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24 Cards in this Set
- Front
- Back
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PC term for a fall
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GRE = gravity related event
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A gait assessment tool
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timed Get up and Go test
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What is Get up and go test step by step
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Rise from a hard-backed chair with arms
Walk 10 feet (3 meters) Turn Return to the chair Sit down |
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What do the results of Get up and go test mean?
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Most adults can complete in 10 sec
Most frail elderly adults can complete in 11 to 20 sec ≥14 sec = increased falls risk >20 sec --> comprehensive evaluation Results are strongly associated with functional independence in ADLs |
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top causes of institutionalization
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1. urinary incontinence
2. Falls (slipping in urine) |
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Name some LOW SENSORIMOTOR LEVEL GAIT DISORDERS (Peripheral sensory)
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Sensory ataxia (unsteady, uncoordinated)
Vestibular ataxia (unsteady, weaving) Visual ataxia (tentative, uncertain) |
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Name some LOW SENSORIMOTOR LEVEL GAIT DISORDERS (Peripheral motor)
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Arthritic (antalgic, joint deformity)
Myopathic and neuropathic (weakness) |
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Name some MIDDLE SENSORIMOTOR LEVEL GAIT DISORDERS (Spasticity)
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Hemiplegia, emiparesis (leg swings out)
Parraplegia, paraparesis (bilateral circumduction) |
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Name some MIDDLE SENSORIMOTOR LEVEL GAIT DISORDERS (Parkinsonism )
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small shuffling steps, hesitation, festination, propulsion, retropulsion, turning en block, absent arm swing
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Name some MIDDLE SENSORIMOTOR LEVEL GAIT DISORDERS (Cerebellar ataxia)
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wide-based gait with increased trunk sway, irregular stepping
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Name some HIGH SENSORIMOTOR LEVEL GAIT DISORDERS (Cautious gait )
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fear of falling, with appropriate postural responses
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Name some HIGH SENSORIMOTOR LEVEL GAIT DISORDERS (Frontal-related gait disorders)
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spectrum, from gait ignition failure to frontal gait disorder to frontal disequilibrium
-Cerebrovascular -Normal-pressure hydrocephalus |
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Are most falls related to syncope?
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no
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the leading cause of death from injury in persons aged ≥65
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Complications of falls
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Annual incidence of falls is close to __% among those with history of falls
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Annual incidence of falls is close to 60% among those with history of falls
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Mortality highest in white men aged ≥__: 180 deaths/100,000 population
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Mortality highest in white men aged ≥85: 180 deaths/100,000 population
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Half of those who fall are unable to get up without help (“____ ___”)
A “____ ___” predicts lasting functional decline |
Half of those who fall are unable to get up without help (“long lie”)
A “long lie” predicts lasting functional decline |
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CAUSES OF FALLS BY OLDER ADULTS:
Complex interaction of what 3 factors |
Intrinsic factors (eg, chronic disease)
Challenges to postural control (eg, changing position) Mediating factors (eg, risk taking) |
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Intrinsic factors causing falls
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Age-related decline
-Changes in visual function -Proprioceptive system, vestibular system Chronic disease -Parkinson’s disease -Osteoarthritis -Cognitive impairment Acute illness Medication use (see next slide) |
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Total number of prescriptions that is associated with 25% increase in falls among the elderly
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4
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Avg number of prescriptions among elderly
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8
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If recurrent falls, SPLAT
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S - recurrent symptoms
P - position before fall L - location (mall, home, etc) A - activity during fall T - timing |
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Most falls in nursing home occur at _pm. (change of nurse shift - pts know that they can get out and do things are normally restricted by nurses.)
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Most falls in nursing home occur at 4pm. (change of nurse shift - pts know that they can get out and do things are normally restricted by nurses.)
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prevention of falls
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Most favorable results with health screening followed by targeted interventions
Aim to reduce intrinsic and environmental risk factors Interdisciplinary approach to falls prevention is most efficacious |
