What can be done to prevent falls?
First, patients who are concerned that they are at risk should be screened by a physician with expertise in fall prevention.  When indicated, individuals should undergo evaluation by special balance testing equipment.  The physician’s evaluation as well as balance testing may reveal abnormalities that can be remedied through physical therapy.  Lastly, every effort should be made to eliminate any environmental factors that might make an individual prone to falling.  A systematic discussion and investigation of all of the above potential factors will often uncover several key causes of instability that can then be remedied.

What can be expected from a physician’s evaluation?
The physician will carefully review the patient’s medical history, including all medications.  A detailed neurological and orthopedic examination will be performed to determine whether there is any weakness, sensory loss, uncoordination, asymmetry, or lack of flexibility.  The physician will also determine whether there are any environmental risk factors.  If indicated, the physician will refer the patient for balance testing and/or physical therapy. 

What will balance testing determine?
There is sophisticated equipment that will challenge the patient’s coordination, strength, and vestibular (inner ear) system.  Objective data will be gathered that will help determine precisely what deficits must be addressed. 

What is the role of physical therapy?
Most importantly, the physical therapist will educate the patient in self care strategies that will allow him to reduce the chance of falling.  Although one is at greater risk of falling as one gets older, there is clear evidence that the risk of falling is significantly reduced through education.  The physical therapist will guide the patient in exercises that will improve strength, flexibility, balance, and coordination.  The physical therapist will also carefully determine whether the patient is using the best possible ambulatory aids and footwear.  Lastly, the physical therapist will educate the patient in how to improve his environment so that the chance of falling is minimized. 

What can be done for those patients that remain at risk for falling?
Individuals who live alone can often be taught how to get up if they fall.  Individuals can also be provided with a personal emergency response system, and be educated in its use.  Osteoporosis (low bone density) should be aggressively treated when present.  People at high risk for falling should be provided with hip protectors which have been shown to reduce the risk of hip fractures in the event of a fall.  Although one hundred percent success is never possible, the combination of all of the above interventions can dramatically reduce imbalance and falls.