209 Falls: Prevention, Assessment, and Intervention

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Item: physi-209FALLS


For all rehab professionals. Covers U.S. fall statistics, fall risk factors and consequences, assessing for fall risk, and creating individualized plans focused on evidence-based exercise interventions. Sample exercises and case studies included.

Available Course Credits

Alaska State PT & OT Board 9.00
AOTA 9.00
Arizona State Board of Physical Therapy 9.00
Arkansas State Board of Physcial Thearpy 9.00
California Physical Therapy Board 9.00
Colorado Division of Professions and Occupations 9.00
Delaware Examining Board of Physical Therapists and Athletic Trainers 9.00
District Of Columbia Department of Health 9.00
FPTA 9.00
Georgia State Board of Physical Therapy 9.00
Hawaii Board of Physical Therapy 9.00
Idaho Physical Therapy Licensure Board 9.00
Illinois Department of Professional Regulation 9.00
Indiana Physical Therapy Board 9.00
Iowa Board of Physical Therapy and Occupational Therapy 9.00
Kansas State Board of Healing Arts 9.00
Kentucky Board of Physical Therapy 9.00
Louisiana Physical Therapy Board 9.00
Maine Board of Physical Therapy 9.00
Maryland Board of Physical Therapy 0.90
Massachusetts Board of Allied Health Professionals 9.00
Michigan Board of Physical Therapy 9.00
Minnesota Board of Physical Therapy 9.00
Mississippi State Board of Physical Therapy 9.00
Missouri Advisory Commission for Physical Therapists 9.00
Montana Board of Physical Therapy Examiners 9.00
New Mexico Physical Therapy Board 9.00
New York State Education Department 9.00
North Carolina Board of Physical Therapy Examiners 9.00
North Dakota Board of Physical Therapy 9.00
Oklahoma Physical Therapy Board 9.00
Oregon Board of Physical Therapy 9.00
Pennsylvania State Board of Physical Therapy 9.00
Physical Therapy Governing Board New Hampshire 9.00
South Carolina Board of Physical Therapy 9.00
South Dakota Physical Therapy License Board 9.00
State of Alabama Board of Physical Therapy 9.00
State of Rhode Island Department of Health 9.00
Tennessee Board of Physical Therapy 9.00
Utah Physical Therapy Licensing Board 9.00
Virginia Board of Physical Therapy 9.00
Washington State Board of Physical Therapy 9.00
West Virginia Board of Physical Therapy 9.00
Wisconsin Physical Therapy License Board 9.00
Wyoming Board of Physical Therapy 9.00

Course Content

209 Falls: Prevention, Assessment, and Intervention
Course Evaluation

Sarah R.Stillings, MA, PT, MPT, CHT

Sarah R. (Sally) Stillings is a PT and Certified Hand Therapist in Texas. She received her physical therapy degree from the University of North Carolina at Chapel Hill. Prior to becoming a therapist, Sally taught university-level writing courses and was assistant editor of The Journal of Craniomandibular Practice. In her extensive career as a PT, she has held a variety of clinical, teaching, administrative, and business roles, including general PT practitioner, upper extremity specialist, clinic manager, hand therapy clinic coordinator, continuing education (CE) instructor, and CE course administrator. She has also served as Executive Director of the Kellermann Foundation, a U.S. nonprofit organization supporting healthcare and community development in Uganda, East Africa. Her work now focuses on creating evidence-based CE materials for rehab professionals. Sally is a lifelong runner who celebrates all those who cover the ground.

