Fall Testing for the Community Dwelling Older Adult
The incidence of falls among community dwelling older adults is on the rise according to a recent study out of the University of Michigan. The study, which was printed in the Journal of the American Medical Association for Internal Medicine, describes an analysis of data from 1998-2010 which revealed a 12% increase in falls for adults 65 years of age and older during this 12 year time period. This is concerning considering the injury rates that are associated with falls for this demographic. The Centers for Disease Control (CDC) reports that 20 to 30% of those who fall will suffer moderate to severe injuries which includes lacerations, fractures, and traumatic brain injury. As a result, the total direct medical costs from these injuries is expected to exceed 50 billion dollars by the year 2020.
In an attempt to reduce the risk for falls and subsequently stem the rising medical costs associated with treating the resulting injuries, physical therapists and physicians alike should be employing screening mechanisms to identify those who are at greatest risk. In addition to a thorough subjective consultation, a functional exam can be performed to determine who is in danger of falling. At Physical Soutions, 3 tests that we commonly employ to accomplish this task are the 30 second chair stand test, the Timed up and Go Test, and the 4 stage balance test.
The 30 second chair stand test is a timed exam which determines how many times a person can transfer from sit to stand in a 30 second time period. This test is usually administered to gauge a patient’s lower extremity strength and is applicable with the community dwelling older adult considering lower extremity strength is highly correlated with fall risk.
The timed up and go test is used to determine a person’s ability to rise from a seated position and walk a total distance of 20 feet, followed by returning to the seated position. It is a timed exam with scores greater than 12 seconds indicating those who are at greatest risk for falls. Walking speed has been closely linked with fall risk in the older adult making this test ideal for the population at hand.
The 4 stage balance test is an exam which challenges static standing balance in four separate positions each with different foot placement. Balance is one of the most recognizable factors resulting in falls among those 65 years of age and older making this test a great screening mechanism for discovering who has a problem.
To view a demonstration of the above mentioned clinical tests, click on the video presented above. If you have a history of falls or believe you are at risk, contact Physical Solutions, to set up a free falls screening at one of our two locations.