Study shows tailored physical therapy program reduces bad falls in the elderly

March 16, 2017, Duke University

Falls are a leading cause of death and disability in the elderly, and also contribute to rising healthcare costs. In 2012, a research team from Duke-NUS Medical School (Duke-NUS) in Singapore teamed up with the Singapore General Hospital (SGH), Changi General Hospital (CGH) and Agency for Integrated Care, to study the effectiveness of tailored physical therapy programmes for the elderly to prevent falls, also known as the Steps to Avoid Falls in Elderly (SAFE) study. The results of that study are now in.

The team, led by Professor David Matchar, Director of the Health Services and Systems Research Programme at Duke-NUS, recruited into the SAFE study 354 who previously sought medical attention at emergency departments for a fall or fall-related injuries. All recruited patients were older than 65 years of age. Of these, half were randomly assigned to the intervention group, to receive tailored and intensive physical therapy. The other half were in the control group, and received no structured physical therapy beyond usual services. All participants were followed over a period of nine months.

Every month, all study patients reported if they had suffered from any falls in the previous month, and the severity of their fall. Although participation in physical therapy programmes did not reduce the number of falls in the elderly, it did significantly reduce the severity of falls and slowed the deterioration of physical decline. Specifically, receiving physical therapy reduced the risk of falls that require medical attention or restrict daily activities by almost 50% in the elderly. Another interesting observation made was that the health of the patient influenced the success of the physical therapy programme in preventing falls. Of the patients suffering no more than one major medical condition, those that received physical therapy reported significantly fewer falls overall, reducing the fall risk in this group by almost 70%.

"What is also particularly interesting about this study is that the elderly in Singapore seem to fall less than their counterparts worldwide. Whether this is from reduced mobility due to the assistance of their families and caregivers, or due to some other reason is yet to be determined, and something we are currently working on", added Professor Matchar, who is also first author of the SAFE study.

"Singapore is facing the challenge of a rapidly aging population and we are certainly seeing more elderly who turn up at the SGH Emergency Department after falls. The fall often triggers a progressive decline with fear of falling, reduced mobility, and difficulty with self-care. Through SAFE, the customized falls reduction exercise programme, conducted in the groups or at home, can assist the elderly in reduced risk of serious falls," commented Associate Professor Marcus Ong, Senior Consultant, Department of Emergency Medicine and site principal investigator at SGH.

The SAFE study adds strong scientific evidence to the current body of research reporting benefits of community-based tailored physical therapy programmes in preventing falls in the elderly, especially for those in better health. Implementation of such programmes are also integral in connecting emergency medicine physicians with community-based physical therapists to extend the continuum of care for fall patients beyond the hospital and emergency department, and prevent future visits due to .

Explore further: Digital toolkit aims to prevent falls amongst the elderly

More information: David B. Matchar et al, A Randomized Controlled Trial of Screening, Risk Modification and Physical Therapy to Prevent Falls among the Elderly Recently Discharged from the Emergency Department to the Community: the Steps to Avoid Falls in the Elderly Study, Archives of Physical Medicine and Rehabilitation (2017). DOI: 10.1016/j.apmr.2017.01.014

Related Stories

Digital toolkit aims to prevent falls amongst the elderly

February 24, 2017
The National Institute for Health and Care Excellence (NICE) has endorsed a new online toolkit developed by researchers at Keele University, which aims to prevent falls amongst the elderly that cost the NHS more than £2 ...

Study finds no link between elderly patient activity and hospital falls

October 28, 2011
In 2008, as part of a larger initiative aimed at reducing preventable hospital errors and lowering costs, Medicare stopped reimbursing for the treatment of injuries related to in-hospital falls.

Physical activity reduces risk of serious falls in older men

February 3, 2016
Older men who engage in regular physical activity experience far fewer serious fall injuries than those who do not, say Yale researchers. Their findings suggest that moderate exercise can help prevent potentially devastating ...

Exercise programs could help to prevent fall injuries in older people

October 30, 2013
Exercise programmes designed to prevent falls in older adults also appear to prevent injuries caused by falls, suggests a paper published today in BMJ.

Depression increases risk of falls in elderly

October 7, 2014
Falls are common in elderly people but the risk increases markedly when they have depressive symptoms, research from Neuroscience Research Australia shows.

Recommended for you

It's not just for kids—even adults appear to benefit from a regular bedtime

September 21, 2018
Sufficient sleep has been proven to help keep the body healthy and the mind sharp. But it's not just an issue of logging at least seven hours of Z's.

Most nations falling short of UN targets to cut premature deaths from chronic diseases

September 21, 2018
People in the UK, US and China have a higher risk of dying early from conditions like cancer, heart disease and stroke than people in Italy, France, South Korea and Australia.

Smart pills dumb down medical care, experts warn

September 21, 2018
Enthusiasm for an emerging digital health tool, the smart pill, is on the rise but researchers at the University of Illinois at Chicago have published a paper in the American Journal of Bioethics that cautions health care ...

China's doctor shortage prompts rush for AI health care

September 20, 2018
Qu Jianguo, 64, had a futuristic medical visit in Shanghai as he put his wrist through an automated pulse-taking machine and received the result within two minutes on a mobile phone—without a doctor present.

Time to ban the sale of energy drinks to children, says senior doctor

September 19, 2018
It's time to bring in laws to ban the sale of caffeinated energy drinks to children and young people in England to tackle the twin epidemics of obesity and mental health problems, argues Professor Russell Viner, President ...

For-profit hospitals correlated with higher readmission rates

September 19, 2018
Patients who receive care in a for-profit hospital are more likely to be readmitted than those who receive care in nonprofit or public hospitals, according to a new study published by University of Illinois at Chicago researchers.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.