The Stay On Your Feet® team’s recent Strengthen Your Legs Forum attracted a diverse range of allied health professionals from across the country to hear from four of Western Australia’s leading falls prevention experts.
Those attending the professional development and networking event at the Bendat Centre in Wembley, and others who tuned in via webinar, were provided with some extremely valuable insights and advice on the effective delivery of leg strengthening programs and exercises to reduce the risk of falls among older clients.
Their presentations included information about how practitioners can harness the motivators that drive older adults to engage in exercise and strategies to overcome the barriers they experience.
In addition to their presentations, the guest speakers also participated in a panel discussion where they were able to share their thoughts on the need to raise the public profile of falls prevention among older adults, health professionals and Government officials through advocacy, and how the collaboration across disciplines is vital for patient outcomes.
One Size Does Not Fit All
Tony Petta, Physiotherapist and Falls Specialist at Sir Charles Gardner Hospital, said that although evidence-based, effective strength and balance programs are available and well known to practitioners, one size does not necessarily fit all.
Mr Petta explained during his presentation that an exercise program needed to be selected and modified according to each client’s capabilities, co-morbidities and preferences.
“We want to maximise the client’s capabilities and functional task performance,” he said.
He said that this may refer to factors from the older person’s pre-existing medical conditions, cognitive impairment or neurological disease as well as their level of motivation and ability to grasp concepts of progressive overload.
“It is up to the practitioner to select appropriate exercises for their client to maximise their compliance with the program therefore maximising the benefits.”
The Need to Engage Older Adults, Family and Health Professionals in Preventing Falls
Principle Physiotherapists at LifeCare Physiotherapy Phoenix, Anthony Imms, described his experience delivering a strength and balance exercise program to older clients in the private practice setting. He outlined both components of the program model that contributed to its success as well as the factors that acted as barriers. His presentation highlighted the importance of falls prevention advocacy from the global level, all the way through to the local and practitioner level.
“The older population has not grown up with the same health promotion messages as younger people,” Mr Imms explained to the audience.
“Often it is the adult children and other family members engaging with their parents GP or booking physiotherapy appointments.”
This reinforces the importance of falls prevention messages reaching the carer, family and broader support systems of older adults who may not seek the services of a physiotherapist or other allied health professional themselves.
Mr Imms also emphasised the need to advocate falls prevention as a priority area among GPs, who are often the first point of contact for older adults reporting concerns about poor balance or strength and who may benefit from the services of a physiotherapist.
Approaching Falls Prevention with Older Clients
“How can I move someone from ‘I do nothing’ to ‘I do something’
This is the question Associate Professor Anne-Marie Hill posed to health professionals attending the Strengthen Your Legs Forum.
Throughout her presentation, she went on to discuss the various ways in which physiotherapists and other exercise specialists can engage with and encourage older adults to participate in strength training to reduce their risk of falls. These included harnessing facilitators and overcoming barriers to participation.
One of the key themes that did emerge was that regardless of what information practitioners were delivering to older clients to promote their uptake of strength training it needed to be delivered in a manner that was respectful to them.
Recent research findings have reported that overwhelmingly, older adults want to receive falls prevention information from practitioners in a respectful, non-patronising manner. It also found that when discussing falls prevention strategies and encouraging healthy behaviours among older clients, it is vital to approach the issue in a personal and positive way that was empathetic and supported them to increase their physical activity levels gradually.
“Sit down and listen to them, show them that it matters to you that they do something,” said Ms Hill.
Enriching Quality of Life Across the Lifespan: A Holistic Approach
Australian Physiotherapy Associated Titled Gerontological Physiotherapist, Vanessa Jessup, shared her experience delivering a series of seated Tai Chi for Arthritis for Falls Prevention classes to a group of Aboriginal Elders as part of a larger general well-being and chronic disease management program.
While she said she did not deliver the program specifically to reduce participant’s risk of falls, she reported extremely positive outcomes across the broad spectrum of health and wellbeing.
“It’s about enjoyment, it’s about moving, it’s about what your body can do” she explained when describing the benefits of tai chi to her class participants.
Following the completion of the six tai chi classes – which included 30-40 minutes of practice as well as yarning, intention setting and reflection time – participants reported improvements in balance, mental and emotional wellbeing, family relationships, reduction in stress and increased confidence.
“Some improvements are not captured by the suite of outcome measures we use (as physiotherapists), however qualitative measures such as feedback from individuals and families about their quality of life are just as valuable,” she said
She also spoke about the language used in falls prevention and how there was an opportunity to improve it in order to raise the profile of falls prevention among practitioners, policy makers and the community.
Phrases such as “Stay on your feet” are a beautiful positive message promoting independence, physical activity and building strength, while ‘Falls prevention” has a different message. Both messages may be appropriate at different times, however the first allows far great opportunity to be more holistic in our practice and engage with a larger population.
“We want to do the best we can for active ageing, quality of life and for the entire human experience. If we look at the entire human experience, we can’t miss falls”.