05 Jun Home Based Physical Therapy Can Help Prevent Falls in the Elderly
MedicalResearch.com Interview with:
Teresa Liu-Ambrose, PT, PhD
Canada Research Chair (Tier II), Physical Activity, Mobility, and Cognitive Neuroscience
Director, Aging, Mobility, and Cognitive Neuroscience Laboratory
University of British Columbia
MedicalResearch.com: What is the background for this study?
Response: Falls in older adults are the third-leading cause of chronic disability and the leading cause of hospitalization for adults over age 65. Older adults who experience multiple falls are at increased risk for disability, loss of independence, and even death. How to best prevent falls in this high risk group is not well established.
MedicalResearch.com: What are the main findings?
Response: We found that a home-based exercise program delivered by physical therapists significantly reduced the rate of falls in high-risk older adults by 36%. What do we mean by high-risk? These were older adults who sought medical attention because they experienced a fall. Not all falls result in medical attention and when it does, it usually indicates the fall was quite serious (resulted in injury) and/or the individual is more frail. On average, those who were in the study had mild cognitive deficits, were falling repeated, and had impaired mobility. Consequently, they are at risk for losing their functional independence (i.e., the ability to live in their own homes) and another fall may be the impetus for that loss.
MedicalResearch.com: What should readers take away from your report?
Response: Falls are not accidents and are preventable. For older adults who have experienced multiple falls or a fall that results in medical attention, they are a high risk for adverse outcomes, including death. A simple home based exercise program of strength and balancing retraining exercise delivered by a physical therapist prevents falls in high risk older adults. Preventing falls in these individuals is critical in maintaining their independence and quality of life.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: Future research should determine whether we can also prevent fall-related fractures with exercise in this high-risk population. 90% of hip fractures are due to falls. Our next step is to look at whether the exercise program resulted in reduced healthcare utilization and medical cost savings in this high-risk population.
MedicalResearch.com: Is there anything else you would like to add?
Response: Exercise is a very practical intervention. The resources required to deliver the home-based exercise program in our study included 1 set of free weights and 4 hours with a physical therapist over 12 months.
Liu-Ambrose T, Davis JC, Best JR, et al. Effect of a Home-Based Exercise Program on Subsequent Falls Among Community-Dwelling High-Risk Older Adults After a Fall: A Randomized Clinical Trial. JAMA.2019;321(21):2092–2100. doi:10.1001/jama.2019.5795
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