Falls Risk Assessment
Falls are one of the most serious problems associated with aging and the statistics are quite shocking. The information below has been taken from NSW Health:
Falls among older people at a glance
- Falls are a major cause of harm to older people and fall-related injuries impose a substantial burden on the health care and aged care systems.
- No other single injury cause, including road trauma, costs the health system more than injuries resulting from falls. In 2006/07 the total cost of health care associated with fall injuries in older people was estimated at $558.5 million.
- The burden from fall related harm among older people is expected to grow as our population ages. It is projected that by 2056, between 23 and 25 per cent of the Australian population will be 65 years or older.
Falls are common among older people
- In 2009, 25.6 % of older people fell at least once in the preceding 12 months.
- Among those who fell, 66.1% indicated they were injured as a result of their fall and 20% had to visit a hospital as a result of their fall.
- The majority of falls among older people happen in and around their homes. In 2009, among older people who had fallen in the previous 12 months, over 65% indicated that they had most recently fallen in their home or yard.
Among the most common reasons for falls are decreased efficiency of the systems that send the information to the brain, namely 1. vision, 2. inner ear (vestibular system) and 3. proprioception (musculoskeletal feedback). Proprioception is a term that describes our physical contact with the world, such as our feet on the floor, our hands on the steering wheel, etc.
However, the good news is research indicates many falls can be prevented and the risk of injury reduced.
How will my falls risk be tested?
We will obtain a necessary medical history from you, check your visual clarity and perform a simple hearing test. We will do a physical evaluation that may include checking your reflexes, sensation, muscle strength and tone, coordination, gait and stance.
Then we will do a series of simple, non-invasive balance tests, using the sensitive CAPS™ force platform and additional special software. We will also look for signs of nystagmus, a rapid, jerky movement of the eyes that often indicated the presence of a balance disorder.
The Ashgrove Spinal Centre’s chiropractor, Dr Robert Bailey, uses the ScreenTRACK(tm) CAPS Balance Protocol allowing him to assess your ability to maintain your balance, and conversely, your risk of falling. This screening protocol measures your sway by means of a computerized posturography test conducted on a perturbed surface with eyes closed. The objective of the test is to assess your ability to maintain balance in a wide variety of combinations of head, body, arm and leg positions, with or without disturbance of stability.
At the end of the test several results are presented in both a graphical and numerical format. In particular: the Stability Score, the Stability Level and the Center of Pressure Trace.
The Stability Level gives a statistical indication of your risk of falling. If the Stability Level is normal, you have a risk of falling considered normal for your age and sex. If it is mildly reduced, it is often because of a transient problem such as lack of sleep, to much caffeine flu or allergies. These can be easily be ascertained in your initial health questionnaire and health assessment. If it is moderately, severely or profoundly reduced, or if you are not able to complete the test because of either losing balance or opening the eyes, the chances of a false positive are very unlikely. In such event, it is possible you may have a serious balance problem, and further investigation is strongly suggested unless the cause of the balance problem has already been determined.
After all these steps have been performed, Dr Bailey will review the results to determine if you are a falls risk and if so, why. Does your problem originate in your vestibular system, central nervous system or somewhere else in your body?
Then once serious medical conditions are ruled out, it is important to manage your condition in a conservative way. If Dr Bailey concludes your problem would benefit from the type of specialised treatment he is trained to provide, those treatments will be discussed with you and a treatment plan will be agreed upon.
Dr Bailey is a fully qualified and registered health professional who is highly trained to diagnose and/or treat conditions of the neuromuscular skeletal system. Dr Bailey works with many other medical professionals and will always refer to your GP or other Medical Specialist if your condition is not one that is suitable to be treated with chiropractic care or if your condition requires further evaluation and/or more testing.
Fall prevention treatment and how long will it take?
Depending on the cause of your balance disorder, treatments may vary. Some of the common treatments we provide usually involve only some simple but very specialised manipulations and/or exercises.
You may be given balance therapy (also called vestibular rehabilitation). This includes training exercises used to help strengthen balance skills and coordination. Exercises might involve bending down, standing or walking with eyes open and then with eyes closed, swimming, or walking barefoot on various uneven surfaces.
During the course of your treatment, you will be tested with the CAPS™ several times. This way, the results of your treatment will be immediately measured and documented. Some patients CAPS™ scores are higher after having only one treatment. Others require multiple treatments and multiple CAPS™ testing before they achieve optimum results.
Most of our balance patients experience an immediate improvement in their balance following treatment. In fact, many experience a dramatic improvement.
In a small percentage of cases, a treatment may actually make your balance temporarily worse, but when that happens we will know it immediately because your CAPS™ score will instantly reflect a change. We will then “reverse direction,” modify the treatment and test you again.
However, as mentioned before, after treatment most of our patients experience great improvements not only in their balance, but more importantly in their overall quality of life!Book An Appointment