Prevention and conservative integrative management, across the lifespan, of injuries from falls

Background: Falls account for significant morbidity across the lifespan. They are the most common home injury in children and involve over 30% of those over 65 years.

Methods: A search of PubMed, CINAHL, Cochrane Database and Dynamed with a focus on synthesized summary evidence was conducted to identify the most pertinent risk factors and effective interventions for the prevention of injuries from falls.

Results: The potentially devastating effects of falls for all ages justify the emphasis placed on this public health issue. The strategies used to address this vary by age, lifestyle and clinical presentation. Clinicians can provide advice to reduce the likelihood and minimize injury from a fall. Examples include recommending safe play environments for children and proper safety equipment for adolescents and adults, such as bicycle helmets. Reducing the likelihood of a fall requires the ability to recognize those at risk. Risk factors can be physical, psychological, social, medical and environmental. Understanding these factors is key to developing effective interventions. A review of best evidence indicates that a collaborative effort of different healthcare disciplines is optimal since risk factors include medications, musculoskeletal issues, neurological deficit, visual impairment, podiatric issues, nutritional deficiencies, pain and depression. Identifying the physical findings in clinical examination that increase risk is important in selecting the best approach for the patient.

Conclusions: Fall prevention entails an enormous number of potential factors that are best addressed in an integrative manner. The selection of interventions based on best evidence must be tailored to the patient.