Citation

Avin KG, Hanke TA, Kirk-Sanchez N, McDonough CM, Shubert TE, Hardage J, Hartley G. Phys. Ther. 2015; 95(6): 815-834.

Affiliation

G. Hartley, PT, DPT, GCS, CEEAA, Department of Rehabilitation, St. Catherine's Rehabilitation Hospital, North Miami, Florida, and Department of Physical Therapy, University of Miami Miller School of Medicine, Coral Gables, Florida.

Copyright

(Copyright © 2015, American Physical Therapy Association)

DOI

10.2522/ptj.20140415

PMID

25573760

Abstract

BACKGROUND: Falls in older adults are a major public health concern due to high prevalence, impact on health outcomes and quality of life, and treatment costs. Physical therapists (PTs) can play a major role in reducing fall risk for older adults; however, existing clinical practice guidelines (CPGs) related to fall prevention and management are not targeted to PTs.

OBJECTIVE: The purpose of this clinical guidance statement (CGS) is to provide recommendations to PTs to help improve outcomes in the identification and management of fall risk in community-dwelling older adults. DESIGN AND METHODS: The Subcommittee on Evidence-based Documents (EBDs) of the Practice Committee of the Academy of Geriatric Physical Therapy developed this CGS. Existing CPGs were identified by systematic search and critically appraised using the Appraisal of Guidelines, Research, and Evaluation in Europe II (AGREE II) tool. Through this process, 3 CPGs were recommended for inclusion in the CGS and were synthesized and summarized.

RESULTS: Screening recommendations include asking all older adults in contact with a health care provider whether they have fallen in the past year or have concerns about balance or walking. Follow-up should include screening for balance and mobility impairments. Older adults who screen positive should have a targeted multifactorial assessment and targeted intervention. The components of this assessment and intervention are reviewed in this CGS, and barriers and issues related to implementation are discussed. LIMITATIONS: A gap analysis supports the need for the development of a PT-specific CPG to provide more precise recommendations for screening and assessment measures, exercise parameters, and delivery models.

CONCLUSION: This CGS provides recommendations to assist PTs in the identification and management of fall risk in older community-dwelling adults.

Language: en