Possibilities of stability evaluation in clinical practice in patients at risk of falls Falls are a serious global public
Authors:
I. Fiedorová 1,2; E. Mrázková 1
Authors‘ workplace:
Ostravská univerzita, Lékařská fakulta, Ústav epidemiologie a ochrany veřejného zdraví, Přednosta: doc. MUDr. Rastislav Maďar PhD., MBA, FRCPS
1; Fakultní nemocnice Ostrava, Klinika léčebné rehabilitace, Přednostka: MUDr. Irina Chmelová, PhD., MBA
2
Published in:
Prakt. Lék. 2020; 100(5): 225-232
Category:
Of different specialties
Overview
Falls are a serious global public health problem with significant socio-economic implications. Stability disorders resulting from disease or aging lead to an increased risk of falls. Risk factors increasing the incidence of falls include age over 65 and chronic illness. Fall monitoring, evidence, diagnosis, prevention and intervention should always be part of a comprehensive preventive and therapeutic approach, not only in hospitals but also in community facilities and other public places. A considerable lack of screening and standardization procedures can still be observed with most general practitioners. Accurate objectification of the risk of falling will make it possible to promptly start with preventive measures, monitoring the development of stability disorders over time, establishing the prognosis, evaluating intervention efficiency both in individuals and in groups, also for recording purposes. This article comes with an overview of the options available for stability evaluation in patients at risk of falling in clinical practice. Given the multi-factorial causes of stability disorders, it is a problem to find one single way to address all aspects of postural control and thus evaluate to what extent exactly the patient is threatened by falling. For this reason, it is optimal to use a combination of instrumental examination (posturography – a somato-sensory organization test), clinical testing (BEST test, Berg’s Balance Scale) and also a subjective stability assessment questionnaire regarding daily life activities (Falls Efficacy Scale International). Testing and examining stability is the responsibility of physicians, physiotherapists and occupational therapists; other related assessment can only detect the presence of risk factors associated with patient falls. Particular attention should be paid to the phenomenon of “fear of falls”, an often overlooked yet significant risk factor, especially in seniors
Keywords:
fall prediction – stability evaluation – fall risk factors – functional stability tests – posturography – fear of falls
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