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FAQ

What kinds of fall prevention intervention programs are currently available?

There are lots of exercise programs that are available at the community centres to work on general strengthenig and conditioning. Many hospitals also run falls prevention programs but entry will require a doctor's referral. A registered physiotherapist can also implement a falls prevention program at a community clinic through a personalized home exercise program.

What are the best strategies for fall prevention?
Falls prevention involves several different components. Firstly, it is important that the patient and their support system understands the reasons behind the falls. Secondly, the enviornment of the senior should be evaluated for potential hazards that may contribute to an increased fall risk. For example, if there are a lot of floor rugs, cluttered furniture and poor lighting in the home, these may have to be addresed so that the home environment is safer. Lastly, it is vital that the senior is invovled in some strengthenig and balance retraining program with a physiotherapist so that they can build their tolerance for activity and prevent falls. The physiotherapist can also educate the senior on how to get up from a fall so that the senior can get to a phone to call for help if necessary.
 
What are the major risk factors for falls among older adults?

Poor general health, taking a number of different medications, low activity levels, poor strength, poor balance, poor vision, cluttered environment and previous falls are all risk factors for falls.

What should be done if a senior falls at home?

The reasons why a senior falls should be closely evaluated. If there have been more than one fall, then the senior should defintely be seen by a doctor for a complete evaluation. If the reaosns for the person's fall have been confirmed to be due to poor strength and balance, then it is important that the senior works with a physiotherapist to improve their strength and conditioning. The physiotherapist can assess the falls risk and develop an exercise program that will help prevent future falls.

Where do falls among older adults occur most frequently?

Older adults fall due to a variety of reasons. Some known causes for falls include increased clutter, polypharmacy (which refers to taking many different kinds of medications for a variety of health issues), poor vision, poor balance and overall poor strength. Majoirty of the falls do tend to happen in the home because that's where older adults spend most of their time. 

How do you treat vestibular dysfunction?

Physiotherapy treatment plan may include eye and head movement exercise. exercise to improve standing balance and walking, specific techniques performed in the clinic to reposition the loose crystals in your inner ear if you have BPPV, advice on falls prevention and education and advice on planning and pacing your activities of daily living to improve confidence and function.

What are common causes of vestibular dysfunction?

BPPV is the most common cause of vertigo due to vestibular dysfunction due to your inner ear pathology and most likely to occur over the age of 50. Vestibular dysfunction can develop due to head trauma, surgical trauma in your inner ear, Labyrinthitis, neuritis, migraine, vestibular system degeneration, Meniere’s disease, barotrauma (increased pressure in the inner ear for e.g. in scuba diving) and ototoxicity (toxicity from antibiotics like gentamycin).

Are there home-based exercises available to treat VRT?
 
Following your first assessment your Physiotherapist will develop personalised exercise-based treatment plans including clinic-based treatment and home exercise program. Your exercise will be reviewed during the follow up visits and progressed as needed to help you with the recovery. Some of the exercise may provoke your symptoms in the initial period, because these exercises are meant to encourage your brain to compensate for the problems in your inner ear. Your Physiotherapist will decide on the intensity and repetition of the exercise and it is very important to incorporate exercise in to your daily routine as advised by your Physiotherapist.
 
What medications are available for VRT?

In the initial phase your doctor may prescribe medication to supress your symptoms and also medication for nausea. If you have inner ear infection then you may be on steroids or antibiotics.Your Doctor decides on the appropriate medication, dosage and duration of intake.Vestibular suppressants are normally not continued for long term as it can slow down the process of compensation.

What is vestibular rehabilitation therapy (VRT)?

Vestibular rehabilitation is an exercise-based program based on a detailed assessment by a trained vestibular Physiotherapist. VRT is effective in reducing, dizziness, vertigo and balance problems, there by minimize the risk of falls and helps to improve the quality of life in people with vestibular dysfunction. BPPV or the free-floating crystals in the inner ear is the common cause of Vertigo and the diagnosis is made with a test called Dix-Hallpike. The initial screening includes collecting a detailed history of your problem, tests for BPPV, assessment of visual problems, neurological test, visual screening and various balance test. Initial assessment will also help to differentiate between the vestibular problems due to dysfunction in your inner ear and dysfunction in the parts of brain which controls your balance and coordination.VRT is aslo effective in vestibular dysfunction following surgeries in your inner ear.

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