Falls and PARKINSON’S DISEASE
As people age, falls become a more serious complication and people with PARKINSON’S DISEASE fall three times more often that people without. Consequences of falls can range from minor bruising to fractures and loss of consciousness and account for many trips to the emergency room. Some studies have shown that every third fall results in serious injury and after their fall, people begin to fear going out walking in public.
Several studies have focused on falls in PARKINSON’S DISEASE, most recently published are two papers by a Polish Research team who evaluated the causes and consequences of falls of people with PARKINSON’S DISEASE and looked at the risk factors for falls. Their research found that sudden falls were the most common and were caused by problems related to PARKINSON’S DISEASE, such as freezing, postural instability, or sensory disturbances like vertigo. Other research found that lack of arm movement lead to a higher risk of hip fractures and that stiffness and rigidity lead to falling backward. They also found that subjects who were “multi-tasking” and thinking more about the task than their walking also had a higher incidence of falling. Falls also occur during times when medications are not working properly.
There are many precautions that can be put in place to help make walking in the home safer and prevent falls. Pay attention when in close quarters that require turning around or backing up, such as in bathrooms and kitchens, be extra aware. The installation of grab bars in bathrooms can eliminate some of the problems, especially around showers, bathtubs and toilets. Loose rugs in entryways are another hazard, they need to be smooth and firmly in place so they don’t slip or move around or else removed entirely for safety sake. Long hallways can have hand rails installed the length of them to make waking easier. Look at the arrangement of furniture, the backs of couches and sturdy chairs can serve as extra support for someone walking behind them; but some pieces of furniture, such as tables with sharp edges can be hazards to bump into and should be placed where they won’t cause a problem. Going up and down stairs, whether they be a few or many, require sturdy handrails and step treads to be non-slip and perhaps even edged with reflective tape to make them more visible. Good lighting in all areas is also a safety necessity.
Physical and occupational therapists can also help by showing people with PARKINSON’S DISEASE better ways to get up from chairs and from bed. They can provide exercises to strengthen postural instability and improve gait and balance so walking becomes more natural and less hazardous. People with PARKINSONS DISEASE need to be extra careful on standing up, especially since orthostatic hypotension (low blood pressure on standing) is a frequent problem. Taking a moment to stretch and twist to improve blood flow before walking can also ensure a bit more safety from falling. Following a regular exercise program to strengthen the spine and keep muscles in shape while improving posture is a good idea.
Use of a cane or a walker can also improve balance and is useful especially in crowded areas. A cane or a walker can also signal to other people to stay out of the way and give a little more space to the person using it. If there is a tendency to step or fall backward, a walker can be of use keeping the upper torso forward leaning and the movement going forward.
All falls should be reported to the neurologist, with a note about when and how they occurred. It may be a simple tweaking of medication that can help prevent future falls, depending on when and how they happened. Continuing physical therapy is also beneficial to keeping abreast of exercises and ways to prevent falls and remain independent as long as possible.