Physiotherapy works: Falls and frailty
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Physiotherapy reduces falls, addresses frailty and restores independence
Risks of a fall
A fall is an event that results in a person coming to rest unintentionally on the ground or floor or other lower level.(1)
Over 400 risk factors leading to falling have been identified including lack
of physical activity resulting in loss of muscle tone, decreased bone
mass, poor balance, and reduced flexibility; impaired vision,
medications, disease including Parkinson’s, dementia, stroke and
arthritis, surgery, and environmental hazards.
The risk of falls and
associated complications rise steadily with age and can be a marker of
Half of people who have a fall will fall again within the next 12 months
Frailty is not clearly defined but is widely
accepted to include a combination of weight loss, fatigue, reduced grip
strength, diminished physical activity or slowed gait associated with
increased risk of falls, hospitalisation, loss of mobility and
independence, increasing disability and death.(2)
Size of the problem
- 1 in 3 people aged over 65 will fall every year(10) equating to more than 3 million falls per year.The rate increases to nearly 1 in 2 for community dwelling adults over 80(11)
- Half of people who fall will fall again in the next 12 months(12, 13)
- 10-25% of fallers will sustain a serious injury
- Injury due to falls is leading cause of mortality in people aged over 75 in UK
- Recurrent falls are associated with increased mortality, increased hospitalisation and higher rates of long term care.
Cost of the problem
Cost to the NHS of falls is estimated at £2.3 billion per year.
The cost of falls
Falls cost the NHS £4.6 million every day yet every £1 spent on physiotherapy could save £1.50 across the whole pathway
Physiotherapists work with older adults in interdisciplinary teams and
with other agencies in community, hospital and care settings often as an
integral part of local falls care pathways.
They have specialist skills
in assessment and re-ablement and provide evidence based exercise,
education and advice programmes aimed to prevent falls, improve balance,
increase self confidence, reduce fear of falling and promote active and
Physiotherapy led group exercise programmes have
been shown to be effective and to reduce falls by 29% and the risk of
falling by 15% and individual exercise programmes by 32% and 22%
Community based falls prevention programmes
targeting older adults particularly older women, can be highly cost
effective with the value of benefits from reduced hospital admission
significantly exceeding cost of intervention.(4)
community living older adults tailored exercise programmes delivered as
part of a multidisciplinary co-ordinated intervention reduced the rate
of falls by 31% and the risk of falling by 27%.(5)
Programmes delivering 50+ hours of exercise have been shown to be
more effective (23% reduction in rate of falls) than those with less
than 50 hours (7% reduction) and programmes of 2 hours per week for 6
months are recommended.(3, 6) Up to half of non-injured
fallers are unable to get up following a fall; physiotherapists teach
people how to get up from the ground safely, reducing the risks
associated with long lies including pressure sores, hospital admission
and moving into long term care.(7)
falls clinics providing comprehensive assessment, identifying underlying
pathologies (such as osteoporosis), signposting to other specialist
services and offering individual advice and support.
There is a need for more research into frailty but two systematic
reviews suggested that physiotherapy had a positive effect sustained for
12 months in reducing disability in older adults with moderate frailty.(8, 9)
The Westminster Falls Service offers multifactorial risks assessment and
targeted intervention for clients referred following a fall or who are
at risk of falling. After assessment clients are stratified to receive
either 1:1 physiotherapy and/or attend a 12 week strength and balance
programme designed to increase physical capability and confidence,
improve balance, and reduce fear of falling. On completion of the
programme clients continue evidence based falls prevention exercise via
‘Steady and Stable’ classes in partnership with a voluntary
organisation. The falls pathway enables clients to reach the recommended
50+ hours of strength and balance required to prevent falls in the long
term. High risk clients are also reviewed by telephone.
followed up a year post discharge reported a 60% reduction of falls, 55%
fewer fractures, 92% fewer A&E admissions, and a 80% reduction in
GP appointments compared to the year prior to intervention.
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Our Physio & Rehab Expertise
Specialist Rehab Group works with specialist physiotherapists and specialist rehab therapists who are highly trained, qualified, experienced and passionate to provide high level of expert care to our patients.
Areas of specialization
- physiotherapy: back and neck (spine), sports, shoulder, hip, knee, ankle
- hand therapy: forearm, wrist, hand and fingers
- podiatrist: leg, calf, ankle, foot and toes
- read more on our specializations here
All our therapists are fully insured and registered with Allied Health Professions Council (AHPC) and Traditional Chinese Medicine Board (TCM). See our entire team here by location and specialization.
Initially, our specialist physiotherapists will carry out a thorough
assessment, helping them to select the most appropriate treatment to
help you recover. They then provide
expert treatment for your pain as well as prescribing specific
exercises to reduce your risk of re-injury and giving you a long term
To call for inquiries or appointments, please contact us at:
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SPECIALIST REHAB APPOINTMENTS & ENQUIRIES
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We are a wholly Singapore Private Limited group of licensed physiotherapists, hand therapists, podiatrists, chiropractors, sports massage therapists, clinical pilates practitioners and TCM physicians practicing in our scope of rehabilitation and its areas of specializations. As listed in our website are the list of services we provide our clients as referred by their medical doctors or by self referrals/word of mouth.
The range of rehabilitation results vary from patients to patients, depending on a variety of factors and reasons such as severity of condition, genetics, gender and age. However, we will still deliver the best evidence-based-practice of physiotherapy, hand therapy, TCM, sports training and deep tissue release therapy that we can deliver.
The information available on this site is for educational purposes only, if you need a full professional advise on physiotherapy, hand therapy and occupational therapy, please schedule an appointment with us by contacting our staff by Call/SMS/WhatsApp at xx, thanks!