Fall Prevention: A Practical Guide
Author: Folarin Babatunde, PT PhD, MScSEM, MScPT, BScPT
Falls are one of the most common – and most consequential – setbacks after limb loss. Research from Canadian outpatient clinics found that about one in two amputees with lower-extremity limb loss reported at least one fall in the past 12 months.
But falls are not only a lower-limb issue. In a study of people with upper limb loss, almost half reported at least one fall in the past year as well, and one in four subjects reported two or more falls. Beyond bruises, for amputees, falls frequently lead to injury and can trigger a cycle of reduced activity, community participation and confidence.
Falls after limb loss are common, but contrary to popular belief they aren’t necessarily all that random. Falls follow specific patterns which explains why attempts at prevention can be very effective.
A study of unilateral lower-limb prosthesis users found that falls occur on level ground too, not only on obvious hazards like stairs. The authors suggest that prevention needs to include base-of-support disruptions while walking and not just the usual suspects like throw rugs, slippery and uneven surfaces for example. The fact that falls aren’t just “bad luck” is encouraging in that prevention strategies can be effective. A useful way to think about minimizing the risk of falling is to consider the several factors that interact during movement.
Body + Device + Environment + Attention
When there are changes in any one of these factors - fatigue, pain, socket discomfort, low light, rushing, distraction — the risk of a fall rises quickly. The goal isn’t to be cautious all the time. It’s to be strategic in the moments that matter most. So, let’s focus on fall-proof confidence. That is, identifying your highest-risk moments and training “catch yourself” skills that matter most in real-time. Here are some of the most common high-risk moments and fall prevention strategies.
Falls after limb loss are common, but contrary to popular belief they aren’t necessarily all that random. Falls follow specific patterns which explains why attempts at prevention can be very effective.
A study of unilateral lower-limb prosthesis users found that falls occur on level ground too, not only on obvious hazards like stairs. The authors suggest that prevention needs to include base-of-support disruptions while walking and not just the usual suspects like throw rugs, slippery and uneven surfaces for example. The fact that falls aren’t just “bad luck” is encouraging in that prevention strategies can be effective. A useful way to think about minimizing the risk of falling is to consider the several factors that interact during movement.
Body + Device + Environment + Attention
When there are changes in any one of these factors - fatigue, pain, socket discomfort, low light, rushing, distraction — the risk of a fall rises quickly. The goal isn’t to be cautious all the time. It’s to be strategic in the moments that matter most. So, let’s focus on fall-proof confidence. That is, identifying your highest-risk moments and training “catch yourself” skills that matter most in real-time. Here are some of the most common high-risk moments and fall prevention strategies.
ABOUT THE AUTHOR: Folarin Babatunde, PT PhD, is a physiotherapist, researcher and educator with expertise in evidence-informed rehabilitation, performance training and community reintegration for people living with limb loss. He is the Owner/Principal at Cogent Physical Rehabilitation Center, a physiotherapy, rehab and wellness clinic. A former Western University Assistant Professor, he provides practical, real-world rehabilitation solutions after a limb loss. For more information visit cogent-rehab.com.
