How to bounce back after a fall

Every time you take a tumble, realize it's just a chance to bounce back.

A fall happens when someone comes to rest inadvertently on the ground or floor or other lower level. Falling over is something that happens at all stages of life, but when you hit a certain age the language of falling over shifts to “had a fall”. Falling affects people differently across the lifespan, especially older adults who are at higher risk of more significant injuries.

Children often bounce back after falls, but as we get older the consequences of falls can be much more serious.

Why do falls matter:

-          238,005 hospitalisations due to falls in AUS in 2022-2023.

-          43.4% of all injury hospitalisations in AUS in 2022-2023.

-          6,378 deaths in 2022-2023.

-          Most common body parts injured were

o   Head and neck (28.1%)

o   Hip and femur (26.2%)

o   Shoulder and upper arm (22.7%)

-          Females have higher rates of falls hospitalisations (772.4 per 100,000), but males have higher rates of deaths caused by falls (14.8 deaths per 100,000)

-          Females were more likely to fall on stairs or steps, from a bed, or from a chair, while males were more likely to fall from a building, a tree, a ladder, or using objects such as roller skates or scooters.

-          Australians aged 65 and over were almost 12 times more likely to be injured in a fall than adults aged 25-44

Common causes of falls:

-          Medical conditions

o   e.g. Parkinsons disease, peripheral neuropathy, postural hypotension

-          Medication side effects

o   Drowsiness, vision changes, dizziness, confusion, blood pressure changes etc.

-          Taking more than 10 different medications

o   Due to the interactions between different medications, and the combined effect these medications may have on cognition drowsiness, or vision etc.

-          Foot problems, including poor footwear.

-          Reduced muscle strength

o   A natural change from aging (though this can be slowed!)

-          Slowed reaction time

o   A natural change from aging (though this can be slowed!)

-          Poor vision

-          Incontinence

o   Due to a rush to get to the toilet and associated weakness of the leg and trunk muscles.

-          Environmental causes

o   Rugs, walkers out of reach, loose floorboards, cables, clutter, and even pets!

What tools are there predict falls risk?

5 x Sit to Stand: this is a test used to assess lower limb strength, speed, balance, and coordination. This test has been used in a variety of population groups (seniors, Parkinson’s disease, stroke etc.) and can be help predict how likely a person is to fall within 12 months. For example, a healthy adult aged 70-79 years should achieve between 6.9s and 13.1s, with a score above 15s indicating an increased risk of falling.

FRAT (Falls risk assessment tool): A 3-part tool that comprises of a falls risk status, a risk factor checklist, and an action plan, developed by Peninsula Health Victoria. This tool is typically administered by a medical practitioner such as a GP or nurse, though some sections can be done without their input. Cognitive status (Part 1, section 4) involves the Abbreviated Mental Test Score, used to assess for delirium or dementia risk, with low scores indicating a need for further cognitive assessment.

These are just two tools out of the hundreds available, if you want to know more feel free to ask your Physiotherapist, Exercise physiologist, or GP.

Can you change your falls risk?

YES!

Falls risk can be reduced by addressing contributing factors to falls. Some can be changed, and some cannot. For example, you can’t change your age, but you can change your vision by using glasses. Speaking to your Physiotherapist or GP about reducing your risk is a helpful way to pinpoint areas to work on.

Increasing your physical activity is a great way to reduce your risk of falling. Activities such as tai chi, yoga, Pilates, hydrotherapy (or aqua aerobics), or general strength and conditioning all have been demonstrated to improve strength, balance, reaction times, and even help with cognition and memory through social engagement. Here at Lilydale Physiotherapy and Sports Medicine we run a Falls and Balance class twice weekly under a physiotherapist, or Eastern Health run a 10 week Falls clinic which involves a variety of healthcare disciplines to help get to the root cause of your falling (See link in references for more information). At the end of the day, the best exercise is the one you will consistently do so pick something you enjoy doing!

According to the World Health Organisation, all adults should be aiming to get 150-300 minutes of low to moderate exercise, or 75-150 minutes of moderate to vigorous exercise, AND 1-2 sessions of resistance training per week. This should be a lifelong goal to keep you healthy and active throughout your lifespan.

Help, I’ve fallen! How do I get off the floor?

Here is our handy flow chart of how to safely get off the floor without the assistance of another person. This is difficult and requires a lot of strength, so some people will need assistance either from a bystander or from ambulance staff. This should only be attempted if there are no obvious injuries such as fractures or head wounds.

Version 1: No Equipment

 

Version 2: Using a chair

Michael Kenihan