presented by Michelle M. Lusardi and Mariana Wingood
Satisfactory completion requirements: All disciplines must complete learning assessments to be awarded credit, no minimum score required unless otherwise specified within the course.
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Michelle M. Lusardi, PT, DPT, PhD, FAPTA
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…
Read full bioMariana Wingood, PT, DPT, GCS, CEEA
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,…
Read full bio1. Developing a Problem List and Delineating Measurable Goals
This first chapter presents the sets of system-based problems that contribute to risk of falling which may be identified during the physical therapy examination and evaluation process.
2. Where do You Start?
This chapter introduces/reminds participants about the resources in The Guide to Physical Therapist Practice, available online (free to APTA members, for a fee to non-members) at the American Physical Therapy Association’s website (www.apta.org/guide).
3. Determining Prognosis and Developing a Plan of Care
This chapter presents prognostic factors; reviews concepts of intervention intensity, frequency (dosage) and duration that influence outcomes of intervention; and presents current best evidence (systematic reviews) of multicomponent exercise, home based exercise programs, perturbation training, pilates, exercise and fear of falling, Wii-based exercise, foot and ankle muscle performance, flexibility exercise and PT led, group based exercise.
4. Individualized Interventions
This chapter provides a brief review of motor learning, as well as the person/task/environment model that forms the basis of Gentiles Taxonomy.
5. Plan and Justify Intervention
This is the clinically applied and longest chapter in the course. It presents the multiple components/factors that may be addressed to reduce risk of falling and improve postural control.
6. Documenting Efficacy of Intervention/Outcome Measures
This chapter prompts the clinician to use minimal detectable change/difference and minimal clinically important difference (where available) for measures used to determine risk of falling (based on cut score), baseline function and documenting outcomes of interventions. It also prompts clinicians to use gender and age-specific performance norms in their documentation to compare patient performance to community living peers. It reviews appropriate G-coding, determination of severity levels, and the timeline required by Medicare for documentation during an episode of care.
7. Planning for Discharge
Physical therapy care is necessary but not sufficient to sustain changes made during an episode of care to reduce risk of falling for the long term. This chapter highlights the importance of an effective (and doable) home exercise program and accessing community based programs to supplement and support gains achieved during one-on-one physical therapy intervention.