Objectives
- Understand the risks of falling in older people with OA, and potential consequences
- Be able to use a screening tool to assess risk of falling.
- Know what protocols are used to measure balance, gait + mobility, and fear of falling
- Be able to perform an appropriate protocol within OAHKS
- Know what falls management interventions in OA are best practice/effective
- Know where to refer for falls assessment clinics (public hospitals)
- Know how to refer to falls management program (e.g. public and private options, dizzy falls clinics)
Risk of falling greater with OA than those without OA -many factors may contribute to this. People with newly diagnosed hip or knee OA have approximately 50% increase in their odds of falling. Factors that may contribute include gait impairments, muscle weakness (quads strength is related to falls risk in general population), pain, impaired proprioception, obesity, joint stiffness, joint instability. fatigue, reduced fitness.
Recent sys r/v and meta-analysis risk factors for falls and knee OA:
- moderate level evidence impaired balance, deceased knee muscle strength, increasing number of symptomatic joints and presence of co-morbidities
- conflicting evidence for pain
- limited evidence for impaired proprioception, knee instability and use of walking aids
Older people with OA are 50% more likely to fall, and over 80% more likely to have a fracture
People with OA who take opioids and/or antidepressants may have an increased risk of recurrent falls, controlling for confounders such as pain severity, depression