The American Geriatrics Society and British Geriatric Society, have released the first updated guidelines on fall prevention for seniors since 2001. It is now being suggested that all interventions for fall prevention should include an exercise element and several new evaluations should be used which include feet and footwear, fear of falling and ability to perform daily life activities. The guideline also note that fall screening and prevention should be a part of all healthcare practices for seniors.
The guidelines were assembled by a panel consisting of members from past panels and new members with significant knowledge, experience and publications in fall prevention along with care of the elderly. The guidelines are also based on a complete review of randomized control trails of fall prevention interventions.
Dr. Mary Tinetti, Yale University School of Medicine, states falls are the most usual health issues endured by seniors and a common cause of losing functional independence. Due to their frequency and outcomes, falls are a serious health issue for seniors just as heart attacks and strokes.
The Guidelines now state health practitioners and other professionals should conclude if their older patients are at risk for falls, inquire if they have fallen recently or unsteady when walking. If yes, then the practitioner should check for the existence of known problems like muscle weakness, poor balance and blood pressure that suddenly declines when standing. If they have the problems then interventions should be provided as described within the guidelines. If there is no proof of walking or falling problems than a risk evaluation does not need to be completed.
The new intervention recommendations concentrate on:
A variety of interventions that include exercise for balance, walking and strength training like Tai Chi.
Environmental adjustments to decrease fall risk elements in the home and in daily activities.
Reducing medications, regardless of number prescribed. Especially, those medications which affect the brain like sleeping medications and antidepressants.
Attention on elevating low blood pressure and managing heart rate and rhythm abnormalities.
Deriving evidence that the rate of serious fall injuries like hip fractures, is lowering moderately in areas where fall prevention is part of clinical practice.
Besides Tai Chi for fall prevention in seniors chiropractic care has been noted also as playing an essential secondary role in senior fall preventions.
Chiropractors have an essential role in fall prevention. Not only do they show outstanding performance on many interventions noted by the Cochrane Review and WHO initiatives, there are experts who do advocate that chiropractic care especially spinal manipulative therapy (SMT) could contribute to the reduction of fall risk among seniors
Most recently Hawk(1) reported findings of a clinical pilot study which examined the effects of chiropractic care on 34 seniors who had dizziness, balance problems and back pain. The outcomes revealed that patients who had received SMT has shown greater improvement in comparison to the control group. No negative reactions had been reported
It was concluded that it is vital to identify and correct vertebral joint dysfunction as within the chiropractic profession due to the fact vertebral subluxations, among those seniors who fall because joint dysfunctions if left untreated could end up in muscle spasm around cervical joints resulting in a decrease in large joint mechanoreceptor firing as well as increased nociceptor firing,” resulting in a greater risk for falls.
Chiropractic in total can play a secondary part of fall prevention due to an excess of clinical trials, investigation studies and case reports along with practitioner experience, have documented that manual therapies such as spinal adjustments and soft trigger therapy can adequately manage a variety of conditions or some of the outcomes from the conditions in relationship of spinal pain and dysfunction which affect senior patients that most of the times are on medications.
A chronicle review recently of chiropractic senior literature(2) along with a chapter out of a text book on spinal adjustments for older patients(3) advocates that conditions with linked symptoms could be alleviated by chiropractic manual treatments, those conditions include asthma, back pain, fibromyalgia, depression, osteoarthritis, pneumonia, lumbar stenosis and multiple sclerosis.
Hawk C, Cambon JA, Pfefer MT. Pilot study of the effect of a limited and extended course of chiropractic care on balance, chronic pain, and dizziness in older adults. J Manipulative Physiol Ther 2009;32:438-447.
Gleberzon BJ. A narrative review of the published literature regarding older patients from 2001-2010. J Can Chiropr Assoc (in press).
Gleberzon BJ, Byfield D, Barber M. Spinal adjusting for older patients. In: Technique Skills in Chiropractic. Byfield D (ed). Oxford, UK: Elsevier. (in press)
Medical News Today