Frequent Falls

Case Description: Pt. is a 78 y/o female who presented to physical therapy with a ~6 mo history of falls (5 occurred in the month leading up to her starting PT).  Over this period of time, she had lost her husband and was attempting to care for her home/yard and she was working part-time on her family’s flower farm.  She was feeling overwhelmed with her progressive physical decline and frustrated by her falls. Most of her falls were occurring while trying to bend over to pick-up household or farm items.  Once on the ground, she had been unable to get up and would have to call family members to come give her assistance. Fortunately, she had avoided any major injuries. 

Objective Measures: She was seen for 10 physical therapy visits over a 2.5 month period.

Tests and Measures	Initial Evaluation	Day of Discharge from Physical Therapy
Lower Extremity Functional Scale	69% impairment	10% impairment
Berg Balance Test	44/56 (high fall risk without use of assistive device)	53/56 (low risk for falls, even without use of assistive device
30 Second Rise Test	5 repetitions, highly labored	10 repetitions with relative ease
Hip Girdle Strength (MMT)	Grossly 4/5 throughout	At least 4+/5 all planes

Impact on Her Life: At the conclusion of her care, she had not had a fall in 2+ months and was able to transfer from ground to stand independently.  She was engaging in more home/farm tasks and feeling more confident in her situation.  She was very pleased with her ability to be more physically active and feeling encouraged about her future! 

Summary:  Physical therapy should be a first line intervention to address balance related issues limitng physical function.  It is a non-invasive means to improving overall function and health related quality of life.  Please consider PT referral for individuals experiencing balance difficulties or with history of recent falls.  Thank you!

Sincerely,

Luke Vander Zouwen, DPT
Full Potential Physical Therapy