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Evidence based geriatric physical therapy Ahmad Osailan.

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Presentation on theme: "Evidence based geriatric physical therapy Ahmad Osailan."— Presentation transcript:

1 Evidence based geriatric physical therapy Ahmad Osailan

2 Falls One of the most common incidents and cause for hospital admission for elderly. Even considered one of the leading causes for sudden death. What are the risk factors for falls? - balance impairments - strength impairments - difficulty in walking

3 History of fall prevention Most common interventions: Moderate to high intensity Balance exercise training Exercise + multifactorial interventions. Q: What is the minimum dose of exercise to prevent falls? A: 50 Hrs of exercise


5 Incidence of falls Falls are the leading cause of traumatic brain injury and fractures in older adults. For individuals aged 65 and older, falls outpace motor vehicle accidents as the leading cause of unintentional death by several thousands Falls are the leading cause of emergency department visits by older adults, and the number one cause of hospital admissions due to trauma

6 Some Definitions




10 Falls prevention According to Shubert 2011, it is recommended by the American geriatric society to do screening for falls for those Aged 65 and above. Effective fall prevention intervention should focus on the contributing risk factor. Doing a triage to find the impairments that can lead to fall.

11 Example


13 Screening for falls American geriatric association recommended screening for balance and immobility. The screen consist of: 1- Hx of fall in the past year ( how many times) 2- any difficutly in walking or in balance (y/n) 3- observe walking performance and balance changes by doing tests (Time up and go test, berg balance test) If one of these is positive, he/she should be referred for a comprehensive multifactorial assessment

14 Falls screening


16 There are many balance and mobility assessment tests, but most of theses tests do not take into account the medical risk factor.

17 Examples for studies

18 What do we learn from this study

19 All risk factors must be assessed and triaged properly. Physical therapist must use clinical judgement to determine which risk factor should be assessed first.

20 Exercise dose

21 Mode of exercise

22 Static activities

23 Dynamic Activities

24 Dual task training

25 Strength training

26 walking

27 conclusion

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