Here at The Feet People, we’re one of the only clinics that have a key focus on falls prevention and falls treatment, regularly
refining our management processes to stay in line with new research and proven strategies. We do this because “having a fall”
has become synonymous with something that’s simply “normal” and almost expected in older adults - without regard
to the dire and life changing consequences of having a fall on that person - or the fact that over one third of falls are preventable.
Falls remain Australia’s leading cause of injury deaths, with a falls-related death occurring approximately every
2 hours.
That’s more deaths from falls than from car accidents and transport-related fatalities every day. Moreover, evidence shows that when
working with a podiatrist, a person’s falls risk can be reduced by a massive 36%.
What Is Our Proven Falls Prevention Treatment?
There are two parts to our proven falls prevention strategy: your comprehensive falls prevention assessment, and then your carefully and
thoughtfully prescribed treatment and management plan.
Falls prevention assessment
Your falls prevention assessment involves a series of specialised tests performed by our podiatrist to gain a clear picture of your falls
risk - and what we can do to manage your risk factors to reduce your likelihood of having a fall. This includes investigations such as range
of motion testing, muscle testing, balance testing, gait analysis and more. You can learn more about our falls
prevention assessments here.
Treatment and management plan
Our treatment and management plan includes both treatments that we can start implementing immediately to best support you and reduce your
risk of falls, as well as a long-term management plan to help keep you best supported over the years to come, especially when many things
can change year-to-year to affect your falls risk and the care you require.
How Does Our Proven Falls Prevention Treatment Work?
Your falls prevention treatment and management program is created based on your unique needs, your falls history, and importantly the
results of your comprehensive falls assessment with us. There are several potential aspects to your treatment, which may include:
-
Custom foot orthotics:
the entirely customisable nature of our foot orthotics means that they have the power to support you in a range of ways to to achieve
your falls prevention goals. For example, they can best support the feet and adjust the way each foot moves through the gait cycle,
which changes how muscles are activated and the feet are loaded with every step. They can promote balance and stability by essentially
doubling the proprioceptive feedback to the brain which improves balance. They can also accommodate a wide range of foot shapes,
structures and deformities including painful protrusions, corns, calluses, prominent joints and much more, with the goal of making each
step less painful and more supported. Behind every pair of orthotics is the years of knowledge and experience from our podiatry team,
who design your orthotics to typically carry out several of these functions to meet your unique needs. In order to get your orthotics,
you’ll have a thorough assessment paired with a 3D foot scan. The use of orthotic insoles has been shown to improve postural
stability in studies of older adults.
-
Ankle Foot Orthoses (AFOs) or
Carbon Fibre AFOs (CFOs):
AFOs and CFOs offer similar benefits to custom foot orthotics, being custom-made, prescribed and designed in every aspect, with the key
difference being that they also encompass, support and control the ankle. AFOs and CFOs can play a significant role in falls
prevention, especially for people with neurological or musculoskeletal conditions that affect their balance and gait. They have been
shown to improve balance and reduce the risk of falls in people with conditions such as stroke, multiple sclerosis, Parkinson's
disease, cerebral palsy, and other neurological or orthopaedic disorders. AFOs can also help people with foot drop, a condition where
the front part of the foot cannot be lifted properly, which can cause tripping and falls.
-
Foot and ankle exercise + balance program: strengthening exercises play a crucial role
in falls prevention as they can help to improve muscle strength, balance, proprioception and coordination, which are all important
factors in maintaining stability and preventing falls. As we age, our muscles naturally tend to weaken, which can lead to difficulties
in maintaining balance and stability, increasing the risk of falls. A number of injuries and medical conditions can also greatly affect
our strength and balance, all of which will be evaluated as part of your falls assessment. Regular strengthening exercises, especially
those targeting the lower body, can help to improve strength for the muscles involved in maintaining balance and gait. Your program
will be specific to your needs, but may target the foot muscles, quads, hamstrings, glutes, calves, Achilles and more to best support
your strength, stability, coordination and balance, thereby aiding falls prevention.
-
Footwear modifications or
changes:
the shoes you wear on a daily basis are well cited as a strong contributor to your falls risk. This is as they influence your comfort,
balance and gait by altering the feedback provided to the foot and ankle from the ground while modifying the friction available for
stability. In simple terms, your shoes become the ground you walk on and can either carry you safely throughout your day - or throw you
off and make daily movement and balance much more tiresome. Studies have shown that 72% of older adults may be wearing shoes that do
not fit both feet correctly, which has a notable impact on gait and balance. Your podiatrist will work with you to assess your current
range of footwear both outside and inside of the home, as studies have advised that wearing shoes inside the home can help reduce your
falls risk compared to walking in bare feet, socks or slippers. Our podiatrists have comprehensive knowledge about a wide range of
shoes, including those best suited to older feet that suffer from conditions like bunions, diabetes, claw toes, age-related changes
such as thin fat pads, and more. We can recommend certain brands and styles, like those with the best traction for a variety of
surfaces and conditions, and are one of few clinics in the area that carry out our own shoe modifications so that you may be able to
continue wearing your favourite shoes with some minor adjustments.
-
Treating existing foot problems and pains: Foot
problems in older people are shown to be associated with falls. Specific risk factors include foot pain, stiffness at the ankle, having
a bunion, and reduced toe strength. Additionally, toe deformities and the presence of corns and calluses are common contributors to a
person’s falls risk that we see in our clinic because of the way that they can alter a person’s gait and therefore
stability. Your podiatrist can simply and effectively treat and help you manage these conditions so they’re no longer a prominent
factor in your falls risk.
