to practice: EnhanceFitness, an innovative community-based senior exercise program. Topics in Geriatric Rehabilitation, 26 (4), 299-309. Berg K, Wood-Dauphinee S, Williams JI, Maki, B. (1992). Measuring balance in the elderly: Validation of an instrument. Can. J. Pub . Health, July/August supplement 2:S7-11. Bird, M. L., Pittaway, J. K., Cuisick, I., Rattray, M., & Ahuja, D. K. (2013). Age-related changes in physical fall risk factors: Results from a 3 year follow-up community dwelling older adults in Tasmania, Australia. International Journal of Environmental Research and Public Health, 10 (11), 5989-5997. References Booshanam, D. S., Cherian, B., Premkumar, C., Joseph, A. R., Mathew, J., & Thomas, R. (2011). Evaluation of posture and pain in persons with benign joint hypermobility syndrome. Rheumatology International, 31 (12), 1561-1565. Borson, S., Scanian, J., Brush, M., & Vitaliano, P. (2000). The Mini-Cog: A cognitive “vital signs” measure for dementia screening in multi-lingual elderly. International Journal of Geriatric Psychiatry, 15 :1021-1027. Briggs R.C., Gossman M.R., Birch R., Drews J.E., Shaddeau S.A. (1989). Balance performance among noninstitutionalized elderly women. Physical Therapy 69 :748-756. Brooke, P., & Bullock, R. (1999). Validation of a 6-item cognitive impairment test with a view to primary care usage. International Journal of Geriatric Psychiatry, 14 , 936-940. Brustio PR. (2017). Age-related decrements in dual-task performance: Comparison of different mobility and cognitive tasks. A cross sectional study. Published online: doi: 10.1371/journal.pone.0181698. Accepted 2017 Jul 4. Cadore, E. L., Rodriguez-Manas, L., Sinclair, A., & Izquierdo, M. (2013). Effects of different exercise interventions on risk of falls, gait ability, and balance in physically fail older adults. A systematic review. Rejuvenation Research, 16 (2), 105-114. Cameron, I. D., Gillespie, L. D., Robertson, M. C., Murray, G. R., Hill, K. D., Cumming, R. G., … & Kerse, N. (2012). Interventions for preventing falls in older people in care facilities and hospitals. Cochrane Database of Systematic Reviews, 12 , CD005465. Canning, S. J. D., Leach, L., Stuss, D., Ngo, L., & Black, S. E. (2001). Diagnostic utility of abbreviated fluency measures in Alzheimer disease and vascular dementia. Neurology, 62 (4), 534-535. Carpenter, C., Avidan, M. S., Wildes, T., Stark, S., Fowler, S. A., & Lo, A. X. (2014). Predicting geriatric falls following an episode of emergency department care: A systematic review. Academy of Emergency Medicine, 21 (10), 1069-1082. CDC/STEADI: Centers for Disease Control and Prevention, National Center for Injury Preventions and Control, Division of Unintentional Injury Prevention (2017). STEADI (Stopping Elderly Accidents, Deaths, and Injuries) tool kit for health care providers . Retrieved from https://www.cdc.gov/steadi/index.html ; page last updated on March 23, 2017. Centers for Disease Control and Prevention. Medicare Learning Network. Medicare Learning Manuals. Certifying Patients for Medicare Home Health Benefit (CDC/CMS, 2018). Retrieved from https://www.cms.gov/ Outreach-and-Education/Outreach/NPC/Downloads/2014-12-16-HHBenefit-HL.pdf; accessed July 12, 2018. Centers for Disease Control and Prevention, Morbidity and Mortality Weekly Report (2016); Falls are the leading cause of injury and death in older Americans. Embargoed until September 22, 2016. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web-based Injury Statistics Query and Reporting System (WISQARS). Retrieved from https://www.cdc.gov/injury/wisqars/ index.html; accessed July 12, 2018. Clemson, L., Cumming, R. G., Kendig, H., Swann, M., Heard, R., & Taylor, K. (2004). The effectiveness of a community-based program for reducing the incidence of falls in the elderly: A randomized trial. Journal of the American Geriatrics Society, 52 (9), 1487-1494.
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