Occupational Therapy in Fall Prevention: Current Evidence and Future Directions

Abstract

Falls are a serious public health concern among older adults in the United States. Although many fall prevention recommendations exist, such as those published by the American Geriatrics Society (AGS) and the British Geriatrics Society (BGS) in 2010, the specific role of occupational therapy in these efforts is unclear. This article presents a scoping review of current published research documenting the role of occupational therapy in fall prevention interventions among community-dwelling older adults, structured by the AGS and BGS guidelines. We identified evidence for occupational therapy practitioner involvement in fall prevention in environmental modifications, exercise, and multifactorial and multicomponent interventions. Although research documenting the efficacy of occupational therapy interventions is identified as part of the Occupational Therapy Practice Framework: Domain and Process (2nd ed.; American Occupational Therapy Association, 2008), we identified little or no such research examining interventions to modify behaviors (e.g., fear of falling), manage postural hypotension, recommend appropriate footwear, and manage medications. Although occupational therapy is represented in the fall prevention research, the evidence for the profession’s role in many areas is still lacking.

The Impact of Fear of Falling on Functional Independence Among Older Adults Receiving Home Health Services

“…Therefore, reducing fatal falls among older adults is one of the nation's health objectives (U.S. Department of Health and Human Services [HHS], 2013). Interventions targeting specific domains or specific fall risk factors, however, have had limited success in reducing the incidence of falls (Chang et al, 2004;Leland, Elliott, O'Malley, & Murphy, 2012). Because several fall risk factors have been identified for community-dwelling older adults, it is difficult to target a single risk factor for intervention (Ambrose, Paul, & Hausdorff, 2013;Cesari et al, 2002).…”

Potential analysis for research on occupational therapy-led physical exercise programmes and home environment adaptation programmes to prevent falls for elderly people living at home / Potenzialanalyse zu ergotherapeutischen körperlichen Trainingsprogrammen und Wohnraumanpassungen zur Vermeidung von Stürzen bei zu Hause lebenden älteren Menschen

“…Sie können in monofaktorielle Trainingsprogramme (Cumming et al, 1999;Steultjens, Dekker, Bouter, Jellema, & Bakker, 2004;Clemson, Mackenzie, Ballinger, Close, & Cumming, 2008;Costello, & Edelstein, 2008;Sherrington et al, 2008;Davis et al, 2010;Sherrington, Tiedemann, Fairhall, Close, & Lord, 2011;Leland, Elliott, O'Malley, & Murphy, 2012) und in multifaktorielle Trainingsprogramme (Steultjens et al, 2004;Costello, & Edelstein, 2008;Peterson, & Clemson, 2008, Sherrington et al, 2008Davis et al, 2010;Sherrington et al, 2011;Leland, et al, 2012) eingeteilt werden. Beide Formen können entweder als Gruppen-oder Einzeltraining in der eigenen Häuslichkeit angeboten werden (Costello, & Edelstein, 2008 (Steultjens et al, 2004;Costello, & Edelstein, 2008;Sherrington et al, 2008;Davis et al, 2010;Sherrington et al, 2011), c) Anleitung, Beratung und Edukation von Angehörigen (Steultjens et al, 2004) sowie d) additiv-begleitendes Training kognitiver Funktionen (Steultjens et al, 2004).…”

“…Beide Formen können entweder als Gruppen-oder Einzeltraining in der eigenen Häuslichkeit angeboten werden (Costello, & Edelstein, 2008 (Steultjens et al, 2004;Costello, & Edelstein, 2008;Sherrington et al, 2008;Davis et al, 2010;Sherrington et al, 2011), c) Anleitung, Beratung und Edukation von Angehörigen (Steultjens et al, 2004) sowie d) additiv-begleitendes Training kognitiver Funktionen (Steultjens et al, 2004). Multifaktorielle Programme kombinieren einzelne Interventionskomponenten in unterschiedlicher Variation und bieten diese zudem als Einzel-und Gruppentraining an (Costello, & Edelstein, 2008;Leland et al, 2012). Monofaktorielle wie auch multifaktorielle Programme sind maßgeschneidert und enthalten vornehmlich diejenigen Trainingselemente, die zuvor mittels Assessments identifiziert wurden.…”

“…Monofaktorielle wie auch multifaktorielle Programme sind maßgeschneidert und enthalten vornehmlich diejenigen Trainingselemente, die zuvor mittels Assessments identifiziert wurden. Gemäß der Meta-Analyse von Sherrington et al (2011) (Cumming et al, 1999;Pardessus et al, 2002;Steultjens et al, 2004;Costello, & Edelstein, 2008;Clemson et al, 2008;Davis et al, 2010;Pighills, Torgerson, Sheldon, Drummond, & Bland, 2011;Leland et al, 2012;Ballinger, & Brooks, 2013 (Peterson, & Clemson, 2008). Der Durchführung von Wohnraumanpassungen durch Ergotherapeuten/-innen wird hohes Potenzial zugeschrieben (Costello, & Edelstein, 2008), da Ergotherapeuten/-innen über die notwendigen fachlichen Qualifikationen verfügen, insbesondere bei der Durchführung von Wohnraumassessments und -anpassungen (Steinmetz, & Hobson, 1994;Cumming et al, 1999;Lampiasi, & Jacobs, 2010).…”

Update on Productive Aging Research in the American Journal of Occupational Therapy, 2012

“…Content about low vision rehabilitation varied widely across curricula, even when specialists within the program or from the community provided the training. Leland, Elliott, O'Malley, and Murphy (2012) searched the literature for studies that were conducted by occupational therapists or that included occupational therapy intervention related to fall prevention. They identified 15 such studies, 6 from Australia and 9 from the global occupational therapy community; 12 were RCTs.…”