-
Falls prevention education: if you don’t know about it, you can’t take the
best steps to manage it or remedy it. That’s why education is a key component of your falls prevention management. Numerous
studies have shown that tailored education results in increased engagement in falls prevention strategies. Aside from being able to
educate you on the various aspects of falls prevention both in your home and when you’re out and about, with various appointments
throughout the year, our team also modifies the information to stay relevant to your existing circumstances, living conditions, and in
light of your medical conditions or injuries. We also offer take-home information for falls prevention and can guide you to additional
trusted sources online.
-
Timely referrals: it is well documented that the best approach to falls prevention
involves a multidisciplinary team. During any of your appointments with us, if we detect any changes or concerns that may indicate that
you could benefit from the involvement of a health professional that you are not currently working with, such as an occupational
therapist, we can refer you promptly. This ensures that new needs and changing aspects of your care are not ‘missed’, and
you maintain the best care from a trusted team.
-
Ongoing reviews and support: a falls risk assessment provides a powerful snapshot of
your falls risk at any moment in time. Year on year, this can greatly change. A big part of our ongoing support and care for you
includes reviews and re-assessments to ensure that you’re always getting the best falls prevention support and management
approaches.
Do I Need A Falls Prevention Assessment?
A
ccording
to the Australian and New Zealand Falls Prevention Society (ANZFPS), all adults aged 65 years or over, or 50 years or over for
Aboriginal and Torres Strait Islander people, should be screened for falls risk at least once a year, or following any fall or change in
health status. If you’re below the age of 65 (or 50) and have noticed issues with your gait, balance or coordination, or you have
previously experienced an unexpected fall, we also recommend coming in for an assessment to see how we can help prevent another fall (or
your first) from occurring. Chances are, the methods we use will also greatly improve your comfort and performance in daily life too,
making it beneficial on many levels.
What Are The Risk Factors Of Falls?
Falls risk factors can be both intrinsic (within your body, such as eyesight or muscle strength) or extrinsic (external, such as tripping
hazards around your home). Common risk factors for falls include:
-
Age: your risk of falls increases with age, and older adults are at a higher risk of
falls than younger adults.
-
Balance and gait disorders: conditions such as Parkinson's disease, multiple
sclerosis, stroke, and peripheral neuropathy can affect balance and gait and increase the risk of falls.
-
Muscle weakness: weakness in the muscles, particularly in the legs, can increase the
risk of falls.
-
Medications: certain medications, such as sedatives, tranquilisers, and some types of
antidepressants, can affect balance and coordination and increase the risk of falls.
-
Chronic health conditions: those with osteoporosis have a much higher risk of falls
and resultant fractures. Other conditions such as arthritis, diabetes, and heart disease can also increase the risk of falls.
-
Environmental factors: hazards in the environment, such as uneven or slippery
surfaces, poor lighting, and obstacles in walkways, can increase the risk of falls.
-
Foot problems: such as pain, numbness, and poor footwear, can affect balance and
increase the risk of falls.
-
Vision problems: poor vision, including
cataracts, glaucoma, and other eye conditions, can increase the risk of falls.
-
Cognitive impairment: living with cognitive impairments, including dementia, can
affect judgement and increase the risk of falls.
Falls can result in a range of injuries, from minor bruises and cuts to more serious injuries that require medical attention. Some common
falls-related injuries include:
-
Fractures: falls can cause fractures, particularly in the wrist, hip, and spine.
Fractures can cause pain, swelling, and limited mobility and may require medical treatment, including surgery, casting, or bracing. A
fracture to the femoral neck, the weakest part of the femur, are particularly concerning, with one tenth of patients dying in the first
month following their fracture and a third within the first year following the injury.
-
Head injuries: falls cause more than 60% of head injuries in older adults, leading
them to feel seriously unwell due to the resulting concussions, skull fractures, and brain injuries. Falls are also the leading cause
of traumatic brain injuries, with the greatest incidence in those aged 83 to 90 years. Unfortunately, the rate of falls-related brain
injuries are on the rise.
-
Soft tissue injuries: falls can cause soft tissue injuries, such as sprains, strains,
and contusions. These injuries can cause pain, swelling, and limited mobility and may require rest, ice, compression, and elevation.
-
Dislocations: falls can cause joint dislocations, particularly in the shoulder and hip
joints. Dislocations can cause pain, swelling, and limited mobility and may require medical treatment, including reduction and
immobilisation.
-
Cuts and abrasions: falls can cause cuts and abrasions, particularly to the hands and
face. These injuries can be minor, but may require medical attention to clean and dress the wound.
References
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3116775/
[2] https://pubmed.ncbi.nlm.nih.gov/27909117/
ccording
to the Australian and New Zealand Falls Prevention Society (ANZFPS), all adults aged 65 years or over, or 50 years or over for
Aboriginal and Torres Strait Islander people, should be screened for falls risk at least once a year, or following any fall or change in
health status. If you’re below the age of 65 (or 50) and have noticed issues with your gait, balance or coordination, or you have
previously experienced an unexpected fall, we also recommend coming in for an assessment to see how we can help prevent another fall (or
your first) from occurring. Chances are, the methods we use will also greatly improve your comfort and performance in daily life too,
making it beneficial on many levels.