presented by Michelle M. Lusardi & Mariana Wingood
How do we screen and assess balance and fall risk? There are many screening and assessment tools to choose from. By completing this course participants will know how to choose a screening tool and/or assessment tool for their patient. The course begins by setting the stage and discussing what clinicians should be looking for, how to screen for it, and how to select the risk factors to further evaluate patients in order to prescribe an appropriate intervention or refer out. Depending on the patient’s screening results, a clinician will be able to use the appropriate assessment tool and document a good clinical assessment.
Be sure to view the other two courses in the series for more detail on assessment and intervention for impaired balance and risk of falls:
Dr. Lusardi’s interest in balance and falls in later life has its roots in her early years as a physical therapist on the neurological service at Hartford Hospital, when she noticed that many of her patients with stroke and amputation limited their physical activity because of concern about falling. Seeing the functional consequence of inactivity in the older adults who completed rehabilitation, Dr. Lusardi returned to graduate school to prepare for an academic and research career that has focused on geriatrics and functional mobility. Dr. Lusardi served on the physical therapy faculty at the University of Connecticut from 1981 through 1996, responsible for the neurological curriculum thread, as well as content on prosthetics and orthotics. She moved to the problem based learning Master’s program as a founding faculty member in 1997, coordinative the 2nd semester with its emphasis on neurological rehabilitation across the lifespan. During her time at Sacred Heart, her research produced gender and age-based "norms" for many functional tests and measures used in rehabilitation. Although now a retired Professor Emeritus, Dr. Lusardi has continued to write and teach about physical therapy care for older adults. Dr. Lusardi has authored more than 40 peer-reviewed manuscripts and book chapters, as well as a textbook "Orthotics and Prosthetics in Rehabilitation", now in its 3rd edition. She has presented her research at both APTA CMS and NEXT conferences, as well as the Gerontological Society of America Annual Meetings. Her continuing Education courses on neuroanatomy and functional assessment have been well received in more than 15 different states. Dr. Lusardi has served on the Board of Directors of the Academy of Geriatric Physical Therapy, as Editor of the Journal of Geriatric Physical Therapy, and as chair of the "GeriEDGE" task force on functional assessment. She has made numerous presentations at APTA Combined Sections and NEXT Meetings, as well as at the annual meeting of the Gerontological Society of America. Dr. Lusardi’s contributions to the profession and excellence as an educator have been recognized by the Joan Mills Award and Outstanding Educator Awards from the Academy of Geriatric Physical Therapy, and by the Baethke-Carlin Award and Lucy Blair Award from the American Physical Association. In 2016, she was named a Catherine Worthingham Fellow of the American Physical Therapy Association. Dr. Lusardi is excited to join the MedBridge team with her colleague Mariana Wingood as part of the GCS preparatory efforts, contributing a three course series on Balance and Falls in Later Life.
Mariana Wingood, PT, DPT, GCS, CEEAA is a physical therapist at University of Vermont-Acute Inpatient Department, in Vermont. She is a highly enthusiastic member of the Academy of Geriatrics who is involved in numerous projects including the CPG research group, GeriEDGE Fall Risk Assessment workgroup, Chair of the Balance and Falls SIG, Vermont State Advocate, and Program Committee. Dr. Wingood’s focus is on fall prevention and exercise prescription for older adults. Her professional goal is improving the profession by increasing the knowledge base of evidence based practice. This is why she has taught at University of Vermont and presented at numerous state and national conferences.
This chapter introduces participants to concepts of pre and post test probability in the “diagnosis” of risk of falling in community living older adults.
This chapter summarizes best current available evidence for screening community living older adults with regard to risk of falling.
In this chapter, examples of questions to be used in intake interview of multifactorial assessment of fall risk are provided.
Chapter four provides an overview of two questionnaires that assess balance confidence and depression, both key risk factors for future falls.
This chapter provides an overview of five functional performance measures supported by the best available evidence currently available, and highlights several impairment-level risk factors that can further inform evaluation, goal setting, and intervention planning.
The final chapter of this course provides a framework that clinicians can use to demonstrate clinical reasoning and justify medical necessity.