Falls prevention remains one of the most critical challenges in neurological rehabilitation. Recently, our specialist neurological physiotherapy team gathered for an intensive SP Therapy Services in-house training day dedicated to advancing our approach to physiotherapy falls prevention in the home environment.
As Clinical Coordinator, I’m proud to share the innovative strategies and insights our expert Chartered Physiotherapists explored together.
Understanding Where Falls Happen Most
Statistics consistently show that most falls occur in the home. This reality shapes how our physiotherapy team approaches assessment and intervention. Unlike hospital settings where environmental factors are standardised, home environments present unique challenges. From uneven flooring to poor lighting, cluttered walkways to pets underfoot. But it is not only what is in our homes but what we do in our homes that places our patients at risk. Walking a short distance by day is completely different to navigating your way to the bathroom half asleep in the dark!
Our neurological physiotherapy specialists recognise that effective falls prevention begins with understanding these domestic realities. Consequently, we’ve refined our home assessment protocols to identify the risks that exist in everyday living ensuring every patient we support has a falls risk and recovery plan.
The Golden Hour: A Critical Window for Recovery
During our training day, we emphasized the concept of the “golden hour” on the floor. When someone falls and cannot get up independently, the time spent on the floor becomes crucial. Research indicates that remaining on the floor for more than an hour significantly increases the risk of serious complications, including pressure sores, dehydration, hypothermia, and pneumonia.
Therefore, our team discussed how physiotherapy falls prevention in the home must also include falls recovery planning. By having a proactive approach this ensures patients and their families know exactly what to do if a fall occurs, potentially preventing the cascade of complications that can follow.
Fear of Falling: The Greatest Predictor
Perhaps the most significant factor we explored was this: the fear of falling is the greatest predictor of potential to fall. This creates a challenging cycle. When individuals become afraid of falling, they often reduce their activity levels. However, reduced activity leads to decreased strength, balance, and confidence, which paradoxically increases their falls risk. But it is not only patients that are fearful of falls, often loved ones are all too aware of the risk of falls and their kind behaviour, coming from a very good place can limit the opportunity for our patients to move and be independent.
Our neurological physiotherapists tackle this issue head-on. Through specialized assessment and graded exposure techniques, we help patients rebuild confidence alongside physical capabilities. Moreover, we recognize that addressing supporting them to practice functional skills in context builds not only their confidence, but the confidence in family members, and this is just as important as addressing what caused the balance problems.
Physiotherapists as Balance Specialists
As the balance specialists within the multidisciplinary team, physiotherapists hold unique responsibility. We accept if an individual has a balance problem they are at risk of falling, and the absence of falls does not reduce the risk!
As Physiotherapists we don’t simply treat after falls occur; instead, we proactively develop individualized prevention and recovery plans. These plans include practical strategies such as floor-to-standing techniques, environmental modifications, and emergency response protocols. Additionally, we ensure that patients and caregivers feel empowered to implement these strategies independently.
Enhancing Clinical Reasoning Through Problem-Solving
To support our physiotherapy team to achieve this our Training Day incorporated backward chaining methodology to strengthen clinical reasoning. This approach involves starting with the desired outcome and working backward to identify the steps needed to achieve it. In this case the desired outcome was getting up off the floor independently. For our expert team, this technique refined their goal-setting processes and enhanced their ability to create truly patient-centred intervention plans.
By challenging ourselves to think differently, our team developed more sophisticated approaches to physiotherapy falls prevention in the home. Our physiotherapists now ask deeper questions:
- How would this patient get off the floor safely?
- What movement components do they need to learn to make this possible?
- How can this be integrated into their balance training programme, so it becomes a confident everyday task?
Conclusion
Most people living with a neurological condition have balance issues predisposing them to the risk of falls. However, evidence shows only way to improve balance is to challenge balance, the skill of a physiotherapist is to challenge balance safely to improve confidence and movement skills. But this must be combined with active an falls prevention and recovery plan.
Active falls prevention in home settings requires expertise, individualized assessment, and comprehensive planning. Our neurological physiotherapy team’s commitment to excellence ensures that we address not only the physical aspects of fall risk but also the fear of falling. Because we fundamentally believe no person should be in fear in their own homes!
About the author
Jayne Hallford is a highly experienced Physiotherapist and is the SP Therapy Services Clinical Coordinator. Her role as Clinical Coordinator means she is responsible for Teamwork and Performance Coaching. Consequently, it is Jayne’s job to assess and develop the training and development plan for the Physiotherapy team. In doing so, Jayne actively contributes to our SP Therapy Services objective of having an Elite Service Model for our patients and our physiotherapists.
Jayne says “Through collaborative professional development initiatives like this Falls Prevention Training Day, the team continuously refine their clinical expertise to ensure the highest standards of neurological rehabilitation”.
View Jayne’s profile here
For further information about how SP Therapy Services we implement constant improvements in our practice
https://www.sptherapyservices.co.uk/neurological-physiotherapy-near-me-expert-specialists/
Further news articles related to falls prevention:
https://www.sptherapyservices.co.uk/neurological-falls-prevention-exercises/
Contact Us
If you or a loved one has experienced falls or has concerns about fall risk in the home, our specialist neurological physiotherapy team can help.
We have expert physiotherapists based in Bury, Blackburn, Stalybridge, Bradford, Holmfirth and Barnsley who are available to provide home based assessments.
Call us on 0161 764 3799 or email us info@sptherapyservices.co.uk and we will organise for one of our team to call you to discuss your concerns.