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Falls and Fall Prevention

Did you know that falls are the leading cause of fatal and non-fatal injuries in older adults? Between 30-40% of people who are mobile in the community, over the age of 65, experience falls every year. Of those individuals who fall, 20-30 % suffer moderate to severe injuries such as hip fractures or head trauma. In fact, falls are the most common cause of traumatic brain injury in older adults. “The most consistent predictors of future falls are clinically detected abnormalities of gait or balance.” (Ganz et al, 2007).

What this means is balance is important. What it also means, is that Physical Therapy can make a big difference in improving the systems involved in balance and gait.  Balance is a complex process involving three sensory systems working together.

These are:


 2. SOMATOSENSORY (perception of touch/pressure/pain/position/movement coming from the muscles and joints).

3. VESTIBULAR  (the system that detects direction/speed of head motion, position of the head relative to gravity, and the difference between self- motion and visual motion).

On a firm/stable surface, 70% of our balance comes from the somatosensory system (the perception of touch/pressure/pain/position generated from the muscles and joints). On the same surface, 20% of our balance comes from our vestibular system (the system that detects head position and motion and the difference between self-motion and visual motion). The final 10% of balance on firm surfaces comes from our visual system. (Peterka and Loughlin, 2004; Horak, 2003).

Physical therapists are called upon to assist when people present with deficits in their balance. Therapists are trained to evaluate the individual’s vision, strength and flexibility, gait patterns, and somatosensory and vestibular systems to identify where the deficits are coming from. Once the affected systems and other risk factors are identified, a physical therapy plan can be implemented to assist an individual to reduce their risk of falling and injury.


Trenna Coghan, PT

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