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Why way to fall?
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Why way to fall? - January 9, 2003 4:16:00 AM
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PTupdate.com
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Joined: October 8, 2001
From: Pittsburgh, PA USA
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We all know that hip fractures in elderly persons result in high mortality rates, and for those who survive, some severe obstacles to overcome.
We should all be reminding our elderly patients to remove throw rugs, wear good shoes, address any eye problems, have adequate lighting, understand side effects of their medications, and even exercise to maximize strength and balance. Some even suggest the use of padded pants to reduce shock to the hip.
Since it appears that lateral falls cause more fractures than forward and backward falls, should we also recommend people try to fall in those directions, when possible? Do we tell them that a Colle's fracture or patellar fracture isn't great, but is a lesser evil?
John Duffy, PT OCS [URL=http://www.PTupdate.com]www.PTupdate.com[/URL]
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Re: Why way to fall? - January 9, 2003 4:17:00 AM
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PTupdate.com
Posts: 1474
Joined: October 8, 2001
From: Pittsburgh, PA USA
Status: offline
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Well, it was supposed to be titled "Which Way to Fall?", but I got distracted and typed the wrong word!
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Re: Why way to fall? - January 31, 2003 7:02:00 PM
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flexion
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I think telling a patient which way to fall is opening yourself up for liability. An elderly person may misinterpret and fall down some stairs thinking that is better than falling sideways on the stairs.
I like the idea of trying to prevent the fall. A simple solution to me would be encouraging earlier use of a walker. I think often the walker comes after a few falls have already happened.
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Re: Why way to fall? - February 1, 2003 4:11:00 AM
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PTupdate.com
Posts: 1474
Joined: October 8, 2001
From: Pittsburgh, PA USA
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Flexion,
Do you really think teaching a person which way to fall would open us up to liability? There have been recent articles in the journals suggesting methods to fall when skiing to avoid either skiiers thumb or ACL disruption. We now teach female athletes how to land from a jump to reduce the liklihood of an ACL tear, and we even train QB's how to fall when sacked. In fact, in school we are all taught how to teach a person on crutches, especially Loftstrand crutches and/or amputees how to fall before they are discharged.
Sure, it would be nice for someone to perform a study on elderly persons, trying to see if those taught a perceived "safer" fall had lower hip fractures than those who fall without instruction.
John Duffy, PT OCS [URL=http://www.PTupdate.com]www.PTupdate.com[/URL]
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Re: Why way to fall? - February 1, 2003 7:26:00 AM
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flexion
Posts: 151
Joined: August 7, 2002
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Yes most definitely I think teaching falling to an elderly population group is a liability. The liability I see is with an elderly patients mental capacity and reaction time.
Those studies you mention are useful; but, we are talking about an elderly population in this thread. I'm more for spending time on prevention of the fall.
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