209 Falls: Prevention, Assessment, and Intervention—Course Objectives


After successfully completing this continuing education course, the learner should be able to:

  1. Recognize the epidemiology of falls among older adults in the U.S.
  2. Differentiate modifiable and non-modifiable intrinsic and extrinsic fall risk factors
  3. Identify fall risk screening principles
  4. Identify components of a comprehensive fall risk assessment for an older adult
  5. Choose and apply appropriate fall risk functional measures in case studies
  6. List interventions appropriate for inpatient and outpatient fall risk management
  7. Identify universal fall risk precautions
  8. Differentiate the factors involved in developing a patient-specific fall risk plan of care
  9. Identify and assess environmental fall risk factors using case studies
  10. Identify modifications to the home environment to decrease fall risk
  11. Recognize the research evidence supporting exercise intervention for fall management
  12. Identify and apply, using case studies, exercise-based fall prevention interventions for older adults
  13. Identify comprehensive evidence-based approaches to decrease patients’ fall risk


209 Falls: Prevention, Assessment, and Intervention—Table of Contents

Page #


Course Instructions 2

About the Author / Course Description 3

Course Objectives 4

Table of Contents 5


Introduction 8

Chapter 1: Understanding Falls—Definitions & Epidemiology 9

Demographics: An Aging Population

Definitions 11

Incidence of Falls 13

Morbidity 15

Injury 16

Psychosocial Effects 21

Mortality 24


Costs 27

Risk Factors 28

Intrinsic Risk Factors

Extrinsic Risk Factors 30


Chapter 2: Clinical Screening and Assessment 33

Screening for Fall Risk

When Fall Risk Screening Is Positive 40

AGS/BGS Algorithm

NICE Guidelines

STEADI Algorithm

Academy of Geriatric PT/APTA Guideline

Screening for Fear of Falling and Depression 43


Choosing Fall Risk Assessment Functional Measures 44

Berg Balance Scale 46

Single Limb Stance, Eyes Open 47

Five Times Sit-to-Stand Test 48

Timed Up and Go Test 48

Self-Selected Walking Speed 50

Dynamic Gait Index 51

Four Square Step Test 52

Fullerton Advanced Balance Scale 52

Short Physical Performance Battery 53

Completing the Fall Risk Clinical Assessment 54

Completing the Post-Fall Clinical Assessment 55

Chapter 3: Reducing Fall Risks—Creating the Plan of Care 57

Inpatient Risk Reduction Interventions 58

Universal Fall Precautions 59


Individual Patient Strategies 60

Outpatient Risk Reduction Interventions 63

Patient Education

Muscle Strengthening and Endurance

Range of Motion/Flexibility Exercises 64

Gait Training 65

Balance Training 66

Special Considerations for Frail Older Adults 68


Chapter 4: Addressing the Environment 70

Lighting Conditions 72

Floor Surfaces 74

Hard Flooring Surfaces


Throw Rugs


Trip Hazards 77

Beds 79

Seating 80

Handrails and Grab Bars 82

Stairs 84



Bathroom 87

Kitchen 89

Other Modifiable Extrinsic Risk Factors 89

Clothing and Footwear

Assistive Devices


Chapter 5: Exercise-Based Fall Prevention Strategies 92

Evidence for Exercise Intervention

Multifactorial Intervention vs. Exercise Alone

Recommendations for Exercise Intervention 94

U.S. Preventive Services Task Force


National Inst. for Health and Care Excellence

Academy of Geriatric PT/APTA



Intervention Focus Areas 99

Evidence-Based Fall Prevention Programs 100

A Matter of Balance



Enhance® Fitness


FallsTalk 104


Fit and Strong!

Healthy Steps for Older Adults

Healthy Steps in Motion 106

The Otago Exercise Program

Stay Alive and Independent for Life (SAIL) 107

Stepping On

Tai Chi for Arthritis

Tai Ji Quan: Moving for Better Balance

YMCA Moving For Better Balance 109

Individualized Exercise Intervention 111

Gait Training 112

ROM/Flexibility Exercises 114

Strength Training 120


Balance Training 128


Conclusion 133


Case Studies 134


Appendix A: Patient Education Resources 137

Appendix B: Provider Resources 138


Appendix C: Exercise Instructions 140


References 154

Examination 165

Evaluation 176

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Educational Level: Intermediate


Target Audience: PT, PTA, OT, OTA, ATC

This course is approved for 0.9 CEUS. 9 contact hours

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